SCHIZOPHRENIA AND AFFECTIVE DISORDERS

Most people whose illnesses have been diagnosed as schizophrenia or affective disorders (such as general anxiety, depression, post-traumatic stress, obsessive-compulsive disorder or bipolar depression) are treated privately, said Kathy Perry, public information officer for the state Department of Mental Health. But when family funds have been exhausted, they fall into public treatment. The county helped 13,447 seriously mentally ill people in 1989-90.

Mainstream psychiatry has accepted the revised view that mental illnesses are biologically based medical illnesses that affect the functioning of the brain.

Schizophrenia

Schizophrenia is the most serious of the mental illnesses because it is usually lifelong and disabling. It is now thought to be a group of related illnesses that cause disordered thinking and perceptions.

Statistics show that schizophrenia afflicts one out of every 100 people. In Orange County, there are an estimated 24,110 cases. Schizophrenia most often strikes young people in their late teens to early 20s.

Contrary to public belief, schizophrenia is not a split personality. “Split” or multiple personality disorder is a different and very rare form of mental illness.

Careful scientific studies suggest that the susceptibility or vulnerability to developing the disease is inherited. Since antipsychotic drugs--which block dopamine receptor sites in the brain--are generally effective, scientists have deduced the dopamine theory of schizophrenia (that schizophrenia is due to overactive transmission in the circuitry of the brain that uses dopamine, a neurotransmitter, as its chemical messenger).

Characteristics: A person with schizophrenia may experience one or more of the following:

* Delusions and hallucinations. The person may have persistent false beliefs (delusions) or hear voices or see visions (hallucinations). He may believe outside forces are trying to control him.

* Disorganized speech. Sometimes the person with schizophrenia will talk in a way that is difficult to follow. Occasionally he will make up words or use unusual expressions. Sometimes he may speak very little and be almost impossible to communicate with.

* Strange behavior. This may include adopting unusual postures, peculiar mannerisms or habits, rocking or pacing.

* Isolation. The schizophrenic person may withdraw and become absorbed by internal thoughts and feelings. Avoidance by other people may cause further withdrawal.

* Disordered thinking. Inability to concentrate or to make logical connections is common. There is often a rapid flow of unrelated thoughts that cannot be controlled--sometimes reflected in strange speech patterns.

* Numbed or inappropriate emotions. The person may have difficulty relating to others. He may laugh inappropriately or appear to have no emotion when one is called for.

* Irrational fear. The person may experience threatening thoughts and ideas that cannot be controlled or gotten rid of, even though he may sense they are false.

Affective Disorders and Manic Depression

About 150,000 people in Orange County suffer from an affective disorder. Depressive disorders are personally anguishing, disruptive to family life and careers and often lead to alcohol and drug abuse or suicide. The possibility of suicide is the most serious result of depressive disorders.

Within this group of affective disorders, an estimated 19,285 people in Orange County have been determined to have a manic-depressive (bipolar) disorder. In this disorder, the person’s mood changes between extreme high and extreme low. The mood-stabilizing drug lithium has worked well for approximately 75% to 80% of those suffering from manic-depression, but only about one-third of the estimated 2 million people suffering from manic-depression in the United States are receiving the treatment.

Research shows that medication coupled with supportive counseling provides the most effective treatment. As many as 80% of individuals with a mood disorder respond well to medical treatment. Nearly all respond at least partly.

There is growing evidence that a genetic factor is involved with the recurrent forms of mood disorders. Whether the physical and mood changes associated with mood disorders are caused by biochemical factors or whether the disorders cause the biochemical disturbances is not known. It’s possible that the chemical imbalance represents a genetic vulnerability set in motion by prolonged stress, trauma, physical illness or some other environmental condition.

Characteristics of mania include:

* Boundless energy, enthusiasm and need for activity.

* Decreased need for sleep.

* Rapid, loud, disorganized speech.

* Short temper and argumentative behavior.

* Impulsive and erratic behavior.

* Possible delusional thinking.

* Rapid switch to severe depression.

Symptoms of depression include:

* Persistent sad, anxious or empty mood.

* Feelings of hopelessness, pessimism.

* Feelings of guilt, worthlessness, helplessness.

* Loss of interest or pleasure in ordinary activities, including sex.

* Sleep disturbances (insomnia, early morning waking, oversleeping).

* Eating disturbances (changes in appetite and/or weight loss or gain).

* Decreased energy, fatigue, being slowed down.

* Restlessness, irritability.

* Difficulty in concentrating, remembering, making decisions.

* Thoughts of death or suicide, suicide attempts.

Sources: The California Alliance for the Mentally Ill Resource Handbook, National Alliance for the Mentally Ill and National Mental Health Assn.