Schizophrenia is a severe neurological disorder causing a break between a person’s experience and their surrounding environment. Although it is often referred to as a mental illness, it is more accurately defined as a group of neurological disorders that can seriously alter an individual’s sense of reality. Schizophrenia is often characterized by hallucinations, odd personality traits and disorganized thoughts, all of which can leave both the individual and their loved ones in frightened and discouraged. Often symptoms interfere with thought processes, communication and behaviors, which can have profound effects on a person’s areas of work, social interaction, cognition and interpersonal relationships. Below we discuss the relationship between schizophrenia and addiction.
How Many are Affected?
Schizophrenia affects about one percent of all Americans—nearly two million adults. The rate of substance abuse among these individuals is significantly higher than the general population as drugs and alcohol are often used as a way to cope with the severely negative effects of this disease. Most people are diagnosed with schizophrenia in their teenage years. The early onset of the disease, combined with a persistence in the severity of symptoms, often makes the social impact of this disorder quite substantial, especially when combined with addiction.
Substance Abuse & Schizophrenia
Although substance abuse cannot cause schizophrenia, research shows that it can act as an environmental trigger. Additionally, the disorder is often mistaken for substance abuse due to a similarity in symptoms. This can often make it difficult to diagnose schizophrenia or co-occurring disorders. However, researchers continue to study both disorders both concurrently and independently to improve the accuracy of a dual diagnosis. Let’s take a closer look at the relationship between schizophrenia and addiction.
Subtypes of Schizophrenia
Schizophrenia is now defined as not a single neurological disorder, but rather a group of disorders. Several forms of schizophrenia exist based on an individual’s dominant symptoms. These forms include:
- Paranoid: As the most common form of the disorder, this subtype is characterized by delusional beliefs such as being persecuted or threatened. Individuals often obsess over conspiracy theories and hear voices telling them to harm themselves or others. They may be socially isolated and often exhibit hostile or irritable behaviors.
- Disorganized: Characterized by chaotic thought patterns, odd emotional reactions or strange speech. Hallucinations are less prominent, while bizarre behaviors are more dominant. People with this form of schizophrenia often have trouble holding a job or interacting normally with others. Often, writing and speaking may come across as eccentric or incomprehensible.
- Residual: Persons who no longer display obvious schizophrenic symptoms, but who have in the past, may have residual schizophrenia. Although they may no longer be affected by the most serious symptoms such as hallucinations, they may still retain some of the less debilitating effects of the disorder.
- Undifferentiated: This subtype includes individuals who have the symptoms of schizophrenia but do not fall under the other subtypes clearly. For example, they may exhibit disorganized speech or hallucinations, but to a milder degree than those who clearly meet the specifications for the other subtypes.
What Causes Schizophrenia?
Schizophrenia is often confused with multiple personality disorder, or MPD. However, most people suffering from schizophrenia do not have multiple personalities and are not violent, both of which are common to those with MPD. Researchers are still unclear as to the direct cause of the disorder, but most believe it is linked to the following factors:
- Heredity: Schizophrenia has a tendency to run in families, occurring in 10% of people with a first-degree family member, such as a parent or sibling, who have the disease. It is believed that certain genes inherited from one’s parents can increase the risk of developing schizophrenia. Further research has also shown schizophrenics to have rare genetic mutations that disrupt natural brain development.
- Brain Chemistry: Research finds that certain chemical imbalances, such as serotonin and dopamine, in the brain are linked to schizophrenia. Imbalances affect the way the brain responds to various stimuli, leading to hallucinations and hypersensitivity. Science has also found differences in brain structure for schizophrenics—reduced gray matter and increased or decreased activity in specific areas of the brain.
- Environment: Some research indicates that a person’s environment, when combined with genetics, may play a contributing role in the development of schizophrenia. Environmental factors can include health related problems during birth such as viruses, malnutrition and infection.
Symptoms of Schizophrenia
Schizophrenia displays a broad range of symptoms which can make it difficult for the affected individual to function normally. Symptoms can be emotional, behavioral or cognitive in nature and also vary based on the subtype of schizophrenia. However, there are a general set of symptoms which most individuals will display. Delusional thinking is one of the most common symptoms. Individuals may have beliefs that are not based on reality. These delusions can include misinterpreted sensory cues (such as a flickering light being a signal of some kind) to delusions of feeling threatened or harassed. Some individuals may feel they have mystic powers or believe they are a famous celebrity or historical figure.
Hallucinations are another common symptom. They occur when a person sees, hears, smells or feels something that does not exist. Often an individual may be completely obsessed with this experience, although it has no basis in reality. Hearing voices is the most common hallucination to those with schizophrenia.
Schizophrenics may also exhibit disorganized, if not childlike, motor behaviors. These can include excessive movements, lack of impulse control or strange postures. They may also fluctuate in and out of a catatonic state, in which they cannot move, speak or respond to communication. Individuals, similarly, will display disorganized speech patterns, resulting from disorganized thinking. This may often lead to sudden or mid-sentence topic changes or utterances of gibberish. A person may also repeat words or phrases or make random and nonsensical statements.
A final class of symptoms of schizophrenia are negative symptoms—the absence of normal functioning or behaviors. These symptoms often appear years before a person has their first schizophrenic episode, such as hallucinations or delusions. These negative symptoms are often mis-classified as other mental health issues, such as anxiety or depression. Common negative symptoms include diminished emotional expression, changes in sleep patterns, lack of interest, disinterest in hygiene and social withdrawal.
Schizophrenia and Addiction
Almost half of all individuals diagnosed with schizophrenia in the United States struggle with a drug or alcohol addiction. This rate is nearly four times the rate of drug and alcohol abuse found among the general population. Despite this relationship, most mental health specialists do not believe that drug use triggers the onset of the disorder. However, there is mounting evidence that suggests a causative relationship between the use of drugs and specific schizophrenic symptoms. For example, individuals with heightened genetic risks for schizophrenia may develop active episodes as a result of using hallucinogenic drugs such as LSD. There is similar evidence regarding the use of marijuana and the onset of active schizophrenia.
Additionally, stressful situations—major transitions in life, the death of a loved one or a physical illness— can cause schizophrenic symptoms to intensify. During these stressful times, individuals may have a heightened risk of psychotic episodes. They may also turn to drugs and alcohol as a maladaptive way of coping with the stress. Most diagnostic theory holds that substance abuse is more common among schizophrenics because of the social consequences of this severe mental disorder. Often, these individuals have a higher rate of homelessness, poverty, incarceration and social marginalization. These situations often increase the odds of drug and alcohol abuse.
Schizophrenia and Marijuana
According to the Journal of Neuroscience, the use and/or abuse of marijuana may play a factor in the onset of schizophrenia for some people. Tetrahydrocannabinol or THC, the main psychotropic ingredient in marijuana, plays a strong role in both the prefrontal cortex and the hippocampus regions of the brain—both regions essential to a person’s ability to make judgements and form or access memories. Likewise, these same structures show signs of disruption or altered function in schizophrenics. For individuals already at risk of developing schizophrenia, the altered mind functions associated with the ingestion of marijuana may increase the likelihood of symptoms of schizophrenia to develop and intensify.
Schizophrenia and Tobacco
Addiction to nicotine is an extremely common form of substance abuse among schizophrenics. They are addicted to tobacco products at three times the rate of the general population (75-90% compared to 25-30%). Although the relationship between schizophrenia and smoking is complicated, most schizophrenics seem driven to smoke. Research is still exploring whether there is a biological basis for this craving. In addition to the negative health effects of smoking, studies have found that smoking may also reduce the efficacy of certain antipsychotic drugs, making treatment less viable. Schizophrenics who try to quit smoking may also experience intense withdrawal symptoms, causing their psychotic symptoms to worsen as well.
Schizophrenia and Alcoholism
The National Institute of Alcohol Abuse and Alcoholism reports that alcohol addiction is the most common co-occurring condition in individuals with schizophrenia. Unfortunately, many people receive treatment for their alcoholism, yet the symptoms of their schizophrenia still remain. When both disorders are treated side by side, recovery rates are much higher. Individuals in recovery often report a higher quality of life, with fewer breaks from reality.
Treatment Options for Schizophrenia Addiction
When treated independently, treatment for addiction and schizophrenia often both involve a combination of psychotherapies, rehabilitation, medication and help groups. However, the most long-lasting and effective recovery has been found to be when both schizophrenia and drug or alcohol addictions are treated simultaneously, rather than as separate conditions. Dual diagnosis programs tend to have the most lasting results when it comes to treating individuals with both disorders.
During treatment, withdrawal from alcohol, cocaine, meth, heroin or other psychotropic drug addictions can cause episodes of delusional thinking or hallucinations, especially for heavy users. During detox phases, addicts may believe they are being persecuted or harassed, without any rational justification for their beliefs. In order for treatment professionals to make a diagnosis of schizophrenia, they must be able to determine a difference between substance induced psychosis or other mental illnesses. This diagnostic process can be more easily done once a patient has been through detox phase and the symptoms of schizophrenia are made more clear.
Substance abuse can also make treatment drugs for schizophrenia less effective. Some drugs, such as stimulants like cocaine or amphetamines, as well as marijuana, may worsen symptoms. Additionally, individuals who abuse drugs are less likely to follow their treatment plans. Once an individual has been through a detox process, antipsychotic medications are usually prescribed to alleviate symptoms of schizophrenia. While taking these medications, individuals will attend various therapies to address the underlying causes of their disorders.
A common modality used to treat schizophrenia is family therapy. Many people with schizophrenia are part of a high-stress family environment. Family therapy can be effective in reducing the stressors and triggers contributing to their schizophrenia and substance abuse disorders. Cognitive behavioral therapy (CBT) is another common therapy used. CBT helps patients identify certain behaviors or ways of thinking which contribute to their addiction as well as to their schizophrenia. This therapy also helps patients learn to manage the symptoms of their disorders that may persist even when taking antipsychotic medications.
Is Schizophrenia Addiction Curable?
Recovery from schizophrenia and addiction is possible. Schizophrenia is a chronic disease of the brain and like a drug or alcohol addiction, there is always a possibility for relapse, even after treatment or rehab. However, with consistent therapy via a dual diagnosis program, psychiatric medication and a strong support system, individuals can achieve a full and lasting recovery. If you or a loved one is struggling with schizophrenia and an addiction, contact Blu By the Sea today. We are a dual diagnosis rehabilitation facility located in Destin, Florida.