For many years psychological researchers were hoping to find a definitive cause to schizophrenia and therefore find an actual direct cure. When I reviewed the available literature surrounding this topic and spoke with various people about this; something became clear to me. Firstly, that there wasn’t an exact pattern to indicate that schizophrenia occurs during early age or is triggered by a specific traumatic event. Furthermore, even if an individual’s ancestors showed a predisposition to mental illness; this also wouldn’t guarantee that the children would also be experiencing the same thing. Based on this observation alone, it may be enough to assume that schizophrenia is triggered by a combination of genetics with a traumatic event in early childhood.
However the question remains why is schizophrenia triggered and not other mental illnesses instead? Is there a specific gene that can trigger schizophrenia? According to the NHS website treatment guidance: “No single gene is thought to be responsible, therefore it is perhaps caused by a combination of genes”. Therefore, most researchers and healthcare professionals look to both environmental factors as well as the inherited factors.
If we were to observe the symptoms of schizophrenia from purely a biological psychology perspective; we may see distinct differences in brain structure and brain chemistry compared to the average brain. These distinct differences are spotted in neuro-imaging studies (using brain scans) and typically show irregularities in the frontal cortex and limbic system. It is these areas that are associated with cognitive (thinking) and emotional processes. These arguments must be viewed with caution as many other patients with other psychiatric and neurological disorders showed similar changes in the brain. Hence, it was suggested by Meehl (2009) that “it is unlikely that a disorder as complex as schizophrenia will be traced to a single site in the brain”. Other studies have suggested that schizophrenia is linked to a high amount of dopamine produced in the brain or perhaps a high amount of dopamine receptors. This could explain the negative symptoms that schizophrenic patients experience (e.g. lack of energy), since dopamine is the neurotransmitter responsible for your mood. However there have been cases where some antipsychotic drugs (which directly affect dopamine receptors) have been prescribed and they have not fully cured the negative symptoms. Therefore, you can see why medication is typically taken alongside conventional forms of therapy such as: counselling or CBT.
So it is clear that inherited biological/genetic factors have some effect on a person’s likelihood of attaining schizophrenia. So if we were to imagine a scenario where someone has a family history of schizophrenia, then what lifestyle choices or events can trigger these latent genes? In terms of lifestyle choices there have been some studies that have suggested that people who take mind altering substances, increase their risk of attaining schizophrenia. These mind altering substances, include: marijuana and LSD. The ingredients of marijuana have a strong effect on the pre-frontal cortex and the hippocampus, these same regions have also been associated with symptoms of schizophrenia. In the beginning when a healthy individual ingests marijuana, they only exhibit some symptoms of schizophrenia temporarily. However, if that same person were to regularly ingest or smoke marijuana there is a potential risk that these symptoms will remain and the actual mental disorder itself will develop. It is important to note that, a lot of these studies only indicate patterns but no direct causes. One cannot assume that every person who regularly intakes these drugs will then develop schizophrenia; however it is important to bear in mind that these drugs will worsen the symptoms of schizophrenia if a person already has it. Therefore, I would take precautions against taking mind-altering drugs when dealing with schizophrenia.
Given the fact that we have explored mostly physical and biological direct causes, the only factor left to explore is how social and environmental factors effect the risk of attaining schizophrenia. One key study by the “British Journal of Psychiatry” (2000) explored the “causes of schizophrenia as reported by patients’ family members in China”. The findings from this study indicated that 84% of causes of schizophrenia can be linked to social, interpersonal and psychological problems. The most common causes reported by the participants in this study were: “stress”, “personality problems” and “conflicts in non-family relationships”. Therefore, this study supports the significance of personal traumatic events as being factors that may predict the likelihood of someone attaining schizophrenia. However, findings like these raise more questions in my mind. For example: How does stress eventually cause schizophrenia and not other mental illnesses instead? On what spectrum of personality are we judging someone as having “personality problems”? Also, how can conflicts in non-family relationships be highlighted and not family relationships? Nevertheless, one cannot negate the influence of social factors based on the sheer enormity of this statistical figure (84%).
Traumatic events which occur very early on in a patients life need to definitely be taken into consideration. For instance, pregnancy and birth complications have commonly been attributed to the later development of schizophrenia later on in life. One study which support this claim was titled: “Schizophrenia and Complications of Pregnancy and Labor: An Individual Patient Data Meta-analysis”. The key findings from this study were that there were significant associations between schizophrenia and premature rupture of membranes, gestational age (duration of pregnancy) shorter than 37 weeks and use of resuscitation. Lesser significant findings were also discovered for babies with a birth-weight lower than 2500 g and forceps delivery (involving use of an instrument to assist in the delivery of the baby). One can assume that these events may cause chronic stress for the baby and therefore the psychological pain experienced by the baby remains in the subconscious mind of the individual as he or she grows up. Hence, this may be why the symptoms of schizophrenia develop as a result.
From reviewing all that I have written in this blog, it is clear that schizophrenia remains a complex mental illness. We may not get to a definitive answer as to why it occurs, however I hope that when I share my personal experience it can provide more hope and further insights. I will share my story after I have covered all the fundamental points of this topic. Therefore in the next blog I will cover the various treatments of schizophrenia. So stay tuned! P.S. Here is a general summary of the factors which can increase the risk of attaining schizophrenia:
- Family history of schizophrenia.
- Pregnancy and birth issues.
- Taking mind-altering substances or drugs.
- Traumatic events and inter-personal issues.
- Brain damage or brain chemistry abnormalities.