Nia Coline Mendoza

Bernadette Perez

Mr. Jose Macatangay

ComSki2-P1B

12 Mar 2010

Schizophrenia: Nature or Nurture?

Schizophrenia continues to create new challenges today and continues to be a

complicated mental illness. There had been a misconception that Schizophrenia is a

rare condition. But it is actually not rare; in fact each person has a risk of developing it

within their lifetime. It is most common to psychoses, and half of the inpatients in mental

hospitals are Schizophrenics. It is a brain disorder that can happen to anyone occurring

in any culture, affecting men and women equally and all areas of functioning, including

thought, emotion, perception and behavior. So to prove that Schizophrenia is a major

mental health problem that can affect people from all walks of life.

The cause of Schizophrenia is not fully known. However, it shows that

Schizophrenia may be caused by the interaction between genetic and environmental

factors. Biological interpretations have dominated in past studies. But twin and adoption

studies suggest that environmental factors help in triggering Schizophrenia.

Nonetheless, neither the biological nor the environmental categories is completely

determinant, and there is no assurance that one will ensure if he will or will not develop

Schizophrenia.
 Problems associated with Schizophrenia as a disorder

Schizophrenia not only affects the person with the disease but also their

relationships with the people around them. Schizophrenics often withdraw and isolate

themselves, thus, developing paranoia and creating difficulties within their relationships.

Their paranoia causes them to form absurd and suspicious beliefs about their family or

friends. And it is hard to reason with them because they are incapable to think rationally.

The common signs and symptoms they have are grandiose delusional thoughts, anger,

tendency to argue, intensity when interacting with others and violent behavior. A

schizophrenic accuses everyone around him of lying or somehow trying to hurt him. And

it would just be normal for all the people who love him and deal with him to feel

frustrated and run out of ways to respond anymore. Usually they would feel irritated and

confused on whether to just go along with such crazy accusations or otherwise, to

confront them. And these arguments destroy the relationship, if not, close to giving up

on it.

Schizophrenics are unable to carry out routine daily activities; this is due to the

delusions, hallucinations and fantasies they experience which confuse them to focus on

their tasks, even simple ones like eating meals and taking baths. They behave quite silly

and have troubles of taking care of themselves. Other signs and symptoms include

impaired communication skills, incomprehensible or illogical speech, emotional

indifference and infantile behavior. Because of these, they lose touch on how they are
supposed to carry out their duties for the day. There are also cases when the diagnosed

show inappropriate expressions or responses to certain situations.

Alcohol use disorder is said to be the most common co-occurring disorder in

people with schizophrenia (Dworkin 2001). And it also complicates the course and

treatment of Schizophrenia. People with schizophrenia who continue to drink alcohol

frequently abuse other substances as well. They probably use alcohol and other drugs

for many of the same reasons as others in society, but it could also be an attempt to

self-medicate, or relieve symptoms. However, the addiction treatment programs expect

a Schizophrenic to be stabilized before they can be admitted to their addiction program,

and the psychiatrists say they can't help a patient if they have an active substance

abuse problem.

Schizophrenics are most likely to attempt suicide, and a few of them succeed in

doing it. It is more likely to happen in upswing of the disorder, when the symptoms have

abated a little and the person sees reality more clearly. They often keep their thoughts

private, so any suicidal talk, threats, or gestures should be taken very seriously.

Schizophrenia as a biological cause

Schizophrenia has a strong hereditary component. Individuals with a first degree

relative (parent or sibling) who has Schizophrenia have a 10 percent chance of

developing the disorder, as opposed to the 1 percent chance of the general population

(Beebe 2003). But Schizophrenia is only influenced by genetics, and not determined by

it. While Schizophrenia runs in families, about 60% of Schizophrenics have no family

members with the disorder. Furthermore, individuals who are genetically predisposed to
Schizophrenia don’t always develop the disease, which shows that biology is not

destiny.

One possible cause of schizophrenia may be heredity, or genetics. Experts think

that some people inherit a tendency to Schizophrenia. In fact, the disorder tends to “run”

in families, but only among blood relatives. People who have family members with

Schizophrenia may be more likely to get the disease themselves. Nader Bechara points

out that if both biologic parents have Schizophrenia, there is nearly a 40% chance that

their child will get it, too (48). This happens even if the child is adopted and raised by

mentally healthy adults. In people who have an identical twin with Schizophrenia, the

chance of Schizophrenia developing is almost 50%. In contrast, children whose

biological parents are mentally healthy – even if their adoptive parents have

Schizophrenia – have about a 1% chance of getting the disease. Some studies have

shown that influenza infection or improper nutrition during pregnancy and complications

during birth may increase the risk that the baby will develop Schizophrenia later in life.

Another factor for the development of Schizophrenia is the brain chemical

imbalance. In the Biopsychosocial theory, it is stated that dopamine is indeed to some

degree responsible for the onset of Schizophrenia. In addition to the dopamine factor

however, specific stressors and genetic factors may also be important. “In the area of

major mental illness, specifically Schizophrenia, excluding biological or neurological

factors from research is a liability for research and clinical efforts because

Schizophrenia is such a complex Biopsychosocial phenomenon” (Farmer & Pandurangi,

1997, p. 109). The research conducted by Farmer and Pandurangi suggests that while

dopamine may be a factor, there may be a tendency to inherit the specific levels of
dopamine and how they function in a person’s brain. In other words, some people may

be predisposed to chemical imbalances in the brain. The two researchers state very

clearly though that the disease itself is not inherited but the vulnerability for the disease

can be inherited.

“…vulnerability, in combination with relevant stressors, leads to the

development of symptoms of schizophrenia. This perspective integrates

biological characteristics with psychological and social aspects of human

behavior, providing a biopsychosocial understanding of the variables that lead to

a schizophrenic illness” (Farmer & Pandurangi, 1997, p. 109).

Schizophrenia as environmental cause

Twin and adoption studies suggest that inherited genes make a person

vulnerable to Schizophrenia and then environmental factors act on this vulnerability to

trigger the disorder. As for the environmental factors involved, more and more research

is pointing to stress, either during pregnancy or at a later stage of development. High

levels of stress are believed to trigger Schizophrenia by increasing the body’s

production of the hormone cortisol.

Research points to several stress-inducing environmental factors that may be

involved in Schizophrenia, including prenatal exposure to a viral infection, low oxygen

levels during birth (from prolonged labor or premature birth), exposure to a virus during

infancy, early parental loss or separation, physical or sexual abuse in childhood.

 In addition to abnormal brain chemistry, abnormalities in brain structure may also

play a role in schizophrenia. Enlarged brain ventricles are seen in some Schizophrenics,

indicating a deficit in the volume of brain tissue. There is also evidence of abnormally

low activity in the frontal lobe, the area of the brain responsible for planning, reasoning,

and decision-making. Some studies also suggest that abnormalities in the temporal

lobes, hippocampus, and amygdala are connected to Schizophrenia’s positive

symptoms. But despite the evidence of brain abnormalities, it is highly unlikely that

Schizophrenia is the result of any one problem in any one region of the brain.

Schizophrenia can be a bewildering and destructive force, not only to those who

suffer from it, but also to their friends and relatives. The families of people with

schizophrenia often struggle with a wide range of difficult emotions, including fear, guilt,

anger, frustration, and helplessness. Worried about the stigma of mental illness or

confused and embarrassed by strange behaviors they don’t understand, family

members may also try to hide their loved one’s illness from others.

Coping Mechanism

Unfortunately, isolation and denial only compound the problems Schizophrenia

causes in the home. According to the National Alliance on Mental Illness, the families

who deal most successfully with Schizophrenia are those that come to accept the illness

and its difficulties, are realistic in what they expect of the ill person and themselves, and

maintain a sense of humor. Keeping a positive outlook is much easier when you have

others to turn to for support. Like a loved one with schizophrenia, support,

encouragement, and understanding should be rendered.

 The best way to assist the recovery of a family member with Schizophrenia is to

get them into treatment and help them stick with it. Often, the first challenge of

treatment is convincing the ill relative to see a doctor. To people experiencing delusions,

hallucinations, and paranoia, there is no need for medical intervention because the

voices and conspiracy theories are real. Once a family member is in treatment, careful

monitoring can ensure that he or she is staying on track and getting the most out of

medication. Medication monitoring involves dealing with side effects, encouraging loved

ones to take medications regularly, avoiding drug interactions, and tracking medication

response. Many people stop taking their Schizophrenia medication because of side

effects, so one must pay attention to any drug complaints. Antipsychotic medications

can cause unpleasant and dangerous side effects when combined with other

substances, including certain prescription drugs, over-the-counter medications,

vitamins, and herbs. Help a family member avoid any problems by giving the doctor a

complete list of the drugs and supplements he or she is taking. Mixing alcohol or illegal

drugs with Schizophrenia medication is also harmful, so talk to the doctor if a relative

has a substance abuse problem. One can help the doctor track treatment progress by

documenting changes in a family member’s behavior, mood, and other symptoms in

response to medication. A journal or diary is a good way to record medication history,

side effects, and everyday details that might otherwise be forgotten.

Schizophrenia is a serious brain disorder. It is a disease that makes it difficult for

a person to tell the difference between real and unreal experiences, to think logically, to
have normal emotional responses to other, and to behave normally in social situations.

People with schizophrenia may also have difficulty in remembering, talking, and

behaving appropriately.

The literature reviewed for this paper is definitely clear that Schizophrenia is the

most complicated of all the psychiatric conditions to understand and treat. The research

on the dopamine theory states that the dopamine levels in the brain are one of the

central factors in the development of schizophrenia. However, as this paper has noted,

that body of research is still unclear as to why some people have a problem with

dopamine levels. At least one piece of research suggests that schizophrenia may

be associated with specific personality types.

Elevated dopamine activity appears in personalities that are intolerant of

structure and monotony, whereas low dopamine activity appears in those personalities

manifesting orderliness and inflexibility. To be clear, it seems that the levels of

dopamine reveal an unexpected parallel: Dopamine activity correlates with both

schizophrenia and creativity. In the Dopamine theory, it is stated that people who have

high levels of creativity, high levels of dopamine, and experience a sequence of

traumatic events and/or stressors may be predisposed to developing schizophrenia.

There could be genetic factors at work. In addition to genetic factors, there are

psychosocial factors that must be considered such as stress or a traumatic event which

could be part of the reason why some people become ‘schizophrenic’. Generally, both

the genetic factors and the environment are the aspects which create the predisposition

towards schizophrenia.
 Many questions regarding Schizophrenia remain unanswered. The one fact that

we do know is that the development of newer antipsychotics have been able to provide

people who suffer with schizophrenia at least some measure of relief and the ability to

live their lives. However, these drugs can often cause a broad range of side effects

which can also be disabling to the individual. In addition to the drugs, people with this

condition are definitely in need of strong supports including professional counseling and

other community support services. Most people with schizophrenia will live with the

condition their entire lives. Many will require several periods of hospitalization. Some will

react well to the drugs but some do not. There are also many people who do well on the

drugs and then come off in the belief that the condition has been cured, only to find they

relapse.

Even though there may indeed be a connection between elevated levels of

dopamine and schizophrenia, there are literally hundreds of neurotransmitters in the

brain. This fact means that the dopamine theory may be an oversimplification of what is

likely to be a far more complex connection than research has yet to uncover. However,

even though we do not yet fully understand the connection (or all the connections)

between dopamine levels and schizophrenia, the Dopamine theory is an excellent

starting point for further research which is definitely promising.

The unfortunate truth is that there is no cure for schizophrenia. There is only the

constant need to keep researching and understanding this complex condition in greater

depth and provide the people who suffer with it a healthy and complete life.
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