Theories of Schizophrenia

Introduction

John Forbes Nash is the protagonist and the central character of the movie “A Beautiful Mind”. The movie is based on the true story of John Nash, who was a genius and a remarkable man; his theories related to mathematics have established him as one of the greatest geniuses of the twentieth century. And his struggle with the illness of paranoid schizophrenia has been a challenge for his wife, his friend, and the community in which he lived. His life has been a series of remarkable achievements. The movie captures his life from the time he arrives at Princeton. He is portrayed as a young, brilliant, and perceptibly odd West Virginia math student, who struggles with the devastating illness of paranoid schizophrenia and ultimately wins Nobel Prize as an old man.

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He is recognized for his extraordinary capabilities and talent intellectually at deciphering complex mathematical theories. He established theories that influenced not only mathematics but also various other academic fields from economics to biology. The real focus of the movie is the struggle which characters Nash experiences with the terrible illness of schizophrenia. The effect of the illness strikes him while he is a student at Princeton in the early 1950s. Later he joins the prestigious Massachusetts Institute of Technology (MIT) as a research professor. His disease began to grow worse and coincidentally there he also meets Alicia, with whom he falls in love and gets married. Alicia is not aware of his illness, by the time she discovers his illness, they are already married and she realizes the seriousness of her husband’s sickness. She becomes the pillar of strength for the family and takes care of him, herself as well their newborn son.

The story of John Nash is the story of trials and triumphs in which with great determination, John Nash is successful in fighting back from his gripping delusions with the help of his wife, friends, community, and his doctor. He ultimately becomes an honored member of the Princeton community. His story is one of the fascinating windows which reveals the intricate and intimate relationship which exists between genius and madness. John Nash’s extraordinary battle with paranoid schizophrenia is inspirational, which is why he won a Nobel Prize.

Even when struck by the initial stages of the disease John Nash was able to evolve The Game Theory which is the study of strategies to win games. It began with games like chess, noughts, and crosses where strategies are developed taking into account the position of the other player. This same theory fascinated mathematicians in games like poker where it was much more interesting because players cannot see each other’s cards and bluff came into the analysis. Ultimately, the final attempt was to evaluate and analyze more two-sided games which would include economics, warfare, and divorce. The primary emphasis was that in each of these cases there were two parties that held the position of competition in the areas of money, territory and they developed strategies that were based on their objectives and strengths.

Game theory is math with a touch of psychology. As a man, John Nash contributed significantly in the sphere of game theory as it was applied to the real world. His contribution was over and above any other man’s contribution in this field. He published four papers between 1950 and 1953 which revolutionized the game theory, while he was still in his early twenties. “Nash enshrined his theory in mathematical equations, and in particular he identified the Nash equilibrium, a situation in which both the players have a perfect strategy that results in instability.”(Singh,2002).

“A Beautiful Mind” is the story of the most insightful mathematician in the history of America. Nash provided the world with the most brilliant and intuitive ideas which were based on precise mathematical formulations. This is reflected in the Nash Equilibrium. Nash solved problems that baffled the greatest of minds. And even when struck by debilitating illness like paranoid schizophrenia he was able to overcome it through years of suffering and was an ideal recipient of the Nobel Prize. He goes through a range of highs and lows from the time he is a mathematics student till he wins the Nobel Prize for Economics in 1994. He is presented as a brilliant, anti-social character that sees mathematical formulas associated with everyday life and makes connections that are extraordinary.

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Schizophrenia: Disease, Symptom, Treatment, Causes, Diagnosis, and Medication

Schizophrenia is a very severe brain disorder, which can have devastating effects on the individual, family, and friends. It leaves the people suffering from this disorder in a state of withdrawal in which one is paranoid with delusional symptoms. Once the clinical and medical diagnosis is made and the disease is identified variety of treatment options are available. It has to be understood that the disease has no cure, it can be managed through the use of highly effective drugs in combination with cognitive therapy and psychotherapy along with stress reduction practices. The treatments are necessary as they are very effective in the reduction of the symptoms of the disorder as well as in the prevention of relapse which is very common in schizophrenia.

If a patient suffers from Schizophrenia it is important to seek medical help as soon as possible and start effective treatment at the earliest.

The diagnosis of schizophrenia is a very challenging task; it is quite difficult to identify the symptom as sometimes they can mirror symptoms of some other disease or medical conditions. Diseases like brain surgery or injury or Vitamin B 12 deficiency along with drug abuse and tuberculosis also reveal symptoms that are similar to the symptoms of schizophrenia. This has been proven and accepted by medical reports. There is no physical test that can confirm the disease. In order to make a diagnosis, these factors are taken into consideration family history, emotional history, and the clinical symptoms of the patient. It is very difficult to diagnose the patient just based on one sitting. The doctor has to track the patient over a period of time to fully diagnose the symptoms of the disease; sometimes it is also necessary to get feedback from the family and friends to have a full evaluation of the symptoms.

The disease mostly occurs in a person in their teens or early twenties. It is known to impact more men than women. Once the diagnosis is made, it is recognized as a lifelong disease that is not cured but treated with medication, psychotherapy, and psychosocial support therapies. Adherence to the medication is the single most important factor in controlling the symptoms. It has been noted that there is a strong tendency in the patients to go off of medication which is acutely felt by the individual as well as family members. Individuals who cope with this disease need all the support from their families, friends, and communities. This can bring about determination to fight back the symptoms of the disease with understanding and compliance to medication regime along with psychosocial support. Compliance with the treatment plan is necessary for an individual to maintain the balance between medication and therapy. A sudden stopping to stick with this regime will lead to relapse of the symptom associated with the disease.

It is a very complex process to identify the causes related to schizophrenia as there is no single cause that can be identified as the main cause of the disease. The onset of the disease is the outcome of the role of the genes, the effect of the behavior, and other related factors. Even scientists do not understand all the factors necessary to produce the symptoms of schizophrenia. Modern biomedical research has focused on the search for genes, critical moments in brain development, and other factors as contributory elements in the development of symptoms of schizophrenia. There has been a strong indication of genetic factors as one of the factors which lead to the production of the disease. Schizophrenia runs in families and people who have close relatives with schizophrenia are more likely to be affected by the disease. “There has been a report that monozygotic (identical) twin of a person with schizophrenia has the highest risk 40 to 50 percent of the developing the illness. A child whose parent has schizophrenia has about a ten percent chance. And by comparison, the risk of schizophrenia in the general population is about 1 percent.” (Grohol, 2006).

Another cause has been attributed to brain chemistry and its strong link to schizophrenia. According to this, the interactivity of neurotransmitters plays an important role in the communication between the nerve cells.

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It has been affirmed that this link has been involved in the development of schizophrenia. “It is very likely that any disorder associated with some imbalance of the complex, interrelated chemical systems of the brain which involves the neurotransmitters dopamine and glutamate plays a role in the onset of the disease.” (Grohol, 2006).

It has been proven that people with schizophrenia have abnormalities in the brain structure; this has led to neuroimaging and the study of brain structure and function in a new light in the living individual. There has been noticed enlargement of the fluid-filled cavities, called ventricles, in the interior of the brain and decreased size of certain brain regions. This leads to impaired function of the brain which is marked by decreased metabolic activity in certain brain regions. The microscopic study of the brain cells reveals small changes in the distribution of the brain cells. This is strongly accompanied in the case of schizophrenia patients in the studies conducted on brain cells.

There is also speculation that affirms that schizophrenia is a developmental disorder resulting when neurons form inappropriate connections during fetal development takes place. The abnormality is the result of adverse reactions and faulty connections which are experienced during the critical years of puberty. The errors lie dormant until puberty. This stage of maturation is critical to the development of the disease. There are apparent biochemical changes that precede the onset of the disease and its symptoms. This is confirmed using brain–imaging techniques. Scientists are also exploring the possibility of abnormalities based on genetics that impacts brain development and causes the neurotransmitters systems regulating brain function to malfunction.

The experts point to the fact that schizophrenia develops with the interaction and of the biological pre-disposition along with the environmental factors in which a person is exposed. This relationship between biological predisposition and environmental factors is vital to the development of schizophrenia. In the lines of research, these factors are associated early on during pregnancy or early childhood leading to subtle alterations which make the brain susceptible to the symptoms of schizophrenia. The role of the environmental factor is in causing further damage to the brain which is already predisposed and thus increases the risk of schizophrenia. This leads to the lessening of the appearance of genetic neurodevelopment defects which can result in the risk of schizophrenia.

The final analysis of the experts is that schizophrenia is caused by a combination of biological, psychological, and social factors.

The use of antipsychotic medication is the first line of action according to medical science. This is also the most common medical treatment. The use of medication has resulted in marked improvement in the patients with schizophrenia and it also reduces the rate of relapse by half. The most used medicines for schizophrenia include Thorazine, Fluanxol, Haloperidol, etc. these medicines are very effective in treating the positive symptoms of schizophrenia. There are few newer medicines that are of atypical nature like Risperdal, Clozaril, and Aripiprazloe which are appropriate for reducing the negative symptoms.

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Alternative medication along with sound dietary supplements in accordance with the primary medical treatment has proven to be very effective in controlling the symptoms of schizophrenia. The role of Glycine supplements, Omega 3 Fatty acids, and antioxidants have been proven in controlling the positive and the negative symptoms.

Theories on Schizophrenia: Dopamine, Developmental, Genetic

There have been several theories that have been put forward in the light of understanding the onset of schizophrenia. The developmental theory suggests that the development of the brain is a very complex process that takes place from pregnancy to early childhood. The development of the brain from the earliest fetal development to early childhood is a series of complicated processes in which millions of neurons are formed, which move from one region to another leading to different functions of the brain. This is a complex process during which things can go wrong as a result of infections, hormonal imbalances, errors in genetic encoding, stress, and nutritional factors.

The primary focus in all developmental theories is that the cause event occurs during brain development. Mostly, the symptoms come to be recognized during late adolescence or early adulthood. It is amazing to recognize how those symptoms could be caused by developmental events that took place decades ago. It has been affirmed according to development theory that the early disruption leads to some degree of disorganization in the brain structure which becomes more apparent during puberty. The beginning of puberty is marked by a great many neurological events which cause programmed death of many brain cells and at this time the abnormalities resurface in a critical manner.

This theory also points to the fact that schizophrenia is more common in spring and winter births, in the case of children whose mothers experience famine during the first trimester and pregnant mothers who experience pregnancy and birth complications during this critical period have an increased risk of developing schizophrenia.

According to the Dopamine or the DA theory associated with schizophrenia, the disease is associated with increased activity at dopaminergic receptor sites. This leads to the conclusion that antipsychotic drugs exert clinical effects by reducing DA activity in the patient. This leads to the prediction that drugs which increase DA activity leads to symptoms of schizophrenia and drugs which decrease DA activity lead to control of the symptoms related to schizophrenia. There are drugs that are used to test the DA hypothesis which emphasizes that schizophrenia is associated with abnormal neurotransmitter activity. This can be investigated by using drugs that interfere with the metabolism of DA in the brain. There is evidence that increased DA hyperactivity leads to psychotic episodes in healthy people. There is a need to administer antipsychotic drugs like chlorpromazine which has the potential to exert their therapeutic effects by blocking DA receptors.

There is a strong genetic component to the disease which emphasizes the fact that those who have immediate relatives with a history of schizophrenia or other psychiatric disease have a significantly greater risk of developing schizophrenia over the general population. There have been noticed some degree of complexity in genetics and environment which is not understood well. The evidence of a genetic predisposition to schizophrenia is overwhelming. The statistics reveal that the prevalence of schizophrenia in the general population is 1%, in cases where a brother or sister has the illness the chances increase to 9 percent, if it is the case of identical twins the chance of developing schizophrenia increases to 28 percent. If both parents have the disease one has the chance of a 36 percent likelihood of becoming affected by the disease. These family risks are calculated based on the genetic rather than the family environment. It is also a fact that genes alone don’t cause schizophrenia, as there has been the investigation in the case of twins who are identical and share the same gene code, who have a 100 percent likelihood of sharing the disease, but they are inflicted by the disease with only 28 percent chance.

Biological Vs Environmental Role

The investigation into this research related to schizophrenia has led to the common agreement among the experts who now agree to the fact that schizophrenia develops as a result of the interplay between biological predisposition and the kind of environment s person is exposed to. The research converges on the fact that brain disruption is the result of the genetic predisposition and environmental stressors which are recognized during pregnancy or early childhood. This leads to subtle alterations in the brain which makes a person susceptible to developing schizophrenia. The environmental factors later on in life can either damage the brain further and thus the risk of developing schizophrenia is increased. There is a great possibility that these environmental factors can also decrease or increase the manifestation of genetic neurodevelopment defects and lead to a decrease in the risk of schizophrenia.

Conclusion

Schizophrenia is an acute mental disorder that has a devastating impact on the individual. Many theories have evolved to describe and analyze the onset of the disease which literally cripples the life of an individual. A person with schizophrenia needs a sound support system that may come from several sources including family, friends, and the support groups organized for the specific purpose. A very important consideration is the right medication and implementation of the medication regime. The family ought to be the primary support source in the system making sure the implementation with medication is regular. The family and community need to accept the problem and implement a regular routine in which treatment is given priority.

There are numerous situations when patients with schizophrenia resist treatment and believe strongly in their hallucinations and delusions try to avoid psychiatric help. These are the times when family and friends can take an active role in having them seen by the proper medical authority and ensure that medication is adhered to. It is quite n arduous task to live and cope with a family member struck by the disease. The disease accompanies overwhelming stress and hardship, for the individual suffering as well as for the family. It is important for the family to use a support group and share common experiences to benefit themselves as well as the support group.

References

Singh, Simon.(2002). A Beautiful Mind. New Statesman. Web.

Grohol, John M.(2006). Schizophrenia Treatment. PsychCentral. Web.

University Of California At Los Angeles (2005). New Theory Explains Schizophrenia As Abnormal Courtship; Disorder Survives As.Science Daily. Web.

Kenyon, C.A.P.(2006).Schizophrenia. Web.

ANI. (2008). What Causes Schizophrenia?. About.com. Web.

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