Schizophrenia: Living in a Different World
Page Three
Certain factors are associated with a better prognosis for schizophrenia. The individual with the best chance of recovery is a female with a history of good functioning before her schizophrenic symptoms began and whose schizophrenic symptoms came on suddenly in later life. She would have experienced some specific precipitating event such as a loss or break-up of relationship, rather than symptoms arising without clear environmental distress. She would also have experienced some mood disturbance like depression, rather than solely a loss of contact with reality. Her active symptoms would last only a brief time, and she would be able to function quite well in between episodes of active symptoms. There might be a history of mood disorders in her family, such as depression or bipolar disorder, but there would be no family history of schizophrenia. She would also have no structural brain abnormalities, and she would display normal neurological functioning. These factors would lead to the best possible long-term prognosis for an individual diagnosed with schizophrenia.
Causes
The finding that the prevalence of schizophrenia is about equal across and within cultures supports the view that schizophrenia is strongly biological (rather than primarily resulting from cultural or familial patterns). However, biology cannot fully explain why certain individuals with a predisposition toward schizophrenia develop the disorder and other individuals with a predisposition do not. Therefore, both biology and the environment appear to play a part in the development of schizophrenia.
Genetics
Studies of families and adoption provide strong support for the genetic component of schizophrenia. People with a nuclear-family member with schizophrenia have a 10 percent chance of developing schizophrenia, while the general population has only about a 1 percent chance. And when a family member has schizophrenia, biological relatives demonstrate an increased risk for schizophrenia, whereas adoptive family members demonstrate no increased risk.
Researchers have discovered that if one genetically identical (monozygetic) twin has schizophrenia, the other twin has a 40-50 percent chance of developing schizophrenia. But if the twins are not genetically identical they have only a 10 percent chance of developing the disorder, just like any other nuclear family member.
It appears that a number of different genes may help create a predisposition toward developing schizophrenia, but scientists still do not understand exactly how or why certain individuals develop schizophrenia and other individuals do not.
Prenatal and Birth Problems
Biological factors other than genetics may also play a part in the development of schizophrenia. Prenatal and birth difficulties appear to be particularly important. Biological predictors of schizophrenia include low birth weight, birth problems, prenatal difficulties (especially during the second trimester), and viral or bacterial infections.
Brain Structure and Chemical Imbalance
Studies of the human brain have also demonstrated some differences in the brain structure of those with schizophrenia in comparison to the general population. One of the strongest neurological findings is that in schizophrenia, certain parts of the brain (the lateral and third ventricles) are enlarged, which suggests possible loss of brain tissue. Autopsies of individuals with schizophrenia have also revealed smaller overall brain weights.
 Studies of twins also demonstrate
the environmental impact on the
development of schizophrenia.
Researchers have also focused on an imbalance or excess of certain chemicals in the brain (called neurotransmitters) in schizophrenia. One neurotransmitter, dopamine, has been implicated in schizophrenia. The medications used to treat schizophrenia work by blocking the brain's reception of dopamine.
Environment
The causes of schizophrenia, however, are not solely biological or genetic. Studies of twins also demonstrate the environmental impact on the development of schizophrenia. Not all genetically identical twins, for example, develop schizophrenia if their twin sibling suffers from schizophrenia. Since their genetic makeup is completely identical, if schizophrenia was 100 percent genetic, both twins would develop schizophrenia. Clearly, the role of the environment plays a part. Problems in early mother-infant bonding, strong parental intrusiveness, chaos, and mixed messages all appear to play a role in the development of schizophrenia in some individuals. Peer rejection and rejection of peers has also been explored in schizophrenia. While it is likely that the environment plays a part, the exact role of the environment in the development of schizophrenia remains a mystery.
Spiritual Issues in Schizophrenia
As human beings, we are not only affected by biology, genetics, and the environment, but we are also spiritual beings who live in a broken world. How does the spiritual realm affect schizophrenia? Perhaps you have heard people suggest that schizophrenia is not a result of brain chemistry or genetics, or impaired psychological development, but a consequence of sin. If the individual and his or her family would repent of the sin in their lives, they would be healed of the schizophrenia. Or perhaps you have heard it suggested that schizophrenia is not even a mental disorder; rather, it is demon possession. It has erroneously been said that the individual does not need medication or therapy; he only needs prayer or possibly even exorcism. But this is not true.
Responding to schizophrenia in one of these ways only adds to the stigma and misunderstanding that schizophrenia already has in our culture. Schizophrenia is not directly caused by individual sin or demonic or satanic activity. Since we live in the brokenness of our sin-cursed world, people develop all sorts of problems, including problems with brain chemistry, family dynamics, and psychological functioning. When people live in a physically, emotionally, and spiritually toxic environment (as we all do in varying degrees), some people inevitably develop physical and mental disorders. Hopefully, we would never suggest that a woman with leukemia has sinned and is being punished, or that a man with Alzheimer's disease is demon possessed when he no longer recognizes his wife of 50 years. While we would certainly pray for healing for these individuals, we would not suggest that they have done something wrong if God does not heal them in the way we would like. Rather, we would respond with compassion for the individual's suffering. We would ask God to give him or her strength and courage to face life day by day.
Our world is a broken and sinful one, and things are not the way they are supposed to be. Schizophrenia is a very powerful example of the fallen nature of our world. Individuals with schizophrenia, like all of us, are created in the image of God. They deserve our understanding, respect, compassion and support.
 Continued on Page Four
|
