Early signs and symptoms of schizophrenia in women

The first external signs, unusual behavior are noticed by the close environment and may suggest that a woman needs to pay attention to her mental status, go to a psychotherapist or psychologist for a consultation, but in no case are they not a reason for diagnosing a mental illness at home. Moreover, the way that schizophrenia begins in women also manifests other, more harmless disorders, triggered by acute or chronic stress.

The harbingers of schizophrenia in women are not 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 its appearance. Women generally attach great importance to this factor. And if the previously tidy, well-groomed lady walks in the same dress for weeks, with a shabby polish, untidy hair, ceases to do the usual makeup, then this is alarming bells. Sometimes a woman begins to dress very bizarrely and is completely irrelevant. Pets may notice that their daughter or mother has stopped brushing her teeth regularly, takes a shower less often, changes clothes, and the intervals between these actions are lengthened. At the very least, such symptoms speak of emotional burnout, when habitual and automatical actions become simply unfeasible.

In parallel, it can be noted that the sociable and often hanging on the phone the girl began to sit more at home, to communicate less with her friends and friends, even with family members. At the same time, it can be noted that this is not caused by any new hobby or work. She just sits or lies, obviously doing nothing, preferring to be alone, stops watching her favorite movies, reading her favorite books, doing things that fascinated her before. She is not attracted by the new clothes, previously loved food. Absences of classes can begin later if a girl studies, absenteeism at work, loss of interest in walks, visits to theaters, cinemas, exhibitions — everything that used to fascinate her. The gaps of isolation are increasing; she clearly prefers her own society.

Of course, there are more closed and more sociable women, however, they are all capable of simultaneously solving several tasks, sharing their experiences with friends, are not indifferent to appearance. They tend to improve and decorate everything. Therefore, the above-described changes in behavior become noticeable fairly quickly.

Behavior in schizophrenia in women changes as their attitude changes. In addition to the care in and neglect of appearance, noticeable suspicion, unfriendly attitude towards others, sometimes outright unreasonable hostility attracts attention. Looking sick becomes expressionless, turned inward. The emotional component is lost, however, patients can express emotions, laugh and cry, completely inappropriate, in inconsistency with the situation, some kind of thoughts and experiences.

They may have increased drowsiness or insomnia, problems with concentration of attention are noticeable, which adversely affects their studies or professional activities. Although the knowledge and skills acquired before the manifestation of the disease persist.

Inadequate reactions, strange statements, sheer intolerance of criticism, schizophrenic cannot be overridden by any reasonable arguments and logical conclusions.

Another possible sign of schizophrenia is a sudden strong passion for religion, the occult, esoteric, superstition. This contributes to an increasing separation from reality. Schizophrenic women are more susceptible to supernatural beliefs and, over time, can completely immerse themselves in the mystical unreal world.

You should pay attention to the emergence of unusual motor activity - more intense facial expressions, fussy movements, twitching arms and legs. At the same time, suddenly appeared slowness, decrease in motor functions, stress tremor can also appear in prodrome of schizophrenia. A strange fanciful speech, often full of neologisms, repetitions, and inconsistency, must be noticed.

The occurrence of auditory hallucinations is recorded in most schizophrenic patients. They hear voices discussing them in the third person, giving commands, scolding or mocking. Other types of hallucinations are not excluded - tactile, sound, however, they are much less common. On the part, the presence of hallucinations is manifested in conversations with oneself, and it is noticeable that the woman is obviously talking to someone or answering questions, her appearance is usually worried or irritated, and she can start crying or laughing, becoming silent and listening, looking. The impression of a dialogue with an invisible interlocutor.

Some of the thoughts are perceived by the patient as strangers, embedded in 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 an echo of thoughts.

Besides him and hallucinations, the productive symptoms of schizophrenia include delusions of influence, ordering to perform certain actions, to think in a certain way, to sense something. There may be the emergence of other delusions, very stable, absolutely incompatible with the cultural traditions of society, fantastic.

Signs of the appearance of delirium are: groundless hostility or suspicion towards relatives or strangers, fear for their lives or loved ones, visible symptoms of fear - various protective actions (locking windows and doors, additional locks, shading windows, checking food for poisoning ), allegations of threats, harassment or their own great mission, constant complaints against neighbors, employees, their children, who interfere, harm, damage property, etc.

One of these symptoms (large), clearly expressed and not passing for more than a month, is enough to raise the question of the diagnosis of schizophrenia.

The minor symptoms of the same duration include:

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

The last groups of symptoms relate to cognitive impairment, indicate the beginning of personal disintegration and loss of whole layers of the psyche. Such symptoms are called negative.

The patient must have at least two small signs. Schizophrenics can also have other symptoms - pronounced depersonalization / derealization syndrome, dysmorphophobia, hypochondria, senesthopathy, sexual perversions.

The course of schizophrenia in women is usually accompanied by affective disorders (mood disorders) in the form of depressions (depressed mood characterized by pessimism, lethargy, anguish, inferiority, guilt, attempted suicide) or mania (hyperactivity, agitation, unreasonably high spirits). The easiest manic state is called hypomania. She is often mistaken for natural gaiety, some exaltation, optimism, swagger. The painfulness of such manifestations becomes apparent when hypomania gives way to depression without any reason, or the manic symptoms become aggravated and go beyond the limits of the norm - an obvious overestimation of one's own forces, fantastic projects, constant agitation, absurd acts 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 such as hyperhidrosis, sleep disorders, cardiac activity, endocrine disorders - anorexia, bulimia, menstrual disorders.

Signs of schizophrenia in young women after 20 years, as well as in more adults (after 30, 40 years), in principle, are no different. Subjects of nonsense may be different: someone has delusions of grandeur, others have persecution delusions or pathological jealousy, some of the above symptoms may be more pronounced, and others may not be at all.

Only an experienced psychiatrist should diagnose schizophrenia on the basis of a comprehensive examination. In adults, a certain symptom complex should be identified, other diseases, tumors and injuries are excluded.

The first signs of schizophrenia in children are very different - they are erased, in different age groups they appear differently. Up to two years are irrational fears, for example, the fear of a certain color; in older children, paradoxical development - in some indicators the child is ahead of the norm, in others - it is far behind; when a child's social life is activated, obsession, aggressiveness, indifference begins to appear, and these signs are striking to everyone. Later, children with schizophrenia become difficult to control, show a tendency to runaway from the house, use of psychoactive substances, become isolated or, on the contrary, tend to not childishly wisely, to philosophize. In childhood, especially in girls, schizophrenia is extremely rare.

Schizophrenia after childbirth in women develops in the presence of a genetic predisposition. Pregnancy and childbirth are a serious burden for the body and can be a factor that provokes the debut of the disease. Psychological and social factors - lack of support in the face of the husband and parents, precarious financial situation and others are additional stressors. Childbirth can also provoke an exacerbation of schizophrenia if a woman has had it before. Postpartum psychosis occurs in one or two out of a thousand pregnant women, and not all of them are manifestations of schizophrenia. As a rule, these are short-term disorders.

The experiences of a young mother usually center around a recent event and are related to the child - she may worry that milk is gone and the child is hungry, that he is sick, that he is taken or replaced by someone else, sometimes the child is rejected - the mother does not want to see him, take her in her arms to feed. Psychoses are accompanied by agitation or apathy, loss of strength, insomnia, an abrupt change of mood. Schizophrenic infections can show all the symptoms of the disease - hallucinations, delusions, 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 at a young age and, after timely successful treatment, does not manifest itself 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 the subsequent development of negative symptoms. Late schizophrenia (after 40 years) and very late onset (after 50, 60 years) is usually characterized by the absence or mild negative symptoms and a good response to antipsychotic therapy. In later life, women are more likely to become ill, and these cases are usually not associated with a family history. They are more often associated with bouquets of somatic diseases acquired with age, triggered by taking a large number of drugs, loneliness, age-related changes of the sense organs and the brain. Senile schizophrenia is manifested by the emergence of obsessive thoughts, actions and fears. Social isolation is more often voluntary, almost always there is hallucination, in most cases tardive dyskinesia develops.

Schizophrenia in women and family problems

The cell of the society, in which there is a patient with schizophrenia of any gender and age, is not to be envied. Especially sad is the situation if the mother of the family is sick. In schizophrenics, serious changes occur in the sensual-emotional sphere, and first of all, the higher feelings and emotions associated with compassion, altruism, and love, which require intense emotional impact, are deformed. Therefore, first of all, the patient is strained by relationships with close people. The decline of mental activity leads to the fact that it is not formal communication that bore the most, but communication with spiritually close, loving and beloved people, whose support and love are still needed by the patient, but there is no longer enough strength for the response. Therefore, at an unconscious level, patients quite aggressively reject the most energetically costly relationships with close people. At the same time, they feel the need for participation, support and are very sensitive to indifference to themselves.

The progressing disease leads to the fact that the woman is increasingly moving away from her relatives, nothing cares about her, except for some personal contrived ideas. Caring for oneself, constant breakdown, inability to care for oneself and family members are often interpreted as laziness and negligence. Suspiciousness of the patient, generating unreasonable jealousy, the emergence of delusions, some of their own, absurd, incomprehensible interests of others, activities, provokes frequent scandals and leads to the fact that the family often breaks up when no one yet realizes that the disease is the cause of the inadequacy of the mother.

Of course, children suffer the most in this situation. They are completely dependent on adults and can in no way influence the situation. Well, if the father or grandparents, loving and adequate, will notice something wrong in time and ask for medical help.

In 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 personal destruction.

[1], [2], [3], [4], [5], [6]

How to recognize schizophrenia in women, diagnosis

No tests and instrumental studies that could reliably confirm the diagnosis of this disease, does not exist. Diagnostics is carried out on the basis of the patient having specific behavioral signs and symptoms, speaking about violations of the sphere of thinking - lack of logic, verbosity, pretentious expressions, symbolism, inadequate reactions. If you suspect schizophrenia, they study the family history, examine the patient's behavior, talk with her and her relatives, and ask about feelings in order to detect the presence of hallucinations and delusions. It is best to place the patient in the hospital for the diagnosis, where she will be under constant medical supervision.

Symptoms and their dynamics are observed for half a year; in the presence of their persistent manifestations, differential diagnostics are performed using laboratory and hardware studies to help identify and eliminate the organic causes of schizophrenia-like symptoms.

There is no special test for schizophrenia in women. There are various test studies suggesting the presence of schizophrenia or schizotypal disorder. They are intended for patients of any gender and age, but their results are not the final verdict. Tests are used in medical diagnosis, however, rather, as additional research to assess the level of mental perception in a patient.

The clinical picture of schizophrenia is quite complex and is always a combination of the main symptoms - loss of associative connections and clarity of thinking, inability to purposeful thoughts and actions, alienation and coldness, monotonous mood, increase in 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 episodes of the disease differentiate from psychosis in infections and intoxications, especially since even their proven presence cannot completely exclude schizophrenia. The final diagnosis is based on the results of follow-up collected during the course of the disease. In schizophrenics, after an acute attack, psychomotor retardation, reduced activity and expression of emotions, scanty speech and mimicry, indifference to appearance and health condition are common.

The atypical manic-depressive psychosis is reminiscent of schizophrenia, however, the presence of the “thought echo” phenomenon does not occur during a pure mood disorder in any phase. And upon the completion of affective psychosis, 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.

The diagnosis of schizophrenia delimits the occurrence of schizophrenic-like symptoms in the presence of epilepsy, obvious organic pathologies of the brain, and links to injuries and substance misuse.

[7], [8], [9]

Consequences and complications

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

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

They represent the danger of depressive-delirious bouts of schizophrenia, accompanied by delusions of sinfulness or self-accusation, since patients in such a state often commit so-called extended suicides, killing their loved ones, and then themselves, from far-fetched motives.

Suicidal tendencies are characteristic of schizophrenics, about a third of patients attempt to deprive themselves of life. The likelihood of such an outcome increases the active period of the disease and frequent exacerbations, the patient’s depressive state, substance abuse, which schizophrenics are prone to. Approximately half of patients use such drugs as prevention of depression, for stopping melancholy and anxious thoughts about the future, to forget even for a time, 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 significantly.

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 overall health. Studies have shown that smoking somewhat levels the effects of neuroleptics, and smoking patients require higher therapeutic doses of drugs.

The social danger of patients with schizophrenia is greatly exaggerated, however, its probability should not be underestimated. It increases during periods of exacerbations, when there is a high likelihood of developing psychomotor arousal.

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

[10], [11]

Prevention

Modern medicine is not yet able to give an exact answer to the question why even among children, both parents of whom are sick with schizophrenia, only half of them get sick. Since the causes of the disease are not precisely established, then preventive measures are of a general nature. A healthy lifestyle, positivism will surely not hurt anyone.

Prevention in schizophrenia is more likely to prevent exacerbations. And this, in turn, is determined by the pragmatic attitude to the disease as the patient herself, her ability to respond to the first signs of aggravation, and her family members, their awareness, willingness to help cope with the problem, calmly discuss it. Such an approach prevents stigmatization and contributes to successful treatment and social re-adaptation.

[12], [13], [14], [15]

Forecast

Currently, there are a number of effective psychotropic drugs, allowing to maintain an active social standard of living of the majority of patients. Schizophrenia in women, in general, has a rather favorable prognosis, as it develops at a relatively mature age. Successful treatment is favored by the high social status of the patients and the manifestation of the disease, triggered by a traumatic event.

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

[16], [17]