The aim of this essay is to outline how treatment for schizophrenia has changed quite significantly over time. Schizophrenia is a chronic mental illness which affects the brain (RANZCP, 2019). Approximately 1% of the world’s population has schizophrenia (Mentalhelp.net, 2019). It usually appears around the ages of 16 to 30 years. It affects men and women equally but is usually seen at a younger age in males (Brain & Behaviour Research Foundation, 2019). For a person to be diagnosed with schizophrenia that must have two or more of the following symptoms, with each present for a significant portion of time during a month period (Behavenet.com, 2019). The most common symptoms for schizophrenia are delusions and hallucinations, they are considered positive symptoms as they are not seen in healthy people. Hallucinations are experiences and sensations that others cannot comprehend, they may seem real, urgent and vivid. Roughly 70% of people with schizophrenia experience them. Delusions are known as beliefs that conflict with reality. The other symptoms include disorganized speech, being grossly disorganized and a few negative symptoms. These negative symptoms are called this as it is an “absence as much as a presence”, inexpressive faces, blank looks, lack of interest in the world and other people and an inability to feel pleasure (Psycom.net – Mental Health Treatment Resource Since 1986, 2019). No single cause has been identified, but several factors have been shown to associated with its onset. Some causes included are complications during pregnancy or birth that cause structural damage to the brain, chemical imbalance of dopamine from a person’s genetic predisposition to the Illness, Predisposition to schizophrenia can run in families, stressful incidents and harmful alcohol and other drug use may trigger psychosis in people who are vulnerable to developing schizophrenia (Www1.health.gove.au, 2019).
John Nash was one of the greatest thinkers in mathematics of the 20th century. He was born on June 13th, 1928. While teaching in 2958 the first signs of schizophrenia became noticeable. Nash would disappear for days and then have no explanation on where he was. He would often make visitors stand in front of the door as he believed that there were people following him. Nash continued to work but over the year from 1958-1959 his behaviour became increasingly worse. It got to the point were his wife decided to talk to a psychiatrist, whom acknowledged that Nash had what they called ‘nervous breakdown’. He was offered to stay at hospital because of his illness but he had convinced himself that he was the leader of a world movement for peace that only he knew existed. Nash’s mother visited him and became very disturbed at his mental state. He had a stable upbringing and has a circle of close friends during his adolescence. Having schizophrenia effected his life quite drastically as he was admitted to hospital for quite a significant amount of time. After he was let out of that confinement he still had to go for constant consultations about his illness and how to monitor it. His family around him became very disturbed by his actions. He would often have very weird conversations with his wife and often say meaningless sentences to her (living with Schizophrenia, 2019).
To get an official diagnosis for schizophrenia a person much show two of the following symptoms for a month. Delusions, hallucinations, incoherence of speech and disorganization(Psycom.net – Mental Health Treatment Resource Since 1986, 2019). The tests used now to diagnose schizophrenia are urine or blood tests to rule out any alcohol or drug abuse. They then take tests that can scan your body and brain, for example MRI and CT scans that could help rule out other problems like brain tumours (Cleveland Clinic, 2019). John Nash was diagnosed with paranoid schizophrenia based on his delusions that were persecutory. At this period of time it was a habit to put the blame of his illness on his earlier life. Nash’ first known symptoms of schizophrenia was “paranoia and erratic behaviour. According to his wife, he developed the idea that all men who wore red ties were included in a communist conspiracy against him”. Old treatments such as electric shock and insulin shock were still very popular at this time, but the new antipsychotic drugs brought hope to everyone. The early trials of this drug demonstrated that this could be an option (living with Schizophrenia, 2019).
Treatment for schizophrenia has changed drastically over the year. Most older treatments were aimed at controlling the patients disturbed behaviour rather than trying to cure the illness or alleviate the suffering of the patients. Some countries like Germany took this to drastic measures during the Nazi era and led acts of forced sterilisation and genocide. Another drastic treatment was prefrontal leucotomy which is a removal of the part of the brain that processes emotions, this was very controversial but were performed for more then two decades not just for schizophrenia but also for manic depression and bipolar disorder. Other past treatments include fever therapy, sleep therapy, gas therapy and electroconvulsive (ECT) or electroshock treatment (Psychology Today, 2019). Some past treatments have been developed and are being used now but the general idea of the treatment has been kept. For a person to be admitted to hospital they must have severe symptoms and be in what’s known as a crisis period. This is not because they are putting others in danger but instead themselves. Suicide risk is high and about 10% of people with schizophrenia take their own lives. The hospital creates a plan to help manage them back to normal mental state. Another reason they are admitted to hospital is to try out new medication and the effects that has on them. John Nash was put on chlorpromazine and this began showing lots of improvement in a short time. This was all while in confinement but after around 50 days he began outpatient treatment (living with Schizophrenia, 2019). If this happened before this time period Nash may not have had access to antipsychotic drugs as they would not have been invented yet. He may have even been subject to genocide as that was some form of treatment in the Nazi era.
Schizophrenia requires a lifelong treatment even when symptoms have subsided. Anti-psychotic medications are the most common treatment for schizophrenia. This affects the brain neurotransmitter dopamine (Mayoclinic.org, 2019). This chemical has effects on changing your behaviour, mood and emotions. By using these antipsychotics, it can suppress or prevent you from hallucinations and delusions. Antipsychotics are not always affective and out of every 10 people it is said that 8 people will experience an improvement. The first antipsychotic drug, chlorpromazine first became available in the 1950s and this was the first glimpse of hope for schizophrenia sufferers. It is still one of the most commonly used treatments today, but it also has serious side effects like blurred vision, depression, uncontrollable shaking and muscle stiffness. Since antipsychotic drugs, the use of electroconvulsive therapy has become increasingly rare, but it is a safe and humane way that I highly effective in treatment of sever mood symptoms that do not respond to medication (Sane.org, 2019). ECT is a very effective way to ease symptoms of schizophrenia. Electroconvulsive therapy is done by sending a finely controlled electric current though electrodes for a very short time causing a brief seizure in your brain (WebMD, 2019). During the 1940s and 1950s John Nash may also have been treated with insulin coma treatment. Insulin coma therapy used to be a type of schizophrenia treatment in which patients were repeatedly injected with large doses of insulin to make them go into a coma. It was found that as a patient would come out of the coma it would improve their mental illness. If Nash had been treated with insulin coma therapy, he would have experienced side affects such as restlessness or drowsiness and perspiration. It was also common for seizures to occur before or during the coma. Some of the psychiatrist saw seizures as a good thing and patients were also given electroconvulsive therapy whilst in the coma.
The main changes for treatment of schizophrenia is that newer treatments are aimed at relieving the suffering and curing the illness. Treatments before the 1950 when antipsychotics were invented were to control the disturbed behaviour. Treatments changed from fever therapy being the most common to antipsychotics nowadays being the most common. Fever therapy was carried out by injecting patients with fever producing diseases. Normally injected with malaria and because of this deadly disease about 15% of patients who were treated with fever therapy ended up dying from the procedure (Science Friday, 2019). Although the number of deaths fever therapy was the very first effective treatment that could help alleviate the sever symptoms of mental illnesses. This shows the main changes being that although they could help alleviate the suffering of the patient, they still had 15% of people using fever therapy die, but nowadays with antipsychotic drugs there is no deaths so it is a lot more effective. There is no known cure for schizophrenia but ten years after diagnosis 50% of people with schizophrenia are either recovered or improved to the point that they can work and live on their own. 25% are better but need help from a strong support network to get by. 15% are not better and most of these are in the hospital. 10% see no way out of their pain and die from suicide (WebMD, 2019). Many people that have schizophrenia do return to a more normal lifestyle, have a job and live independently. For someone who has recovered from the severe symptoms of schizophrenia it is important for them to continue medication. Many people stop their medication as it has died down and seem like it has gone away but schizophrenia is a chronic illness and requires ongoing care (BrightQuest Treatment Centers, 2019). For John Nash the possibility for full recovery was a pretty low chance as he stopped his medication without telling anyone. This would have made his condition worse than it started off as. If left untreated, schizophrenia can cause extreme physical, emotional and behavioural problems that affect every area of the person’s life (CenterPointe Hospital, 2019). For John Nash this was clear from 1958-1959 when his behaviour became increasingly worse.
- Cleveland Clinic. (2019). Schizophrenia Diagnosis and Tests | Cleveland Clinic. [online] Available at: https://my.clevelandclinic.org/health/diseases/4568-schizophrenia/diagnosis-and-tests
- Psychology Today. (2019). A Brief History of Schizophrenia. [online] Available at: https://www.psychologytoday.com/au/blog/hide-and-seek/201209/brief-history-schizophrenia
- Sane.org. (2019). Antipsychotic medication. [online] Available at: https://www.sane.org/information-stories/facts-and-guides/antipsychotic-medication
- BrightQuest Treatment Centers. (2019). Can Schizophrenia Be Cured? – BrightQuest Treatment Centers. [online] Available at: https://www.brightquest.com/schizophrenia/can-schizophrenia-cured/
- Www1.health.gov.au. (2019). Department of Health | What causes schizophrenia?. [online] Available at: https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-w-whatschiz-toc~mental-pubs-w-whatschiz-cau
- WebMD. (2019). Electroconvulsive Therapy (ECT) and Mental Illness. [online] Available at: https://www.webmd.com/schizophrenia/electroconvulsive-therapy#1
- Behavenet.com. (2019). Diagnostic criteria for Schizophrenia | Behavenet. [online] Available at: https://behavenet.com/diagnostic-criteria-schizophrenia
- Science Friday. (2019). From Fever Cure to Coma Therapy: Psychiatric Treatments Through Time – Science Friday. [online] Available at: https://www.sciencefriday.com/articles/from-fever-cure-to-coma-therapy-psychiatric-treatments-through-time/
- RANZCP. (2019). Schizophrenia. [online] Available at: https://www.yourhealthinmind.org/mental-illnesses-disorders/schizophrenia
- Mayoclinic.org. (2019). Schizophrenia – Diagnosis and treatment – Mayo Clinic. [online] Available at: https://www.mayoclinic.org/diseases-conditions/schizophrenia/diagnosis-treatment/drc-20354449
- CenterPointe Hospital. (2019). Schizophrenia Disorder – CenterPointe Hospital – Missouri. [online] Available at: https://centerpointehospital.com/schizophrenia-disorder/
- WebMD. (2019). Schizophrenia Prognosis. [online] Available at: https://www.webmd.com/schizophrenia/schizophrenia-outlook
- Mentalhelp.net. (2019). Schizophrenia Symptoms, Patterns and Statistics and Patterns. [online] Available at: https://www.mentalhelp.net/schizophrenia/statistics/
- Psycom.net – Mental Health Treatment Resource Since 1986. (2019). Schizoprenia: Understanding Hallucinations and Delusions. [online] Available at: https://www.psycom.net/schizophrenia-hallucinations-delusions/
- Brain & Behavior Research Foundation. (2019). What Is Schizophrenia? An Overview of Schizophrenia Signs, Symptoms and Treatments. [online] Available at: https://www.bbrfoundation.org/what-is-schizophrenia-signs-symptoms-treatments
- Living With Schizophrenia. (2019). John Nash – Living With Schizophrenia. [online] Available at: https://www.livingwithschizophreniauk.org/john-nash/