About one out of every 1,000 people suffers from schizophrenia. It is a cross-cultural phenomenon that shows no favorites as to age, race, creed, sex or national origin.
Schizophrenia is an illness. Having it means your ability to process and understand the environment is grossly disturbed. It appears to involve a breakdown in the mind's ability to filter out extraneous stimuli from the environment. As a result, the mind retreats into itself in order to make some type of sense from the information being placed into it.
What we used to believe was a single illness now appears to be a cluster of illnesses with some common threads. Schizophrenia often can be completely treated, and it usually can be at least modulated and controlled. Only rarely does it doom an individual to a life of nonproductivity, isolation and institutionalization.
Massive institutionalization was the predominant mode of treatment and sedatives were the commonly prescribed drugs until the late 1940s. Electroshock therapy routinely was used in the '30s, '40s and into the late 1950s. While it remains as a last-resort treatment for schizophrenics who are medication-resistant or are in such an agitated state that drugs won't work, electroshock therapy generally is reserved for people with depressive disorders.
The watershed event in the treatment of schizophrenia was the discovery in the late 1940s of Chlorpromazine, better known as Thorazine. It was not until the 1960s, however, that expertise in the use of Thorazine and similar antipsychotic drugs reached a level where they could be used widely and effectively.
How do antipsychotic drugs like Thorazine work?
Imagine a window screen turned on its side. The holes in the screen represent receptor sites in brain cells.
In normal individuals, there are a given number of these receptors within the brain. In individuals who have a medication-responsive schizophrenic illness, it appears that there are too many receptor sites. Information floods in too fast for the brain to handle.
Medications like Thorazine selectively block some of these sites to slow the flow of information so the individual is able to regain control of his thinking.
It is not as simple as it sounds, of course. Finding the right type and amount of medication takes expertise, since there are several different types of receptors. And all medications have side effects, some potentially lethal.
Tardive dyskinesia, an incurable condition characterized by abnormal, involuntary movements, affects about one-fourth of all users of antipsychotic drugs.
I believe schizophrenia is on the way to being placed in full remission, and continued advances eventually will bring it under complete control.
Sigmund Freud predicted that all psychiatric illnesses would be shown to have biochemical origins. Dr. Freud appears to have been right one more time.