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Multiple Personalities?
by Drew Westcott

In the movie "What About Bob?", Bill Murray's character recites a poem when he is humoring the doctors in a hospital. He says, "Roses are red, violets are blue. I'm a schizophrenic, and so am I." Schizophrenia is classified at the most chronic and disabling mental illness, but contrary to common misperception, schizophrenics do not experience the sensation of multiple personalities. Schizophrenics, instead, display other symptoms which usually become apparent during late adolescence or early adulthood. Men and women are equally affected to this disease which affects about 1 percent of adults and 0.005 percent of children.

Doctors have developed several theories regarding the causes of schizophrenia. Although symptoms may not appear until adolescence or early adulthood, doctors believe it is likely that viral infections or other environmental factors affects the brains of schizophrenics when they are still within the mother's womb. As a result, they have noticed imbalances of the neurotransmitters dopamine and serotonin within the brain. Up close and personal looks at the brain of schizophrenics have revealed the transfer of excess dopamine and seratonin between nerve cells. In addition, magnetic resonance imaging scans (MRIs) have shown enlargements of ventricles within the brain, reducing the total cerebral capacity. Thus, doctors have discovered that a schizophrenic's brain is less active in certain parts when they are asked to perform simple tasks such as reading a list of words.

A schizophrenic's symptoms can be divided into two categories: negative and positive psychotic symptoms. Negative psychotic symptoms are the more common and less obvious indications that one may have the disease. They appear gradually and may begin with lack of motivation and social withdrawal. An observer may notice one's poverty of speech, where random and incoherent words or statements are spoken at a time. This poverty of speech may be attributed to a schizophrenics difficulty in concentrating; they may claim that words either disappear or are stolen from their mind. Ultimately, one will find it difficult to make emotional connections with schizophrenics. Schizophrenics usually display positive psychotic symptoms during acute attacks, which occur unexpectedly. Positive symptoms are the more serious warning signs. They include hallucinations, delusions, disorganized speech, and disorganized behavior. Schizophrenics may claim that they hear voices commenting on what they are doing or telling them what to do. They may experience seemingly real sensations of people giving them poison or attacking them. One does not, however, experience a "dual personality". People diagnosed with schizophrenia display combinations of negative and positive psychotic symptoms, combinations that vary from person to person. People exhibiting a combination of these symptoms should be admitted into a hospital for observation to make sure that they have not acquired a physical illness, such as a brain tumor.

The severity of a schizophrenic's affliction may determine the type of treatment they receive, but in most cases, treatment includes drugs, psychotherapy, and rehabilitation. Drugs are prescribed to remedy the problem of abnormal brain chemistry and are ingested during times of acute attacks. The most common and effective drugs are special tranquilizers, but in rare cases, antidepressants and electroshock therapy may be recommended. Psychotherapy and rehabilitation help a schizophrenic to understand the stresses and pressures that contribute to their condition. They learn how to deal with complex and day-to-day situations without becoming emotionally or mentally upset. After successful rehabilitation, many schizophrenics prepare to return to the real world. Since many schizophrenics have a chronic form of the disease, drugs are taken over a lifetime to contradict problems resulting from brain structure abnormalities.

Doctors have only been able to make clear distinctions between paranoid schizophrenia other types. People with this variation of the disease are characterized as being constantly suspicious and resentful. Paranoid schizophrenics are distrusting of certain people because they fear that they are hostile or plotting to decimate them. Paranoid schizophrenics may exhibit the usual symptoms as well.

There are no major complications [of schizophrenia] except that the illness is lifelong, and acute attacks tend to come and go during times of emotional stress. Childhood schizophrenia tends to be harder to treat and has a worse prognosis than the adult form, although there are are similarities in brain structure. Complications in diagnosis may occur because of the similarities of symptoms between schizophrenia and related disorders.

If the poem in "What About Bob?" was adjusted to be [medically] accurate, it might go: "Roses are red, violets are blue. I'm a schizophrenic, and they're coming to get me."


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