Clang Association: When a Mental Health Condition Disrupts Speech
Schizophrenia is a mental illness characterized by disorganized thinking, auditory hallucinations and delusions. The most common symptoms are loss of contact with reality and impaired social interaction. Schizophrenics may have difficulty in forming new memories or making sense of their surroundings.
They may experience delusions such as hearing voices or seeing things that aren’t there.
The condition is caused by a combination of genetic and environmental factors. Genetic predisposition to schizophrenia exists among both sexes equally. There are many different types of schizophrenia, but they all share some common features.
For example, schizophrenic individuals tend to have problems with relationships and interpersonal interactions. These difficulties affect the individual’s ability to function at work, school and home.
In addition, schizophrenics suffer from depression and anxiety disorders which cause them to lose interest in activities that used to bring pleasure. Many schizophrenics develop substance abuse issues as well.
It is not known what causes schizophrenia; however it is believed that genetic factors play a role in its development. Approximately 80% of people diagnosed with schizophrenia have a genetic relative who was or is schizophrenic.
The symptoms of schizophrenia are very diverse. Some people hear voices which may tell them what to do or comment on their actions. These voices may merge into a single voice that carries on a conversation with the person.
Some people believe that a certain individual is controlling their minds or thoughts. Others have the delusion that machines, electronic devices or the government are sending secret messages only they can receive. These are just some of the many types of delusions suffered by schizophrenics.
Delusions are very common in schizophrenia. In this case, the person believes something that is clearly untrue or imaginary with a very strong conviction. For example, a person may believe he is being followed by the police although there is no evidence or proof that this is true.
The most common symptoms of schizophrenia fall under two categories: positive and negative. Positive symptoms are those where the patient is displaying an increase in the frequency or intensity of normal behaviors. Negative symptoms are characterized by a reduction in the frequency or intensity of normal behaviors.
As mentioned above, some patients experience delusions and hallucinations. Delusions can be either Jealousy or Persecution. Jealous delusions are when the patient believes that his wife is having an affair with a coworker.
Delusions of Persecution are when the patient believes that the government is out to get him.
Hallucinations can be either Visual, auditory or tactile. The most common hallucination is visual in nature and involves a patient seeing things that aren’t there. Tactile hallucinations are when a patient feels something that isn’t there.
For example, a person may feel bugs crawling all over them when there are none. This is called a feeling of corporeal degradation.
Disorganized thinking, an inability to focus and a lack of concern for personal hygiene are a few traits of disorganized behavior. When a person suffering from schizophrenia experiences disorganized thinking they may come off as very odd or completely incomprehensible. Disorganized behavior is when a person with schizophrenia breaks moral codes and societal rules.
A person experiencing disorganized behavior may remove their clothes in public, pick their nose or masturbate in public.
Catatonia is when a person displays little or no movement or response to their surroundings. A person in a catatonic state may remain completely motionless and not respond to anything going on around them. This can sometimes be mistaken for depression or suicide but the lack of response to shouting, loud noises or other external stimuli distinguishes a catatonic state from depression or suicide.
Negative symptoms often lead to the disruption of normal and healthy social interactions. Disruptions in social behavior include a lack of emotional response, a drop in activity level and a decrease in interest in other people.
No two cases of schizophrenia are alike and symptoms can be very mild or very severe. Some patients suffer from all kinds of delusions and hallucinations while others suffer very few or none at all. The schizophrenic patient’s brain has an altered anatomy that causes the symptoms.
The exact cause of schizophrenia is still unknown but there are many hypotheses. It is thought that the cause may be genetic, or it may be that certain viral infections in the womb may cause the disease or possibly a combination of both.
As stated above, the exact reason for the disease’s development is unknown. A few factors have been determined to increase the risk for a patient to develop schizophrenia, though. If one parent has the disease there is a 10% chance of the child also suffering from it.
If both parents have schizophrenia the chance of the child developing it rises to 40-50%.
There is no cure for schizophrenia but symptoms can be managed through a combination of drug therapy and counseling. These medical techniques help to eliminate delusions and hallucinations as well as managing disorganized and negative behavior.
In the past decade studies have shown that early detection and initiation of treatment for a patient greatly increases the potential for better treatment outcomes. Many patients are able to lead happy and healthy lives with the help of therapy and medication.
How are schizophrenia and dissociative identity disorder similar?
Patients with dissociative identity disorder may also experience delusions, hallucinations and strange, disorganized behavior. These symptoms aren’t always present though. DID patients may experience depression and anxiety as well.
It is thought that DID is almost always caused by severe and repeated child abuse.
How are they different?
Unlike schizophrenia, dissociative identity disorder is always caused by a traumatic event and physical abuse is almost always involved.
DID is also known as multiple personality disorder but this is a misconception. The name was changed to better reflect the symptoms of the disease, not because a new disease was discovered.
The main difference between the two diseases is that DID patients suffer from amnesia and have no awareness of ever changing between identities. Schizophrenia patients are always conscious of their symptoms and know when they’re experiencing delusions, hallucinations or disorganized speech and behavior.
With both diseases the patient’s personality, mood and behavior are consistent throughout all of their identities. No identity is aware of any of the other identities and patients do not have conversations with themselves. Also, unlike DID, schizophrenia patients don’t experience episodes of forgetting important information such as their own name or where they live.
When a patient with DID transitions into a new identity they undergo a period of blacking out events in their life. They may not remember what happened an hour ago. The identity will slowly begin to learn more and more information about their surroundings, resulting in a detailed, coherent account of their history.
Schizophrenia patients experience no blackouts and are always aware of what is happening around them. Also, with schizophrenia, each individual identity may have a different memory of an event. One identity may recall the event happening one way while another identity recalls it happening differently.
Can people have both schizophrenia and DID?
It is possible for someone to have both schizophrenia and dissociative identity disorder but it’s extremely rare. Most patients only have one or the other.
As of right now there is no evidence that someone can suffer from both diseases but research needs to be done. It is known that people who experience severe and prolonged child abuse are more likely to develop DID as well as schizophrenia later on in life.
What else is different about these diseases?
Dissociative identity disorder is more common in females than in males. The average age that the first identity appears is around 3 years old and most patients are diagnosed before they reach adulthood.
The number of identities can range from two to over a dozen and each one has their own set of memories, some of which are very detailed. These memories are so extensive that some patients are able to hold full conversations with their other identities.
Unlike DID, schizophrenia only causes a small percentage of patients to have voices inside their head. Delusions and visual hallucinations are also very rare with this disease. In most cases, patients with schizophrenia suffer from disorganized behavior and speech as well as a lack of motivation.
What is the treatment for these diseases?
The treatment for these diseases is fairly similar. Both diseases can be treated with a combination of antipsychotic medications and therapy. Antipsychotics help to eliminate or reduce the psychotic symptoms caused by both schizophrenia and DID.
With the right treatment plan, many patients experience fewer episodes as well as shorter durations. Therapy is important for both diseases because it helps the patient understand their condition better as well as work through any emotional issues that may have been caused by the disease.
Which one is Worse?
It’s hard to say which one is worse because so many variables are different with each disease. It really depends on the patient and how they react to the disease as well as the treatment plan.
For example, it may be easier to handle voices inside your head telling you to do things than it is to cut yourself every time you have a negative feeling. That’s just one example of the differences between the diseases.
However, there are some generalizations that you can make. For one, schizophrenia is considered less common than dissociative identity disorder. Also, schizophrenia tends to begin at a much earlier age than DID.
In the most severe cases of both diseases, it is common for patients to be placed in institutions for the rest of their lives.
Sources & references used in this article:
A unified explanation for the diverse structural deviations reported for adult schizophrenics with disrupted speech by E Chaika – Journal of Communication Disorders, 1982 – Elsevier
Schizophrenic speech: Making sense of bathroots and ponds that fall in doorways by PJ McKenna, TM Oh, T Oh – 2005 – books.google.com
The neuropsychiatric mental status examination by MA Taylor – 2013 – books.google.com
Prevalence of speech and language disorders in a mental illness unit by J Emerson, P Enderby – European Journal of Disorders of …, 1996 – Taylor & Francis