Scenario for developing schizophrenia

There is no hard and fast incontrovertable scenario for the development of schizophrenia. There is no scientific underpinning, randomised control trialled, clearly evidence based, epidemediological model to explain how schizophrenia comes about.

There is an anecdotal model for the development of schizophrenia. This posits an underlying predisposition to develop psychosis, which is triggered by life events. Typically this change will take place in the late teens or early twenties. It involves the development of delusions and paranoia, which may be manifested in behavioural changes. I am happy that this is a useful definition of how I developed schizophrenia. It is useful because it introduces helpful therapies: suitable medication, and talking therapy.

For me, I have developed euphoria during periods of severe illness, and I also subscribe to the belief that schizophrenia and bipolar disorder are on a continuum that does not preclude schizophrenia from being accompanied by mood changes, and does not exclude the possibilty of delusions occurring to someone with bipolar disorder. I have not been assessed with schizo-affective disorder, which I believe fills the space between schizophrenia and bipolar disorder. As well as developing delusions and paranoia, these unhelpful conditions have been the backdrop for severe behavioural changes, ranging from bizarre dressing to living for periods of many months in bus shelters. The dropping off of antipsychotic medication during periods of illness has resulted in heightened mood and euphoria, with sleep being unneccessary sometimes for four or more days and nights.

However, the anecdotal scenario above on how schizophrenia comes about is not an exclusive definition. Some people can develop late-onset schizophrenia into their mature years, and some young people may also be affected. I appreciate that the disagnosis of schizophrenia is not welcome for some people, and I respect that. Schizophrenia is sometimes (particularly in the popular mind) associated with hearing voices or with visual hallucinations. This may not be helpful to all voice hearers, and their informed decision to abrogate the label of schizophrenia can be beneficial. Indeed one voice hearer at least has no medication or psychiatric intervention, and has obtained a first class honours degree and follows a successful career.

Yes, my born name is Voyce, and I have a diagnosis of schizophrenia. I do not hear voices, my delusions occur around the misinterpretation of everyday events, where my view of things is not shared by the majority of people, and may be erroneous. My trigger events were: the loss of a leg in a road traffic collison at age 17; the heavy smoking of cannabis in my early twenties with a large but inadequate sum of compensation whilst at Reading University; my parents' divorce and the breaking up of the family firm which provided me with casual employment; and the result of a fail from my final examinations at Reading at age 23. This is discussed by Richard Bentall in 'Madness Explained' and gives a fuller view of the triggers that bring about the onset of schizophrenia. My view of triggers may be superficial, and as with many aspects of social science, understanding will change and develop over time.

After age 40, circumstances brought about therapeutic treatment for my illness, and the diagnosis of schizophrenia has at last meant help from suitable medication and talking therapy. Schizophrenia is however in the 21st century a 100-year-old descriptor which has become severely prejudicial, and I would agree if it was dropped and replaced with another term. I understand this has been accomplished in Japan and Holland.