Case in point: the child is not crazy, not demented, not impulsive and hitting, not to mention crying and laughing, thinking logically, and even working and studying, getting married and having children. He may even have lost his temper at home or become incompatible with others around him. However, when they are sent to a specialized hospital, they are initially admitted to a ward for mandatory hospitalization, and a week later, the patient and his or her family are given a diagnosis certificate with the words “schizophrenia” in plain view.
Maybe you think this is a scam by a “charlatan hospital”. Maybe you think this is the classic “being mentally ill” scenario that society has come to expect. However, this is indeed a real scene in a regular psychiatric hospital. The reason for the misunderstanding is because of the lack of understanding of the disease “schizophrenia”.
In our traditional thinking, schizophrenia is equated with the image of “crazy” or “stupid”. Therefore, it is difficult to relate the conditions described above to this disease. In fact, schizophrenia is a group of syndromes, which means it is a combination of symptoms. A specialist can make a diagnosis of the disorder as long as the patient meets one or more of these characteristics and meets the diagnostic criteria. This symptom cluster is very rich and contains dozens of psychiatric symptoms, which are described below.
(i) Thought disorders
Among the many symptoms of schizophrenia, thought disorder is the most essential and central symptom, which often leads to incoordination and detachment from reality in the patient’s cognitive, emotional, volitional and behavioral mental activities, which is called “schizophrenia”.
(1) Thought association disorder: The main symptom is the lack of coherence and logic in the thought association process, which is the most characteristic symptom of schizophrenia. It is difficult to understand and impossible to go deeper into a conversation with a person with schizophrenia. Reading written materials written by the patient is also often confusing. During conversations, the patient’s speech drifts meaninglessly from topic to topic. In milder cases, every sentence seems to be on point, but every sentence is not on point, making it difficult for the listener to grasp the main points. In severe cases, the speech is fragmented and can even become a meaningless pile of words. Sometimes the patient may describe things unnecessarily and with excessive specificity, or use words and phrases inappropriately. Sometimes the patient’s logical reasoning is absurd, or he or she may talk about empty arguments that lack central ideas and practicality, or he or she may dwell on fantasies, grand plans, or theoretical discussions that have no realistic meaning, without contact with the outside world. Sometimes patients may have two opposing, contradictory ideas in their minds, unable to judge right and wrong, affecting their behavioral choices. Some patients may have a sudden pause or blankness in their thinking without the influence of external factors, or feel their thinking being withdrawn at the same time. Some patients may feel that their thoughts are not their own, but are forced into them by others or by the outside world. Other chronic patients will show a paucity of thought, a small amount of speech, a lack of active speech, and only superficial responses to problems, lacking further in-depth thinking.
(2) Thought content disorder
This refers mainly to delusions. Delusions in schizophrenia are often absurd, bizarre, and easily generalized. They are clearly inconsistent with reality, but the patients themselves are convinced of them. In the early stages of the illness, the patient may still be skeptical of some of his or her apparently unconventional thoughts, but as the illness progresses, the patient gradually becomes one with the pathological beliefs. This process is similar to that in Resident Evil where the virus gradually eats away at the body and mind, eventually losing its independent personality and becoming a walking corpse. The most common types of delusions are victimization delusions and relationship delusions. Another very common type of delusional experience is called the “passive experience,” which is a classic symptom of schizophrenia. Patients lose their sense of self-governance and feel that their body movements, thinking activities, and emotional activities are controlled by others or by outside forces, and that their thoughts can be perceived by others without their own initiative, or even broadcast by special equipment so that everyone knows about them.
(3) Lack of self-awareness
A very specific symptom of thought disorder is called lack of self-awareness. The patient’s mental symptoms are unique and distinctive, but he or she is not aware of them and is convinced that there is nothing wrong with him or her. The more severe the disorder is, the more impaired the social functioning is, but the less the patient thinks he or she has the disorder. Therefore, patients often argue in front of their families and doctors, and even resist treatment in various ways. This symptom is unique to psychiatry, and it is also the culprit of patients’ failure to heal, leading to mental disability. In my opinion, the symptoms of lack of self-knowledge are like an instigator, who on the one hand, brutalizes the child’s mind, and on the other hand, blinds the child to avoid rescue by good intentions.
(ii) Perceptual disorder
The most prominent perceptual disorder in schizophrenia is hallucinations, which are false stimulus signals generated by the brain while the patient is conscious and has healthy senses. In particular, verbal hallucinations are the most common. Patients often hear comments (mostly negative) or orders from others. Patients may become irritated by the comments or may comply with the commands without resistance and become dangerous. Other hallucinations, although rare, may occur in any of the senses, such as hallucinations of sight, smell, taste, touch, or visceral hallucinations.
(iii) Affective disorders
The main manifestation is emotional retardation or blandness. The patient’s expression is dull and unchanging, spontaneous movements are reduced, body language is lacking, gestures and body postures are rarely or hardly used in conversation, the tone of speech is monotonous and lacks intonation, and the patient rarely makes eye contact with the other person when talking with him/her, and mostly stares blankly. Emotional indifference first involves more delicate emotions, and the patient has difficulty in experiencing the consideration of relatives and the care and sympathy of colleagues, and gradually moves away from the sight of people and lives in isolation. Later, the patient’s emotional response to all things around him becomes dull, and his interest in life, study or work diminishes. Loss of proper interest in life. As the disease progresses further, the patient becomes increasingly emotionally indifferent to everything and loses all emotional connection to the surroundings. Depression and anxiety are also not uncommon in patients with schizophrenia. Other patients may show a dissonance between their emotional responses and their internal thinking or external environment. For example, when talking about their misfortunes, they lack the emotional experience they should have, or show disproportionate emotions.
(iv) Will and behavior disorders
The most central manifestation is that the patient’s initiative decreases and his or her behavior becomes withdrawn, passive, and retreating. They are indifferent to their own future, have no pursuits or intentions, or have so-called empty plans but never implement them concretely. In severe cases, the patient may show behavioral withdrawal, sitting for hours without any spontaneous activity, or neglecting his or her appearance and personal hygiene. Sometimes patients may exhibit silly, childish behavior, or sudden, purposeless impulsive behavior.
The above groups of symptoms are all common symptoms of schizophrenia. It is because of the variety of symptoms that almost every person with schizophrenia presents differently. Because of the complexity of their symptoms, not only patients and family members cannot understand them, but even many non-psychiatric professional doctors and psychologists cannot tell the difference. Schizophrenia also has the highest rate of misdiagnosis in psychiatry. Many patients will be diagnosed with depression, anxiety, social phobia, or even obsessive-compulsive disorder because of atypical symptoms in the early stages, and will not be cured for a long time according to the original treatment, and will be transferred to many hospitals before finally finding out that it is schizophrenia. Schizophrenia a patient does not necessarily develop all the symptoms, but enough to affect his or her ability to work, study and live a normal life.
Although the symptoms of schizophrenia are diverse, there are still rules to follow, which boil down to include the following.
1, predominantly thought disorders, emotional abnormalities and impulsive behavior are based on thought disorders, although they are the most easily detected abnormalities by family members.
2, Most lack of self-knowledge.
3. Regardless of the form, it eventually leads to social withdrawal, causing the patient to lose social functioning.
Schizophrenia is indeed a serious mental illness, but it is not incurable, and as long as patients receive timely and regular treatment, there is still great hope that they will recover their social functions.