The Ignominy of Schizophrenia

Understanding schizophrenia may be difficult because of the stigma it conveys to people connected to someone who has the disease, while those afflicted are targets of social prejudice. For those people who believe that the source is based on genetics, like a mother to child transmission, the mark of reproach may be even greater. For some strongly believe that this is caused by genetic factors while some argue that certain neurotransmitters have interplayed with some brain chemicals during the brain development like- a biological effect. There may be studies to identify this problem, but there is no true explanation as to the etiology of how this disease came about, so as to bewilder scientists and psychologists alike. One writing released mentions that this disease has garnered more than fifty thousand journals so far.

Having worked in a geriatric-psych unit of our hospital for three years, I was amazed at how serious this illness really is. I began to consider that the people with this disease need a lifetime of attention. These patients, as I have learned, do not believe that they are sick, but they do self-medicate and that is the reason why they become addicted to other drugs. Although most of these patients are not violent, it is the effects of certain drugs that could make them commit heinous crimes and unforgivable acts of violence. Most of these patients I believe are not receiving substantial treatment. Many individuals who have the symptoms do not belong to the statistics of schizophrenics either, for many refuse treatment or be seen by a psychiatrist due to the stigma brought about by the ignominy of schizophrenia. We see many of them leading nomadic lives among the urban cities we also call as ours. Can we help these people attain positive outlook in life when more institutions related to mental health are closing shops due to budget cuts, instead of creating and widening coverage for their treatment? What do ‘authorities’ say about this severe and debilitating disease?

Schizophrenia, the meaning

From the dictionary, the word schizophrenia means, ‘any or a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions and hallucinations, and accompanied in varying degrees by other emotional, behavioral or intellectual disturbances’(Farlex Dictionary).

According to M. Zelman (2010), the disease can be analyzed through interview with the patient and family, noting their history and also looking at the pattern of symptoms characteristic of the illness. The signs imply a gradual withdrawal from social contacts, having deviating ideas from the normal beliefs, to fluctuating episodes of anxiety, depression and mania. Catatonia, the state of being motionless followed by aggressiveness and wild behavior may be observed. Almost all people with the disease have hallucinations and delusions which many times are persecutory in nature. Affect, the outward display of feelings may be blunt, dull or flat. In one instance, there is noticeable reduction of expression, while at another instance, a display of agitation. They are dictated by voices unknown to other people, controlling and plotting against them. No wonder the changes of behavior, bodily movements and facial expressions.

Environmental and Biological Factors

Many journals defend the aspect of environmental influence while others try to prove the etiology through biological and hereditary configurations. The National Alliance of Mental Illness (NAMI) believes that it is too early to point at neurodegenerative disorder as the cause of the disease but it may also be the result of genetic factors. While M. Zelman (2010) writes that neurotransmitters involving dopamine and glutamate and its changes in structure are characteristics that provide the basis for its emergence. Continually, scientific research is being done, but there is no primary or accurate lab test to prove the diagnosis of schizophrenia. Other mental disorders may mimic the disease like bipolar disorder, effects of illicit drugs or brain tumor; complicating the diagnosis. An interesting observation is its occurrence in 10% of the population with first degree relative of the disease (M. Zelman, 2010).

One interesting reflection that depicts the influence of the environment regarding the emergence of the disease was written by Tanya Marie Luhrmann in her journal, Beyond the Brain (2012), when she strongly defended the notion that social factors helped greatly in developing schizophrenia. She made a spoof of the notion that this illness come in each society as a pure brain disorder and that it has no boundaries; that the disease is irrespective of race, culture, status and class. She believes that there is something deeply social behind this disease.

She narrated an example related to the Indian culture in which patients suffering from the disease are deceived to believe that they are well, and that they should take the prescriptions necessary to protect their ravaged youth; while relatives are prepared and willing to care for them- both sides not even mentioning the disease. Favorable outcomes were achieved through this family-doctor cooperation.

Another point she strongly emphasized as an example was the effect of migration in which people felt the fierce sense of being unwanted, deeply isolated and depressed in a hostile environment. Like fear, bullying and violence can affect our interactions with other people. Yes, racism; being trapped and in distress can be a cause of schizophrenia. Likelihood of the disease increases also when one has experienced ‘social defeats’ when younger, like taunts, abuse and neglect. Schizophrenia originates from a social cause and hence, must be dealt with socially. Something has gone wrong with the brain, and to charge mothers of transmission is not right for it is no one’s fault; that this illness must be studied out in the open field and not in a laboratory. (T. Luhrmann, 2012)

The Vulnerable Population

Ms. Luhrmann declared that,” There is clearly social causation in the disorder, and it too looks different in different cultures, shaped by particular causes, social settings, and methods of treatment.” (T. Luhrmann, 2012). Other culture experiences the disease but confronts them with different approaches.

The Indian experiment was researched and studied and they found out that after two years, the outcomes were better compared to the West. Psychiatrists attributed the better results to social factors where families were willing to care for their afflicted relatives in their homes. The writer believes that chronic experience of being abused and being disheartened may trigger a reactivation of genetic vulnerability to this illness, irrespective of race, culture or ethnicity.

Although studies on the brain chemistry and genes related to schizophrenia is ongoing, many aspects of chemical and biological findings are still being contested. The good news is that it can be predicted at 80% accuracy to teens prone to develop the disease.

Treatment and Social Factors

Anti-psychotic medications abound and available in the market. Haldol, Risperdal, Cogentin, Seroquel, Lithium; to name a few. There are also a number of agencies and organizations that support the affected individuals like, The Recovery Movement in the US, and Hearing Voices in Europe where concerned people are encouraged to address and deal with the voices when confronted with them. But this aspect runs counter to the other modes of treatment where patients are taught to ignore and discount the imagined voices. Many have sought relief to the former mode of dealing with the voices and many had expressed improvement. More online services and articles are available for research and understanding like the National Institute of Mental Health, Mayo Clinic and a host of services from the internet. Other treatments must include family and psychotherapy.


The challenges faced by a schizophrenic patient are numerous but so are the families’ burden of giving care and attention. In time, for lack of improvement, a family’s support may wane and altogether separate themselves from the responsibility of caring for the schizophrenic sibling. Long term support from friends is rare. As the disease deteriorates, employability may be uncommon and this cycle leads to homelessness; where the patients succumb to the comforts of alcohol and illicit drugs, their way of treatment. To them, the voices they hear are real and they will resist treatment. They may be jailed or institutionalized when behaviors become deadly or when crimes are committed.

There are varying laws from varying states but generally, most of them are institutionalized only if they pose a danger to themselves and to others. Then the cycle will be repeated once they are out of the institution. Unless society enters into an agreement to face the challenges of addressing schizophrenia, its effect on homelessness and crime will never be understood; the ignominy of schizophrenia will always remain visible.


M. Zelman, Human Diseases: A Systemic Approach (2010)

M. Bengston, All About Schizophrenia and Psychosis

T. Luhrmann,Beyond the Brain (2012)

NAMI, National Alliance of Mental Illness,

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