Understanding Schizophrenia.” · 2020. 3. 8. · • Welcome to In The Know’sPowerPoint Companion for the inservice, “Understanding Schizophrenia.” • In order to best navigate

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© 2016 In The Know, Inc


A Disease Process Module:

Understanding Schizophrenia

Living in the Nightmare

• Schizophrenia is a complicated disease of the mind that distorts the way the person experiences the world. The disease makes it difficult to tell the difference between what’s real and what is imagined. And, the person has problems thinking logically and behaving appropriately.

• Doctors are not sure what causes schizophrenia but research is pointing toward a combination of genetics and environmental triggers.

• There is currently no cure for schizophrenia, but there are medications and therapy that can help with the symptoms.

© 2016 In The Know, IncSee Page 1 of “Understanding Schizophrenia”

What Exactly is Schizophrenia?

• A term that describes this disease is psychosis: a loss of contact with reality, usually including false ideas about personal identity (delusions) and seeing or hearing things that aren’t there (hallucinations).

• Schizophrenia occurs equally in males and females and generally develops in the late teens or early twenties.

• Symptoms of the disease can be chronic or can occur in episodes. They can be positive (hallucinations or delusions), negative (depression and withdrawal) or cognitive (disturbed thought and speech patterns).


Types of Schizophrenia

• Paranoid schizophrenia: causes suspicion of others. Hallucinations and delusions are prominent.

• Disorganized schizophrenia: causes disorganized speech (sufferers may use nonsense words or speak in sentences that have no apparent meaning).

• Catatonic schizophrenia: causes extreme withdrawal.

• Schizoaffective disorder: this is a combination of schizophrenia with a mood disorder such as major depression or bipolar disorder.


Positive Symptoms of Schizophrenia

• Hallucinations: seeing, hearing, tasting or feeling things that are not really there.

• Delusions: a false belief that often cannot be corrected by reasoning with the person.

• Altered speech: clients may be difficult to understand, sometimes seeming to speak an entirely different language. Some may even make up their own words (neologisms).


Negative Symptoms of Schizophrenia

• Flat affect: this occurs when a person does not show any emotion in facial expressions, body language or tone of voice.

• Apathy: involves a lack of concern for anything. This person may neglect personal hygiene, fail to eat or drink, avoid work or school and literally have no energy.

• Withdrawal and isolation: when the person shuts out the outside world. There is little or no involvement in social groups; intimate relationships are difficult or impossible; and the person spends a great deal of time completely alone.


Handling Hallucinations

• Try gently reminding the person that the hallucination is not real by saying things like, “There is no one in the room except you and me.” Or, “I don’t hear anyone else speaking right now.”

• Remember that an auditory command is the most dangerous hallucination because it can be hard for the person to resist. This is when the client hears a command to do something destructive or violent like commit suicide or assault another person. Notify the nurse immediately if a client tells you he has been commanded to do something dangerous.


Dealing with Delusions

• The Feeling of Persecution is when the person says things like “The CIA is out to get me.” Or, “They’re trying to kill me.”

• The Delusion of Grandeur is when the person believes he is an important and powerful figure like someone from the Bible. These people may falsely believe God is controlling their thoughts and that the fate of the world rests on their shoulders.

• Remember to always be open, honest and calm when responding to clients with delusions. Speak in matter-of-fact tone.

• If the client is obsessing or dwelling on a delusion, try to change the subject. It also may be helpful to divert the client’s attention to another activity.


How is Schizophrenia Diagnosed?

• To make a diagnosis, doctors will look for two (or more) positive or

negative symptoms to be present for at least one month.

• However, a combination of two or more positive or negative symptoms alone does not always mean the person definitely has schizophrenia.

There are other reasons the person may be experiencing these symptoms, including:

Ø Brain tumors or brain swelling

Ø Alzheimer’s Disease or dementia

Ø Drug abuse


The Latest Research

• Researchers have learned that a certain protein is needed in the brain to help form networks or “roadways” that allow information to flow between neurons. When there is not enough of the protein present, the roadways do not get built.

• Without the roadways, information gets stuck. When this happens, information takes much longer to travel to its destination and sometimes may never even arrive at all.

• This is an important discovery that may lead to a better way to diagnose and treat this serious disease.


Phases of Schizophrenia

• Acute Phase: this is a period of intense psychotic symptoms such as hallucinations, delusions, paranoia, and confused thinking.

• Stabilization Phase: this is when the client may continue to experience mild symptoms but responds well to medication and therapy.

• Maintenance Phase: this is the long-term recovery phase. During this phase the client will continue to take medication but will also work on learning skills for daily living, and may participate in counseling and vocational and social rehabilitation.


How is Schizophrenia Treated?

• Medication: these medications are called antipsychotics. Most people respond well but some do not respond at all. Antipsychotic medications usually being relieving symptoms within a few days.

• Cognitive Behavioral Therapy (CBT): teaches clients that their thoughts are in control of their emotions and feelings. Therefore, if thoughts can be controlled, so can feelings, emotions and reactions.


How is Schizophrenia Treated? continued

• Hospitalization: a person is usually hospitalized during the first episode of psychosis, or during a relapse in order to receive medication and become stabilized.

• Day treatment programs: once the person is stabilized on medication, a halfway house or day treatment program may be beneficial. Here, the person lives full time in a group home environment where there is some freedom combined with supervision and therapy.

• Family support: having a supportive family makes a huge difference in the overall success of the client with schizophrenia.


Side Effects of Antipsychotic Medications

• Side effects may include:

Ø Dry mouth (give frequent sips of water or sugarless candy or gum).

Ø Constipation (encourage plenty of fluids, fresh fruits and whole grains).

Ø Drowsiness

Ø Dizziness and/or blurred vision (notify the nurse).

Ø Rapid heartbeat

Ø Sensitivity to the sun (encourage outings in the early morning or late evening).

Ø Skin rashes


Understanding Your Own Feelings

• If you find yourself feeling angry or frightened, talk to your supervisor right away. Discuss your feelings with your peers who have more experience in these situations. Do not feel ashamed of your feelings.

• Ignoring your feelings can also lead to a syndrome called “Caregiver Burnout.” This is when you become so exhausted and discouraged you begin to feel completely helpless. This can be dangerous for you and your clients.

• If you catch yourself feeling this way, get help! Don’t give up hope.


What’s the Prognosis?

• Although there is no cure for schizophrenia, advances in medicine over the past 25 years have improved the long term outlook.

• About 1 in 3 clients will improve enough with medication to lead independent and productive lives.

• Unfortunately, 1 out of 10 people with the disease will eventually commit suicide.

• Individuals with many stressors in their lives, or who have to deal with critical or emotionally over-involved family members, are more likely to relapse.


Discussion Questions

• Treatment for schizophrenia can last a lifetime. Should a family be expected to pay for it? Should the government be expected to pay for it?

• Should a mentally ill individual be forced to take medication? Should that individual be forced into therapy? Should the individual be forced into an institution? Should there be consequences for refusal?


Thank you for viewing this PowerPoint companion slideshow!

Remember: This slideshow is only meant to be a companion to the complete In the Know inservice “Understanding Schizophrenia.” In order to receive credit, remember to read the entire inservice and take

the quiz as instructed by your supervisor.


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Understanding Schizophrenia.” · 2020. 3. 8. · • Welcome to In The Know’sPowerPoint Companion for the inservice, “Understanding Schizophrenia.” • In order to best navigate