January 12, 2013

Myths Associated with Schizophrenia

People wrongly associate the symptoms of schizophrenia with split or multiple personalities (like Dr. Jekyll and Mr. Hyde), antisocial behavior (similar to what we see in serial killers), and developmental disabilities. Others believe that schizophrenia is a character defect and that the individual could behave normally if he really wanted to.

Here are a few of the most common misconceptions about schizophrenia:

Schizophrenia is the same as a split or multiple personality. Schizophrenia is not the same as multiple personality, which is an exceedingly rare, totally different disorder that is now more commonly called a dissociative identity disorder. (Under stress, people with this disorder often assume different identities, each with different names, voices, characteristics, and personal histories.)

People with schizophrenia are violent. People with schizophrenia are more likely to be victims rather than perpetrators of crimes. Many people believe that most people with schizophrenia have a propensity for violence, but the reality is that most people with schizophrenia don’t commit violent crimes, and most violent criminals don’t have schizophrenia. For example, serial killers (people who commit three or more subsequent murders) usually aren’t psychotic (out of touch with reality); they’re likely to be diagnosed with an antisocial personality disorder (a disorder in which people disregard commonly accepted social rules and norms, display impulsive behavior, and are indifferent to the rights and feelings of others).

However, people with untreated schizophrenia, who refuse to take medication and whose thinking is out of touch with reality are at increased risk of aggressive behavior and self-neglect. The risk of violence also increases if someone with schizophrenia is actively abusing alcohol or illicit drugs. For better or worse, the aggressive behavior is usually directed toward family or friends rather than toward strangers.

Poor parenting causes schizophrenia. For many years, clinicians were taught and actually believed that schizophrenia was caused by parents who were either too permissive or too controlling. The term schizophrenogenic mother was once used to describe such parents — the blame usually fell heavily on mothers because they tended to spend the most time with their offspring.

Another outdated theory is the double-bind theory, which suggested that schizophrenia is due to inconsistent parenting, with conflicting messages. These ideas were not based on controlled studies, and these theories no longer have credibility today. Schizophrenia is a no-fault disorder of the brain.

People with schizophrenia are mentally retarded. Some people think that schizophrenia is synonymous with mental retardation (now called developmental disabilities). No. Like the general public, people with schizophrenia have a wide range of intellectual abilities. They may appear less intelligent because of the impaired social skills, odd behaviors, and cognitive impairments that are characteristic of schizophrenia.

However, they’re not lacking in intelligence, and schizophrenia is distinct from developmental disabilities (physical and mental deficits that are chronic and severe and that generally begin in childhood).

Schizophrenia is a defect of character. Negative symptoms of schizophrenia give people the mistaken impression that those with the disorder are lazy and could act “normally” if they wanted to. This idea is no more realistic than suggesting that someone could prevent his epileptic seizures if he really wanted to or that someone could “decide” not to have cancer if he ate the right foods. What often appears as character defects are symptoms of schizophrenia. When the negative symptoms of schizophrenia are persistent and primarily caused by schizophrenia, they’re referred to as deficit syndrome.

There’s no hope for people diagnosed with schizophrenia. Sixty years ago when people were diagnosed with schizophrenia, they were either kept at home behind closed doors by embarrassed and forlorn families who saw no other alternative, or consigned to long-term stays in distant state hospitals for care that was largely custodial (they weren’t treated — they were just taken care of). Other than using highly sedating drugs, doctors had few tools available to them to relieve the agitation and torment of their patients or to help restore their functioning.

In contrast to how things were in the past, schizophrenia is now considered highly treatable. Several generations of new medications and the emergence of new forms of therapies have enabled doctors to treat the symptoms of the large majority of patients with schizophrenia enabling them to live meaningful, productive lives in their communities.


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