Difference Between Schizophrenia And Anxiety Disorders
The term schizophrenia, referring to a psychosis, was introduced in 1908 by Eugen Bleuler, a Swiss psychiatrist and a onetime colleague of Sigmund Freud. The condition was originally called “dementia praecox,” meaning “early mental deterioration,” because the first symptoms usually develop in young people. The word schizophrenia is derived from the Greek words meaning “split mind.”
The precise cause of schizophrenia is unknown, but research indicates that there may be genetic and biochemical factors. Symptoms begin before the age of 45, often in adolescence; continue over a period of at least six months; and are marked by major changes in personality, delusions, hallucinations, or other forms of thought disturbance. (Schizophrenia does not cause multiple personalities.) A schizophrenic person shows a decline in functioning at work, in social situations, or in self-care.
Bleuler diagnosed the disorder on the basis of four symptoms, although no single feature is consistently seen in schizophrenic people, making the disorder difficult to diagnose.
Those with schizophrenic disorder usually have thought disturbances. The delusions may include thoughts of persecution (paranoia), in which a schizophrenic person believes that others are planning to harm him or her. Or there may be delusions of reference, in which a schizophrenic thinks, for example, that he or she is the target of public criticism by television announcers. Schizophrenics may also believe that their thoughts are being broadcast from their heads so that others know what they are thinking, or that others can insert thoughts into their minds.
Hallucinations, such as when a curtain moves and the person believes someone is hiding behind it, torment schizophrenics because they cannot separate reality from illusion. Most common is auditory hallucination, in which a person hears one or more voices. The voices may make insulting or critical statements, or they may “command” a person to take some action, which might be harmful.
Another kind of schizophrenic thought disturbance is marked by loose associations, with a constant shifting from one unrelated idea to another. A person may talk for a long time in vague terms that convey little information. Words may be chosen for their sound rather than their meaning, and speech may resemble nonsense rhymes, called “word salad.”
The affective, or mood, disturbance typically manifests itself as a “flat” demeanor, characterized by a monotonous voice and a masklike face. Any emotions shown may be inappropriate, such as smiling during a funeral.
Ambivalence, the inability to make a decision, is another symptom of schizophrenia as identified by Bleuler. This symptom becomes apparent when a patient may both love and hate a person with equal intensity, or may debate endlessly the pros and cons of a subject. A patient’s preoccupation with internal thoughts, or autism, causes him or her to withdraw from the real world and become preoccupied with personal fantasies or distorted ideas.
Until the 1920s schizophrenia was assumed to be incurable. Harry Stack Sullivan was among the first to show that schizophrenia was both treatable and curable. Methods of treatment include psychotherapy, antipsychotic drugs, electroconvulsive therapy, family therapy, and short-term hospitalizations.
Anxiety Disorders
A person who experiences unreasonable fears suffers from one of the four types of anxiety disorders: obsessive compulsive disorder, panic disorder, phobia or generalized anxiety. Persons suffering anxiety disorders are haunted by their fears, even though they are aware that their fears are unfounded.
A prolonged sense of fear about nothing in particular, or many things successively, is a generalized anxiety. A person who suffers such constant worry is often irritable, impatient, and difficult to get along with. Physical symptoms include muscle tension, nausea, accelerated heartbeat, and hot or cold flushes.
A phobia is an extreme fear of a specific object or situation that leads to a strong avoidance. Simple phobias include a fear of snakes (ophidiophobia), spiders (arachnophobia), a fear of small, enclosed spaces (claustrophobia), or of heights (acrophobia). Phobics may have a feeling of helplessness or loss of control, and may become nauseated or have a panic attack if they confront the object or situation they fear.
Panic disorder causes a sudden, intense feeling of fear, marked by breathing difficulty, heart palpitations, chest pain, dizziness, trembling, or sweating—symptoms sometimes accompanied by a fear of death. The attack may last minutes or hours, and may occur only once in a lifetime or frequently over a period of years.
Obsessive-compulsive disorder causes an individual to feel compelled to constantly worry about or be obsessed with a certain negative idea or to constantly perform a certain ritual or compulsion. Common obsessions are thoughts of committing violent acts or of becoming contaminated; common compulsions are constant hand washing or endlessly counting the same objects. Such rituals are meant to prevent certain dreaded outcomes.
People with compulsions usually realize the silliness of their actions, but are compelled to perform the rituals as a way to relieve the tension that builds when they are otherwise occupied. In severe cases the person cannot do anything but the compulsive act, and so cannot live a normal life.