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Schizophrenia

By Meg Marinis, Director of Research | Oct 1st, 2009

I Always Feel Like Somebody's Watchin' Me

Paranoia.

Everyone experiences it. You hear a slight noise in the bushes, and suddenly, you feel as if someone might be watching you... when really, a squirrel has jumped down from a tree. You open your extremely dark closet, and you think that a burglar hides behind your clothes... when really, a jacket has fallen off the hanger. You sense clicking while on the phone, and you cannot help but wonder if someone else might be listening in on your conversation... But then, you find out that clicking? Was actually your friend typing on her laptop on the other end of the line. These moments of panic often pop up for many people, but luckily, they usually fade away after time.

But what if that feeling never disappeared?

In Episode 603, I Always Feel Like Somebody's Watchin' Me, Tom Crowley arrives at Seattle Grace with his mother Jodie after a car accident. A paranoid schizophrenic, Tom cannot trust any of our doctors to treat his mother or bandage his wrist. He suspects that "they" caused the accident on purpose and have tapped the hospital with cameras to watch him constantly. In order to calm his suspicions, Jodie must distract Tom by asking him what they need at the grocery store. Once she has caught his attention, Tom's distress lessens as he recounts the fruit they need to buy.

What exactly is schizophrenia?

Schizophrenia is a severe psychiatric disorder, often described by hallucinations, delusions, physical agitation, and incoherence. According to the National Institute of Mental Health, the disease affects 1% of the population, and roughly two million Americans develop it each year. Men and women each suffer from the disease equally; however, men usually present earlier in age, such as late teens to early twenties, while women tend to exhibit symptoms in their late twenties to thirties.

Schizophrenia does run through families. Researchers and scientists have been looking into the genetic factors for years, but if one has a parent with the disease, they have cited that the child will have a 10% chance of developing it. The studies have shown that multiple genes work together to create a disposition of developing the disorder (in particular, most likely chromosomes 13 and 6).

What are some of the signs and symptoms of the disease?

Usually, initial symptoms appear with behavioral changes. Patients might become socially isolated, preferring to be alone rather than with others. They might start hearing voices inside their heads that only instill fear and paranoia. Patients with the disease believe these voices have devised plots to harm them physically or use mind-control tactics on them.

For example, when the paramedics tell the doctors that Jodie and Tom hit a parked car, Tom interjects, saying "They put the car there. It was them." Tom blames these voices for their car accident and his mother's condition. When he receives a CT of his spleen, Tom becomes momentarily convinced that they implanted a camera inside his abdomen. All of his scary thoughts are very, very real to him.

How is schizophrenia diagnosed and controlled?

When a loved one starts to speak or behave that differently, they first need a medical evaluation in order to rule out any other conditions. They will receive a physical examination, laboratory tests, and a detailed medical history will be taken. Depending on the patient and presentation, some doctors encounter trouble distinguishing symptoms from a manic-depressive disorder and schizophrenia. Therefore, with patients whose symptoms do not maintain clear boundaries, they receive a diagnosis of schizoaffective disorder.

Doctors usually prescribe anti-psychotic medication to patients who have been diagnosed with schizophrenia. Prescribed since the 1950s, the drugs have greatly improved in helping patients live normally, reducing the amount of hallucinations and sense of overwhelming paranoia. Unfortunately, side effects to the medications do exist for some patients such as depression and even weight gain. But if they temporarily or permanently stop their medications, patients can easily suffer relapses of psychotic episodes, sometimes even worse than the initial time.

If one has a close friend or family member with the disease, it is important to remember that these patients need a strong support system, whether it be an actual family household or residential treatment facility. Patients with schizophrenia often resist treatment, mistrustful of their doctors and medications. Sometimes only their loved ones may be able to talk to them about their symptoms or their feelings at one particular time in order to keep them calm and maintaining as regular a life as they can.

And even though both Tom and his mother Jodie undergo surgery, we see through the episode that Jodie has been the only person Tom trusts throughout his disease. Her presence reassures him, and she can distract him by having him make the grocery list or remember what kinds of fruit they need from the store.

What is the prognosis of ongoing research?

Currently, there is still no cure for schizophrenia. However, medications and therapies have improved so drastically that many patients can usually lead normal lives, if they stick to their treatment regimen. Federal studies into the complexity of how the brain works along with genetics work hopefully will provide more insight into the cause of the disease itself. Doctors and specialists have also begun following patients who suffer from the disorder throughout their entire lives, so they might learn more, starting with the very first psychotic episode to many years afterward.

For more information on schizophrenia, please visit:

http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

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