Schizophrenia Documentary notes PDF

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Notes from a schizophrenia documentary...

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Schizophrenia Documentary notes

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Psychosis = term used to describe range of different diagnoses incl. schizophrenia 3 key symptoms: Voice hearing; Paranoia; Hallucinations Feel life constantly under threat

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Some use music/drawings to interpret what they feel e.g. little girl voice in someone’s head, draws picture Voices can cause physical pain i.e. searing of skin Voices have characteristics and personalities Some voices try and help

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Due to too much dopamine in brain

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We filter out normal things usually Fire and signal when they detect something unusual and focus attention and brains resources trying to make sense of certain stimuli rather than unimportant stimuli Evolved to help us avoid danger by identifying threat Dopamine fires and tells us to pay attention and avoid dangerous signals Things go wrong when brain is flooded with dopamine Too much dopamine gives things in the environment more importance e.g. eyes staring at you Benign things take on new meaning and become terrifying i.e. eyes staring Inherent drive to make sense of this i.e. sent by aliens to spy

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Antipsychotic drugs block effect of dopamine Over a few days/weeks symptoms subside Side effects of antipsychotic drugs include severe hunger, chest pains Other drugs help with anxiety Sedative psychotics Other ones stop pooing Extra drug to deal with side effects Don’t cure the overactivity that evolved in the first place, just dampens, still underlying problem New treatments have been developed, free of drugs

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‘Experience sampling’ electronic diary keeping

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Looks at way people feel in everyday life, provides snapshot of what they are like at particular moment Looks at what circumstances people hear voices/feel paranoid Uses app; asks questions. Looks at exposure to stressful events and how that might impact behaviour Tries to discover what triggers hallucinations Uploads answers when it gets internet so psychiatrists can keep an eye on patients

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Recording experiences themselves helps patients gain an insight into what triggers hallucinations Patients feel like they are written off with no hope of recovery and many turn back on psychiatric system and join groups of people who all have similar symptoms Voices Avatar therapy - Creates computerised face with voice - Can select the voice that best matches those heard - Design facial features the patient believes best represents voice - Proff. takes role of voice - P required to confront it “I don’t want to hear this any more, go away and leave me alone” be assertive - Attempts to allow P’s to become better equipped with dealing with the voices             

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Some voices are positive and help people e.g. remind people to do things ‘teamwork’ Some feel over 100 different voices of all ages Some have a laugh with some; ‘24/7 company’ More people hear voices that have never had contact with psychiatric services Jackie started hearing voices age 3 and they became more and more aggressive Birth of first daughter marked the peak of schz, saw daughter covered in blood, voices said daughter’s life was at risk, may be kidnapped, daughter better off without her Found talking therapists key to helping her Suggested engaging with voices, speaking to them with kindness and respect so that this could be reciprocated Professors think it starts in childhood, often talk to themselves when doing things (private speech) thinking out loud This helps children think through what they are doing and is an important part of healthy child development Do more private speech when the task is difficult to help them think it through As we get older, this private speech becomes internal, but in stressful situations this may appear as an external voice, don’t recognise voice as being your own Dopamine thought to play a part in voices, doesn’t correctly identify info as coming from outside or internal

Little sensory input allows imagination to take over i.e. in dark places, shadows, more open to interpretation Normally state only lasts a few moments In scz they feel frightened all the time due to increase levels of dopamine Misfiring of dopamine makes everything seem important Daily terror, dominates lives Can feel things like floor buckling below you and opening up

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Still a mystery as to why some people develop it and others don’t Genetic component? But not most important factor Where you live thought to have a huge impact I.e. living in a city before age of 15, not just being born in a city Genes contribute 10% environment contributes 35% Ethnic background also affects chance, not as simple as race High risk in ethnic minority groups – migration significant causal factor Migrant vs host issue All migrant groups all over world have higher rates of psychosis than host population Highest rates of psychosis are amongst Greenlanders in Denmark Face social discrimination and adversity Dislocation appears to be key issue Social defeat related to psychosis? This is repeated experiences of marginalisation, exclusion and discrimination Moving to a new school could affect it, greater number of school moves increases symptoms in adolescence, have to keep starting again as an outsider Therefore, social environment has a powerful impact Abuse and trauma in childhood may trigger it e.g. woman was abused by paedophile when a child, shattered her mind Repression in childhood can cause it, i.e. not talking about sexual abuse, pushing it out of the conscious where possible – crops back up later in life Strong and consistent body of evidence linking childhood abuse to range of mental disorders As stress levels with strangers around rises, hallucinations get worse Dissociative state occurs when anxious – way of handling threat, brain One person lived in fear from age 5-13 constantly scared that he might get beaten up by stepfather who had sudden violent outbursts Would pretend they weren’t really there ‘dissociate’ Repeated trauma makes you learn this habit

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Addressing voices is a big step to recovery Realisation that voices could help Speaking with most frightening voice helped overcome fear, reasoned with voice and said she understood it

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Long term use of antipsychotic medication can have severe side effects Ideal is to get off them where possible Tend to make people put on weight, increased risk of diabetes, heart disease etc Cheaper option than psychological therapy All that can really be done is medication sometimes, diminishes people’s chances to recover

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Other therapy alternative, doctor talking directly to the voice

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Patient speaks the voice of the voice to the doctor Tries to understand viewpoint of voice to improve relationship voices have with person People can help the voices reach their goal in a more fruitful way Research shows that suppression of voices can help them become stronger Need to address voices Change view to see that voice is trying to warn you rather than hurt

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Research shown this is response to traumatic events May not be irreversible, if we know where it came from

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