Sunday, 29 January 2017

In Defence of Schizophrenia

by Isabella Ingram

No mental illness is stigmatised more than schizophrenia. Often met with a mixture of fear and a strange, wary pity, the illness’ reputation embodies all the stereotypical attributes of a deranged madman: fluctuating personalities and wild voices expressing murderous intent. The reality, however, is that schizophrenia is fundamentally misunderstood, and its slandered reputation can cause those who suffer from the condition yet more anxiety and concern.

Schizophrenia is often described as a form of psychosis, meaning that a person afflicted by the condition may have difficulty discerning their own thoughts, memories and ideas from reality. Contrary to popular assumption, the illness does not make sufferers more inclined to behave violently. Instead, aggressive behaviour is usually incurred by the misuse of drugs or alcohol. Despite this, however, schizophrenia is still assumed to encourage cruel and destructive conduct.

The illness’ unjust reputation can largely be attributed to its ambiguous origins. The concept of “madness” has, of course, existed for thousands of years, but it was not until the nineteenth century that any significant progress was made in distinguishing and grouping different conditions. Prior to this, mental illnesses were viewed as forms of divine punishment or demonic possession, and many sufferers from illnesses such as schizophrenia were burnt as heretics. German physician Emile Kraeplin was one of the first to notice distinctions between different “abnormalities”, and in 1882 he used the confusing term “dementia praecox” to categorise symptoms we now associate with schizophrenia. The term – meaning “early dementia” – was used because Kraeplin believed schizophrenia to be a form of dementia that occurred within young people. However, this was discredited in 1911 by the leading Swiss psychiastrist Eugen Bleuler, who recognised that the illness was, in fact, not any form of dementia and thus rebranded it “schizophrenia”.

Unfortunately, this title is equally as misleading, as the term “schizophrenia” originates from the Greek words “schizo” (meaning “split”) and “phrene” (“mind”). This allowed for ideas relating to split or multiple personalities, inspiring fictional concepts of a Jekyll and Hyde complex, or quarrelling psychological voices. This is the condition’s greatest fallacy – “Multiple Personality Disorder” is a condition that is completely unrelated to schizophrenia.

Bleuler created further confusion in his work Dementia Praecox or the Group of Schizophrenias, in which he describes the illness’ integral attributes as “ambivalence, autism, impaired associations, and flattened affect.” The vague an encompassing nature of this description has allowed for a scope of conditions to be branded as schizophrenic, and it is only relatively recently that these different illnesses have been distinguished from each other. Bleuler’s schizophrenia, furthermore, is similar to concepts of dissociation, or a lack of empathy, which are no longer considered schizophrenic symptoms, and perhaps helped to further solidify the popular assumption of a split personality.

Today, schizophrenia is classified by its “positive” and “negative” symptoms – an idea that was initiated by Bleuler. The positive, such as hallucinations, delusions and thought disorder, are seen as additions to a “normal”, or healthy, mind. These are given prevailing public attention – but what is not so well observed are schizophrenia’s milder, “negative” symptoms, such as social withdrawal and limited speech. This lack of participation can cause schizophrenics to appear emotionless, or even callous, causing the illness yet more stigma.

Schizophrenia is an unquestionably severe and violent illness, but its nature is misunderstood and its reputation slandered. It seems to have been excluded from society’s developing understanding and acceptance of mental illness, and thus, in order to remedy this, these mistaken assumptions should be discredited whenever possible. The future of schizophrenia, however, appears a bright one. Whilst Kraeplin conceded in 1919 that “the causes of [schizophrenia] are at the present time still mapped in impenetrable darkness”, the pace of modern medical research has opened up a variety of possibilities for the prevention and even the curing of the illness, which has sparked hopes of treating schizophrenia more effectively than ever before.

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