Early signs and symptoms of schizophrenia in women

The first external signs, unusual behavior are noticed by the close circle and can suggest that the woman needs to pay attention to her mental status, go to a consultation with a psychotherapist or psychologist, but in no case are they a reason for home diagnosis of mental illness. Moreover, in the same way that schizophrenia begins in women, other, more harmless disorders provoked by acute or chronic stress also manifest.

The precursors of schizophrenia in women are non-specific, however, the appearance of the symptoms listed below should not be ignored.

One of the earliest manifestations of schizophrenia, as well as depressive states, is a gradual lack of interest in one's appearance. Women, in general, attach great importance to this factor. And if a previously neat, well-groomed lady wears the same dress for weeks, with peeling varnish, unkempt hair, and stops doing her usual makeup, then these are already alarm bells. Sometimes a woman begins to dress very bizarrely and completely inappropriately for the occasion. Family members may notice that their daughter or mother has stopped brushing their teeth regularly, takes a shower much less often, changes clothes, and the intervals between these actions are lengthening. At the very least, such symptoms indicate emotional burnout, when habitual and automatic actions become simply impossible to perform.

At the same time, you can notice that the sociable girl who often hangs on the phone has started to sit at home more, communicate less with her girlfriends and friends, even with family members. At the same time, you can notice that this is not caused by some new hobby or work. She just sits or lies, clearly doing nothing, preferring solitude to everything, stops watching her favorite movies, reading her favorite books, doing what she used to be interested in. She is not attracted to new clothes, her favorite food before. Later, she may begin skipping classes if the girl is studying, absenteeism from work, loss of interest in walks, visiting theaters, cinema, exhibitions - everything that used to interest her. The periods of isolation increase, she clearly prefers her own company.

Of course, there are more reserved and more sociable women, however, all of them are capable of solving several problems at the same time, share their experiences with friends, and are not indifferent to their appearance. They tend to improve and decorate everything. Therefore, the above-described changes in behavior become noticeable quite quickly.

Behavior in women with schizophrenia changes because their perception of the world changes. In addition to withdrawal and disdain for appearance, noticeable suspiciousness, unfriendly attitude towards others, and sometimes outright causeless hostility attract attention. The look of patients becomes expressionless, turned inward. The emotional component is lost, however, patients can express emotions, laugh and cry, completely inappropriately, inconsistent with the situation, some of their thoughts and experiences.

They may experience increased sleepiness or insomnia, problems with concentration are noticeable, which negatively affects their studies or professional activities. Although the knowledge and skills acquired before the manifestation of the disease are preserved.

Characterized by inadequate reactions, strange statements, complete intolerance to criticism directed at oneself, it is impossible to convince a schizophrenic by any reasonable arguments or logical conclusions.

Another possible sign of schizophrenia is a sudden strong passion for religion, occultism, esotericism, superstition. This is facilitated by an ever-increasing detachment from reality. Schizophrenic women are more susceptible to supernatural beliefs and over time can completely immerse themselves in a mystical, unreal world.

It is necessary to pay attention to the appearance of unusual motor activity - more intense facial expressions, fussy movements, twitching of arms and legs. At the same time, suddenly appeared slowness, decreased motor functions, tremor from tension can also appear in the prodrome of schizophrenia. Strange pretentious speech, often full of neologisms, repetitions, inconsistency should attract attention.

The appearance of auditory hallucinations is registered in most patients with schizophrenia. They hear voices discussing them in the third person, giving commands, scolding or mocking. Other types of hallucinations are also possible - tactile, auditory, however, they are much less common. From the outside, the presence of hallucinations is manifested in conversations with oneself, and it is noticeable that the woman is clearly talking to someone or answering questions, she usually looks worried or irritated, she can start crying or laughing, fall silent and listen, look closely. The impression of a dialogue with an invisible interlocutor is created.

Some thoughts are perceived by the patient as alien, put into her head from the outside. Sometimes she says that her thoughts are open to everyone, anyone can read them or steal them. This phenomenon is called the echo of thoughts.

In addition to this and hallucinations, the productive symptoms of schizophrenia include delusions of influence, which order one to perform certain actions, think in a certain way, or feel something. Other delusional ideas may appear, very stable, absolutely incompatible with the cultural traditions of society, and fantastic.

Signs of the appearance of delirium are: unfounded hostility or suspicion towards loved ones or complete strangers, fear for one's life or the life of loved ones, visible symptoms of fear - various protective actions (locking windows and doors, additional locks, darkening windows, checking food for poisoning), assertion of threats, persecution or one's own great mission, constant complaints about neighbors, employees, their children who interfere, harm, damage property, etc.

One of these symptoms (the big ones), clearly expressed and not going away for more than a month, is enough to raise the question of diagnosing schizophrenia.

Minor symptoms of the same duration include:

• constant hallucinations of any kind in combination with the periodic appearance of delusional ideas, sometimes not fully formed, without a pronounced affective component, or the presence of a constant overvalued idea;
• catatonic syndrome – stupor, agitation, catalepsy, negativism and other movement disorders;
• apathetic-abulic syndrome, practical absence of emotions, their inadequacy, impoverishment of speech, neologisms;
• disorganization of the thought process, expressed in fragmented, inconsistent, constantly switching speech, lack of logic and switching of attention from one thought to another, completely unrelated to it, raisonné;
• a gradual, noticeable change in the qualitative characteristics of behavior towards passivity, desocialization, and isolation.

The last groups of symptoms relate to cognitive disorders, indicate the beginning of personality disintegration and the loss of entire layers of the psyche. Such symptoms are called negative.

The patient must have at least two minor signs. Schizophrenics may have other symptoms - pronounced depersonalization/derealization syndrome, dysmorphophobia, hypochondria, senestopathies, sexual perversions.

The course of schizophrenia in women is usually accompanied by affective disorders (mood disturbances) in the form of depression (depressed mood, characterized by pessimism, inhibition, melancholy, a sense of inferiority, guilt, suicide attempts) or mania (hyperactivity, agitation, unreasonably elevated mood). The mildest manic state is called hypomania. It is often mistaken for natural cheerfulness, some exaltation, optimism, swagger. The painfulness of such manifestations becomes obvious when hypomania is replaced by depression without any reason, or manic symptoms worsen and go beyond the norm - obvious overestimation of one's own strength, fantastic projects, constant agitation, ridiculous actions in connection with the implementation of unrealistic plans. Schizophrenics usually have complex symptom complexes, when depression and mania are accompanied by hallucinations and delusions, cognitive and motor disorders, somatic symptoms - hyperhidrosis, sleep disorders, cardiac activity, endocrine disorders - anorexia, bulimia, menstrual cycle disorders.

Signs of schizophrenia in young women after 20 years, as well as in older women (after 30, 40 years), in principle, are no different. The subject of delirium may differ: some have megalomania, others have persecution mania or pathological jealousy, some of the symptoms listed above may be more pronounced, while others may not be present at all.

Schizophrenia should only be diagnosed by an experienced psychiatrist based on a comprehensive examination. In adults, a specific symptom complex should be identified, and other diseases, tumors, and injuries should be excluded.

The first signs of schizophrenia in children are very different - they are erased, and manifest themselves differently in different age groups. Up to two years old - these are irrational fears, for example, fear of a certain color; in older children, paradoxical development - according to some indicators, the child is ahead of the norm, according to others - lags far behind; when the child's social life becomes more active - obsession, aggressiveness, indifference begin to appear, and these signs are obvious to everyone. Later, children with schizophrenia become difficult to manage, show a tendency to run away from home, use psychoactive substances, become withdrawn or, conversely, are prone to unchildish wisdom, philosophizing. In childhood, especially in girls, schizophrenia manifests itself extremely rarely.

Postpartum schizophrenia in women develops in the presence of a genetic predisposition. Pregnancy and childbirth are a serious burden on the body and can become a factor provoking the onset of the disease. Psychological and social factors - lack of support from a husband and parents, unstable financial situation and others are additional stressors. Childbirth can also provoke an exacerbation of schizophrenia if the woman suffered from it before. Postpartum psychosis occurs in one or two women in a thousand, and not all of them are manifestations of schizophrenia. As a rule, these are short-term disorders.

The young mother's worries usually center around a recent event and are related to the child - she may worry that the milk has disappeared and the child is hungry, that he is sick, that he will be taken away or replaced with someone else's, sometimes there is rejection of the child - the mother does not want to see him, pick him up, feed him. Psychoses are accompanied by agitation or apathy, loss of strength, insomnia, and sudden mood swings. Schizophrenics may exhibit all the symptoms of the disease - hallucinations, delirium, catatonia, depersonalization, etc. Drug treatment usually quickly stops the psychosis, and the young mother returns to normal. Ignoring abnormal behavior can lead to negative consequences.

Schizophrenia in elderly women rarely develops, sometimes the disease manifests itself at a young age and after timely successful treatment does not make itself known for many years, and in old age the disease progresses again. The symptoms of schizophrenia in adults do not depend on age, its manifestations are the same: productive symptoms and subsequent development of negative symptoms. Schizophrenia with a late (after 40 years) and very late onset (after 50, 60 years) is usually characterized by the absence or weakly expressed negative symptoms and a good response to antipsychotic therapy. In old age, women are more often affected, and these cases, as a rule, are not associated with a family history. They are more often associated with bouquets of somatic diseases acquired with age, provoked by taking a large number of drugs, loneliness, age-related changes in the sense organs and the brain. Senile schizophrenia is manifested by the emergence of obsessive thoughts, actions and fears. Social isolation is often voluntary, there are almost always hallucinations, and in most cases tardive dyskinesia develops.

Schizophrenia in women and family problems

A social unit that includes a schizophrenic of any gender and age is not to be envied. The situation is especially sad if the mother of the family is ill. Schizophrenics experience serious changes in the sensory-emotional sphere, and at first the highest feelings and emotions associated with compassion, altruism, love, which require intense emotional feedback, are deformed. Consequently, first of all, the patient is strained by relationships with loved ones. The decline in mental activity leads to the fact that what tires the most is not formal communication, but communication with spiritually close, loving and beloved people, whose support and love the patient still needs, but who no longer has the strength to reciprocate feelings. Therefore, at the unconscious level, patients quite aggressively reject the most energy-consuming relationships with loved ones. At the same time, they feel the need for participation, support and are very sensitive to indifference to themselves.

The progressive disease leads to the woman becoming increasingly distant from her loved ones, nothing excites her except some personal far-fetched ideas. Withdrawal into oneself, constant loss of strength, inability to take care of oneself and family members is often interpreted as laziness and negligence. The patient's suspiciousness, which gives rise to unfounded jealousy, the emergence of delusional ideas, some of her own, absurd, incomprehensible to others interests, activities, provokes frequent scandals and leads to the fact that the family often breaks up, when no one yet realizes that it is the disease that is the cause of the mother's inadequacy.

Of course, children suffer the most in such a situation. They are completely dependent on adults and cannot influence the situation in any way. It is good if the father or grandparents, loving and adequate, notice something wrong in time and seek medical help.

As a consolation, I would like to say that in women, in general, schizophrenia occurs in a milder form than in men and practically does not lead to gross destruction of personality.

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How to recognize schizophrenia in women, diagnostics

There are no tests or instrumental studies that could reliably confirm the diagnosis of this disease. Diagnosis is based on the presence of specific behavioral signs and symptoms in the patient that indicate disturbances in the sphere of thinking - lack of logic, verbosity, pretentiousness of expressions, symbolism, inadequacy of reactions. If schizophrenia is suspected, the family history is studied, the patient's behavior is examined, they talk to her and her relatives, ask about sensations in order to identify the presence of hallucinations and delirium. It is best to place the patient in a hospital for diagnosis, where she will be under constant supervision of medical specialists.

Symptoms and their dynamics are observed over the course of six months; if they persist, differential diagnostics are performed using laboratory and instrumental studies that help identify and exclude organic causes of the appearance of schizophrenia-like symptoms.

There is no specific test for schizophrenia in women. There are various test studies that allow one to assume the presence of schizophrenia or schizotypal disorder. They are intended for patients of any gender and age, but their results are not a final verdict. The tests are also used in medical diagnostics, however, rather as additional studies to assess the level of mental perception in the patient.

The clinical picture of schizophrenia is quite complex and always represents a combination of the main symptoms – loss of associative connections and clarity of thinking, inability to think and act purposefully, alienation and coldness, monotonous mood, increasing passivity and gradual withdrawal from active life.

Differential diagnosis is carried out with schizophrenia-like disorders – neuroses and psychopathies, in which there is no progression of true schizophrenia.

Acute polymorphic attacks of the disease are differentiated from psychoses during infections and intoxications, especially since even their proven presence cannot completely exclude schizophrenia. The final diagnosis is made based on the results of the catamnesis collected during the course of the disease. After an acute attack, schizophrenics usually experience psychomotor retardation, decreased activity and expression of emotions, poor speech and facial expressions, indifference to appearance and sanitary conditions.

Manic-depressive psychosis with an atypical course resembles schizophrenia, however, the presence of the phenomenon of "echo of thoughts" does not occur with a pure mood disorder in any phase. And at the end of affective psychosis, a complete remission occurs with the restoration of all personal qualities. After an attack of schizophrenia with elements of mania and depression, the personality is somewhat transformed and some mental deficit occurs.

When diagnosing schizophrenia, cases of schizophrenia-like symptoms in the presence of epilepsy, obvious organic pathologies of the brain, connections with trauma and abuse of psychoactive substances are distinguished.

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Consequences and complications

Schizophrenia itself is not fatal, however, the development of negative symptoms can lead to life-threatening complications for the patient and those around her. The disease must be treated, since adequate therapy reduces the risk of increasing detachment, social maladjustment, complete helplessness and dependence.

A dangerous complication of schizophrenia is the development of psychomotor agitation. In this state, the patient is a danger to herself and others. This type of exacerbation occurs suddenly, is characterized by unmotivated aggression, hyperactivity, develops rapidly and requires emergency psychiatric care.

Depressive-delusional attacks of schizophrenia, accompanied by delusions of sinfulness or self-accusation, are dangerous, since patients in such a state often commit so-called extended suicides, killing their loved ones and then themselves out of far-fetched good intentions.

Suicidal tendencies are typical for schizophrenics, about a third of patients attempt to take their own lives. The likelihood of such an outcome is increased by the active period of the disease and frequent exacerbations, the depressive state of the patient, abuse of psychoactive substances, to which schizophrenics are prone. About half of the patients use such means as a preventive measure against depression, to relieve sad and anxious thoughts about the future, to forget at least for a while, which negatively affects the course of the disease, increases the frequency of exacerbations, increases the likelihood of suicide and violence, accelerates the development of negative symptoms. Patients become resistant to treatment, the likelihood of a favorable outcome decreases several times.

Nicotine addiction among schizophrenics is three times higher than among the mentally healthy population, it is more difficult for them to quit smoking. It turns out that this habit has not only a detrimental effect on general health. Research has shown that smoking somewhat neutralizes the effect of neuroleptics, and smoking patients require higher therapeutic doses of drugs.

The social danger of schizophrenic patients is greatly exaggerated, however, its probability should not be underestimated. It increases during periods of exacerbation, when there is a high probability of developing psychomotor agitation.

The consequences of the disease are reduced with a later onset. A stable position in society, high professional skills and social activity increase the likelihood of a favorable outcome of treatment and maintaining self-sufficiency.

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Prevention

Modern medicine cannot yet give a precise answer to the question of why only half of children, even if both parents are schizophrenic, get sick. Since the causes of the disease have not been precisely established, preventive measures are of a general nature. A healthy lifestyle and positivism will definitely not hurt anyone.

Prevention of schizophrenia is more concerned with preventing exacerbations. And this, in turn, is determined by the pragmatic attitude to the disease of both the patient herself, her ability to react to the first signs of exacerbation, and her family members, their awareness, readiness to help cope with the problem, and calmly discuss it. This formulation of the issue prevents stigmatization and promotes successful treatment and social readaptation.

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Forecast

Currently, there are a number of effective psychotropic drugs that allow the majority of patients to maintain an active social standard of living. Schizophrenia in women, in general, has a fairly favorable prognosis, since it develops at a relatively mature age. Successful treatment is facilitated by the high social status of patients and the manifestation of the disease, provoked by a psychotraumatic event.

The variant of the disease debut in the form of acute psychosis and rapid provision of intensive medical care is considered more favorable for the patient than imperceptible development and late treatment with the growth of noticeable alienation, emotional dullness, apathy. Alcoholism and drug addiction aggravate the prognosis even more.

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