Negative symptoms

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Lack of motivation- is a of energy or interest in life that is often confused with laziness, because the ill person has very little energy, he or she may not be able to do much more than sleep and pick at meals. Life for the person with schizophrenia can be experience as devoid of interest. Blunted feelings or blunted affect refers to a flattening of the emotions, because facial expressions and hand gestures may be limited or non existent, the ill individual seems unable to feel or show any emotion at all. This does not mean that the individual does not feel emotions and is not receptive to kindness and consideration. He or she may be feeling very emotional but cannot express it outwardly. Blunted affect may become a stronger symptom as the disease progresses.

Depression- involves feelings of helplessness and hopelessness. Often the person believes that he or she has behaved badly, has destroyed relationships, and is unlovable. Depressed feelings are very painful and may lead to attempts of suicide. Biological changes in the brain may also contribute to depression. Social withdrawal- as a result of feeling no safety in being alone and being so caught up in his or hers feelings and fearing that he or she cannot manage the company of others. People with schizophrenia frequently lack the resources needed to show interest in socializing.

Positive symptoms Hallucinations- A person with schizophrenia may hear voices or see visions that are not there, or experience unusual sensations on his or hers body. Auditory hallucinations are the most common involving hearing voices that are perceived either insides or outside the persons body. Sometimes the voices are complimentary, reassuring and neutral. Sometimes they are threatening, punitive, frightening and may command the individual to do things that may be harmful.

Delusions- many people with schizophrenia suffer from delusions and are termed paranoid, they believe that they are being watched or spied upon. A common delusion is that ill person thinks that their thoughts are being broadcasted over the radio or television, or that other people are controlling their thoughts. Thought disorder- refers to problems in the way that a person with schizophrenia processes and organizes thoughts.

For example, the person may be unable to connect thoughts into logical sequences. Racing thoughts come and go so rapidly that it is not possible to catch them, because thinking is disorganized or fragmented, the ill person’s speech is often incoherent and illogical. Thought disorder is frequently accompanied by inappropriate emotional responses; words and mood do not appear in tune with each other. The result may be something like laughing when speaking or frightening events.

Altered sense of self- is a term of describing a blurring of the ill person’s feeling of who he or she is. It may be a sensation of being bodiless, or non-existent as a person. The ill individual may not be able to tell where his or her body stops and the rest of the world begins. It may be as if the body is separated from the person. Behavioural model Schizophrenia can be explained in terms of conditioning and observational learning, schizophrenics show behaviour when it is more likely than normal behaviour to receive rein-forcement.

Schizophrenic behaviour can be modified through conditioning, although there is little information to suggest that such techniques can make major changes to the expression of thought disorders. It is difficult to see how schizophrenic behaviour patterns can be acquired when people have no opportunity to observe such patterns. The behavioural model has little contribution of the above to make the understanding of the causes of schizophrenia.

Psychodynamic model Schizophrenia has one way of psychodynamic explanation, the disorder results from an ego that has difficulty distinguishing between the self and the outside world. The major psychodynamic account of schizophrenia attributes the disorder to regression to an infantile stage of functioning. Freud believed that schizophrenia occurred when a person’s ego either became over whelmed by the demands of the id or was besieged by unbearable guilt from the superego.

The ego retreats to the oral stage of psychosexual development, a stage in which the infant has not yet learned that it and the world are separate. Initially, regressive symptoms occur and the person suffering with schizophrenia may suffer experience of delusions of self importance. Their fantasies may become confused with reality which gives increase to hallucinations and delusions as the ego tries to regain reality.

Cognitive model Cognitive supporters believe that involving thought, perception, attention and language, are a cause rather than consequence of the disorder. Maher (1968) believes that a fault occurs in the minds of schizophrenics when they process information, which gives them a bizarre use of language. The cognitive model proposes that catatonic schizophrenia may be a result of breakdown, the human brain processes information to a limited extent, it suggests that the lack of interaction with the outside world can cause the person to be less social there fore schizophrenia can become worse.

Biochemical influences Some people inherit an error of metabolism which causes the body to break down naturally occurring chemicals into toxic ones. These toxic chemicals are held to be responsible for the characteristics for schizophrenia Following an examination a doctor will ask questions about how the problem started, about the person’s family history, work, environment/community, stressful events, health and previous medication they have received. The doctors and nurses will be watching and asking questions to get a better idea about the person and their problems. Often the doctor may talk to the family to get more information.

The doctor will then use the information to make a diagnosis. There is no special test for schizophrenia, so it is not always easy to diagnose it straight away, sometimes the doctor may not be sure that it is the right diagnosis for them so he or she would have to watch the person for a little while deciding whether the person has schizophrenia or not. In the hospital the doctors and nurses should decide on a plan of treatment. The treatment nearly always includes medication. Going into hospital is only a part of the treatment. The main aim for hospital treatment will be to reduce symptoms and get the person out of hospital and living back at home. His is sometimes called REHABILITATION. The family has an important job to play by helping the person get back to normal way of living as far as possible

The amount of medication varies for different people, depends on such things as a persons height and weight. At first the person will be given a high dose to reduce the symptoms quickly. The dose will be cut down to the lowest amount possible. The main medicine which is given to reduce schizophrenic symptoms are called ‘neuroleptics’. Other types of medicine may also be used;
There is some evidence that the brain produces its own internal hallucinations for example.

“Smythies (1976) reported small amounts of hallucinogen – like chemicals in the cerebrospinal fluid of schizophrenics whilst Murray et al (1979) reported that hallucinogen dimethyltryptamine (DMT) was present in the urine of schizophrenics, when DMT levels decreased schizophrenic symptoms also decreased. However, later research indicated that the characteristics of schizophrenia were different to those produced by the hallucinogenic drugs, and researchers turned their attention to other bio-chemical agents”

“Anti-psychotic drugs relieve florid psychotic symptoms such as thought disorder, hallucinations, and delusions and prevent relapse. Although they are usually less effective in apathetic withdrawn patients, they sometimes appear to have an activating influence. Patients with acute schizophrenia generally respond better than those with chronic symptoms” Long term treatment of a patient with a definite diagnosis of schizophrenia may be necessary even after the first episode of illness in order to prevent the manifest illness from becoming chronic. Withdrawal of drug treatment requires careful surveillance because the patient who appears well on medication may suffer a disastrous relapse if treatment is withdrawn inappropriately.

“Anti psychotic drugs are considered to act by interfering dopaminergic transmission in the brain by blocking dopamine receptors which may give a rise the extrapyramidal effects. Anti-psychotic drugs may also affect cholinergic, alpha-adrenergic, histaminergic and serotonergic receptors.” Researchers do not know what actually causes schizophrenia. They are always looking at many possible reasons which might explain why people develop schizophrenia.

Although there is good evidence that severe schizophrenia is probably caused by brain malfunction, in some cases it may be caused by influenza affecting the fetus when it is in the mother’s womb. Anyone, anywhere in the world has a one in hundred chance of developing schizophrenia some time during their lifetime. It occurs in both men and women and often begins when someone is in their early twenties.

Anorexia Anorexia is a very secretive illness and anorexics often feel ashamed of their behaviour and try to pretend that there is nothing wrong. However, it is obvious when someone is suffering from this disorder because it involves severe weight loss. This weight loss can be so extreme that sufferers may die of starvation. The faster the weight loss, the more dangerous the illness, because the body has no time to adjust and a sufferer can die when their heart simply stops beating.

Weight loss however is not the only symptom of anorexia. There are other signs that someone is suffering from this illness. People with anorexia seem to lose confidence and start to become quieter and more withdrawn than usual, often isolating themselves from their friends and family. They become totally preoccupied with thoughts of food because their body is starving and their mind can only focus on nothing but eating. Sufferers find that they want to cook complicated meals and then sit and watch the rest of their family eat, while they have nothing. They avoid food at all costs and can seem angry or frightened if offered a meal or a snack.

The suffer has a terrible fear of becoming fat and cannot se how thin they really are. They often start to wear many layers of baggy clothing, not only because they want to hide their body but also because they are very cold. As they are eating no food, they have no fuel to keep their body warm and their feet and hands can turn blue. A fine covering of dark hair called ‘lanugo’ starts to grow on the sufferer’s chest, stomach arms and face. This is the body’s way of trying to keep itself warm.

Anorexics often feel physically very ill since their bodies are trying to function without any food. Fainting and dizziness are common problems and anaemia is another side effect of anorexia. Aneamia occurs when there is not enough iron in the blood. This means that the sufferer often feels short of breath and very light headed. Restlessness at night (insomnia) and muscle spasms often occur. They can develop constipation because they are just not eating enough food to keep their bowels working properly. This leads many anorexics to turn to laxatives and they can become addicted to them very quickly.

There are many emotional as well as physical changes when someone develops anorexia nervosa. They may find it hard to concentrate and as a person’s weight drops, their brain shrinks in size too. Sufferers often fell moody and irritable and may become snappy with friends and family. Depression is also a common problem that is associated with anorexia and other eating disorders. Anorexia nervosa is an illness about control, the sufferer feels in control when they restrict the amount of food they eat but the reality is very different.

The illness is actually in control of the sufferer because once a person starts down the anorexia road, it is very difficult to turn things around without a lot of help, encouragement, support and love. Anorexia is an addiction and to fell good, the sufferer needs to ct down on more and more food everyday. A lot of anorexics also try to exercise as much as possible, often running everywhere rather than walking normally.

Anorexia nervosa is sometimes called the “slimmer’s disease”. I believe this is an unfair description because it is very rare for people to develop anorexia simply because of a desire to lose weight. At least 75% of the people who develop this illness have never been over weight and so there have to be other reasons why theses disorders start. What all anorexics seem to have in common is a distorted body image, a belief that they look and are greatly overweight when, in fact they are severely underweight.

They are also particularly vulnerable to ordinary life events, have rather obsessive personalities and tend to avoid situations they fear. They have low self esteem and seem incapable or afraid of managing their own lives. Some anorexics can not control their desperate need to eat and find a solution in starving, then going on a binge of eating and then finally making them selves vomit (this is known as secondary anorexia or bulimia nervosa)

Psychodynamic model

Psychodynamic model proposes that the disorder may represent an unconscious effort by a girl to remain pre- pubescent. It has been argued that, as a result of overdependence on the parents, some girls fear becoming sexually mature and independent. In order to achieve puberty, we must attain a particular level of body fat, and there is evidence to suggest that anorectics will eat, provided they do not gain weight. The weight loss prevents the rounding of the breasts and hips and the body takes on a boy-like appearance. Theorists say that this is a way of avoiding the issue of sexuality in general and the prospect of pregnancy in particular.

Some say that anorexia can result in overdependence of the family hence thinness and starvation to gain self control and independence. Anorexia nervosa can be called a phobia concerning the possibilities of gaining weight. The phobia is assumed to be the result of the impact of social norms, values and roles. In at least some occupations such as ballet dancing or modeling there is a great deal of pressure on women to be thin.

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