Many harmful stereotypes have arisen around the disease of schizophrenia, which is why parents hardly accept the fact that their child has fallen ill. The news about schizophrenia is denied because it is the worst that could have happened to them. We talk to Dr. Maja Herman, a specialist in psychiatry, about childhood schizophrenia.
- Even specialists can easily confuse schizophrenia with any other condition, such as autism spectrum disorder or anxiety disorders.
- Schizophrenia is the most “controlled” disease in terms of pharmacology. Drugs for schizophrenia are effective. The problem is that it is diagnosed too late
- Parents should be anxious about, among other things, closing themselves off to the outside world and all kinds of weirdness
- More current information can be found on the Onet homepage.
A specialist in psychiatry, psychotherapist, art therapist, hypnotherapist, community therapist. Mental health educator in social media.
Founder and president of the Polish Medical Media Society, board member of the Society of Patients’ Friends – Amici. Author of many books and guides on mental health. Academic lecturer, educator of medics.
Edyta Brzozowska, Medonet: Schizophrenia, although relatively rare in children, is a very dangerous disease. What causes this disease in the youngest patients?
Dr Maja Herman, specialist in psychiatry, psychotherapist: Schizophrenia is a multi-factorial disease, which means that we cannot prevent it, among other factors. Since we do not fully know the reasons for its occurrence, we simply cannot protect our children from it. Whether a child falls ill depends on various genetic, infectious, environmental and immunological factors. But also, when this disease occurs in a family member, it is more likely that the child will also experience it, and it is not simple, single-gene inheritance, but multi-gene inheritance.
The most important thing is the second trimester of pregnancy and the period of adolescence, i.e. puberty. These are the moments when neural networks are formed. These are the paths that ensure the flow and connection of information. It must be remembered that it is not a single factor, but several factors that influence the development of the disease.
Can relationships with parents make a child ill with schizophrenia?
It is known for certain that any serious pathologies, such as physical, sexual and psychological violence, have a huge impact on the well-being of children. How parents behave may activate a given disease. However, in the case of schizophrenia, it does not appear that this environmental factor, which is parental behavior, is not predominant. It should also be remembered that stress can be the ultimate “trigger” of disease.
However, mothers and fathers blame themselves that their child has just been affected by the mental illness.
Apart from constantly analyzing what they did ‘wrong’, most often they blame themselves for not noticing the symptoms. Often wrong, because schizophrenia and the associated states of psychosis are a group of conditions that are very difficult to spot. We are usually talking about a group of symptoms and these are also the diagnostic criteria – symptomatic. Equally important, even a specialist can easily confuse schizophrenia with any other condition. In differentiating diagnostics – when dealing with a set of symptoms – we estimate which diseases can be assigned to them. In this way, through elimination, we come to casuistry, that is, to compare the problem with known medical cases. It is difficult, especially since schizophrenia is extremely rare – it affects 1% of people. population. And the one before the age of 6 – very rare. We talk about early childhood schizophrenia when it occurs before the age of 13. Then we deal with very early-onset schizophrenia. If the disease occurs before the age of 18, it is referred to as early onset.
Symptoms of schizophrenia are not difficult to confuse with those of other diseases. What kind?
There are tons of diseases that manifest with similar symptoms. This is for example the autism spectrum or other neurodevelopmental disorders such as ADHD. Still other diseases include depression, bipolar disorder, anxiety disorders, and obsessive-compulsive disorders. It is also all phobias, including agoraphobia, which is associated with the fear of open space, as well as social anxiety, anorexia, addiction to psychoactive substances. The list of disorders similar with their symptoms to schizophrenia can be supplemented for a long time.
Of all these conditions, is schizophrenia the most dangerous?
Contrary to appearances, not at all. For a simple reason: schizophrenia is the most “controlled” disease in terms of pharmacology. Medicines used in schizophrenia are really effective. The fact is that this disease is usually diagnosed too late. The problem is also that patients often do not have the so-called insight into their disease and stop any started drug therapy.
Are they pushing the disease out of consciousness, or are they rather concluding that there is nothing wrong with them?
This disease changes thinking, and the patient does not share his anxieties with the environment for years. People in the environment notice that something is wrong with you. The latter, however, perceives reality as distorted. Even when the patient is correctly diagnosed and takes medication, it is discontinued over time. She says: “I’m fine”, “I’m fine”, “I don’t need to be treated”. And the disease comes back. All this makes schizophrenia a particularly dangerous disease. Patients become so tormented by it that they decide to take their own life.
Treatment seems to be simpler for children and adolescents. Also because it is easier for parents to prescribe medication. Adults can always refuse to take them.
I do not agree with this thesis. For example, due to the specificity of adolescence, when teenage rebellion may be particularly intense, and refusal to treat it more firm. Unfortunately, despite the fact that childhood schizophrenia is really a rare phenomenon, it must be emphasized that the earlier it occurs, the more unfavorable it is in terms of prognosis. This is mainly due to the formation of the central nervous system: the younger the brain, the less “integrated” it is, with less developed psychological-adaptive mechanisms that are acquired with age.
There are many harmful stereotypes around schizophrenia, as in the case of other mental illnesses. We are usually afraid of these disorders.
Therefore, parents hardly accept that their child has fallen ill. Diagnoses of depression, anxiety or personality disorders are more acceptable. The news of schizophrenia, however, is always denied. This disease is, according to them, the worst that could have happened to the family. This is due to, among other things, ignorance about treatment methods and the course of the disease. People do not realize that the components of schizophrenia are psychosis, impaired concentration, logical thinking, cognitive deficits and impaired social functioning. Schizophrenia is also accompanied by withdrawal from social life and internal closure in one’s own world.
We know such behavior from films, for example from Alfred Hitchcock’s “Psycho”, Roman Polański’s “Disgust” or “Beautiful Mind” with the unforgettable role of Russel Crowe.
The heroes of these paintings see, hear, feel and even taste things that are not in the real world. Because psychosis can be very spectacular. It is easy to describe in literature, or to illustrate it in a film. Pop culture shapes the image of a patient with schizophrenia and hence a lot of distortions about this disease. Meanwhile, schizophrenia and psychotic episodes are not always manifested in madness or inexplicable quirks, or the patient’s belief that he is being eavesdropped on, followed up or persecuted.
In the context of schizophrenia, what should worry parents when they observe their children’s behavior?
Otherness, deviation from the norm. Determining what is the norm would require more explanation, but behaviors such as shutting out to the outside world and all sorts of quirks can be suspicious.
Oddities?
It may not be the happiest word, but it is very adequate. Please believe me that even such behavior as covering the window curtains by children during the day and at night, parents can explain and rationalize themselves. Meanwhile, the child is convinced that covering the windows protects against radiation, which captures thoughts and controls them. In addition to the norm, it can also be lining the walls of the room with soundproofing foam or metal elements. Such a kid does all this in fear of the alleged interference of external forces. He sees non-existent people, hears their voices “talking” to him. He may feel that everyone is looking at him, criticizing him, talking behind his back. Psychosis can be acute or chronic.
It happens that the sick person has some kind of “windows” in his consciousness and realizes that “something is wrong with him”?
This is what happens when the acute phase of psychosis is in remission. The patient thinks: «How could I have thought that someone was following me, threatening me? Am I sick? ». Sometimes, he shares his anxiety about health with his relatives. But this condition recurs and the patient loses the ability to rationally assess reality. Again he hears and sees non-existent characters or objects. He listens, stares into space, talks to people who are not there. Or he has a feeling of change in his body, believes he is possessed by Satan, is an object or another person.
How to deal with such delusions of a loved one?
His delusions must not be argued. And neither agree with them nor disagree. However, you have to feel the feelings of the sick person. For example, if a child claims that he or she is being bullied at school, you could say, “I understand that this feeling must be terribly difficult for you.” Appealing to emotions is more credible for a child. And, what is equally important, it helps persuade to undergo psychiatric therapy. It is easier to accept help from empathetic parents.
What can happen when we deny, minimize, or deny these delusions?
We automatically become enemies, a party to the conflict. The sick person feels that he has to defend his arguments, fight for his perception of the world. And all the energy of the young man goes to the unnecessary war with his parents. It is not worth denying the delusional content also because it increases the patient’s anger and hinders cooperation. On the other hand, when we agree that imaginary situations can be real, we reinforce the patient’s beliefs about being followed or persecuted.
However, not every psychotic episode proves the development of schizophrenia in a child. Sometimes hallucinations and delusions disappear on their own after intense, stressful situations have stopped. However, when they appear, it is necessary to consult a doctor who will make an appropriate diagnosis and select the appropriate pharmacological treatment.
Can schizophrenia be completely cured?
Unfortunately, this disease is incurable and when it occurs in a child it disrupts the natural process of his maturation. Schizophrenia has a huge impact on the child’s development and therefore, in addition to pharmacotherapy, it is important that the child remains under constant medical care.
Need something for troubled times? Do you want to reduce stress and soothe your nerves? It can help Adapto Max – dietary supplement for sedation, containing ashwagandha, Rhodiola Rosea, Indian nettle and Japanese knotweed. You will find it at a good price in Medonet Market.
We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to ecology. How to be eco and not go crazy? How can we care for our planet on a daily basis? What and how to eat? You will hear about this and many other topics related to ecology in the new episode of our podcast.