Borderline Personality Disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.

Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thoughts and behaviors, and suicide.

People with BPD may experience extreme mood swings and can display uncertainty about who they are. As a result, their interests and values can change rapidly. Other symptoms include:

• Frantic efforts to avoid real or imagined abandonment
• A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
• Distorted and unstable self-image or sense of self
• Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
• Recurring suicidal behaviors or threats or self-harming behavior such as cutting
• Intense and highly changeable moods, with each episode lasting from a few hours to a few days
• Chronic feelings of emptiness
• Inappropriate, intense anger or problems controlling anger
• Having stress-related paranoid thoughts
• Having severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality

Seemingly ordinary events may trigger symptoms. For example, people with BPD may feel angry and distressed over minor separations, such as vacations, business trips, or sudden changes of plans, from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.

Some of these signs and symptoms may be experienced by people with other mental health disorders, and even by people without mental illness, and do not necessarily mean that they have BPD. It is important that a qualified and licensed mental health professional conduct a thorough assessment to determine whether or not a diagnosis of BPD or other mental disorder is warranted, and to guide treatment options when appropriate.

The causes of BPD are not yet clear, but research suggests that genetic, brain, environmental and social factors are involved.

• Genetics – BPD is five times more likely to occur if a person has a close family member (first-degree biological relatives) with the disorder
• Environmental and Social Factors – Many people with BPD report experiencing traumatic life events, such as abuse or abandonment during childhood. Others have been exposed to unstable relationships and hostile conflicts. However, some people with BPD do not have a history of trauma and many people with a history of trauma do not have BPD
• Brain Factors – Studies show that people with BPD have structural and functional changes in the brain, especially in the areas that control impulses and emotional regulation.

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. CBT is brief and time-limited compared to other therapeutic techniques. A sound therapeutic relationship is necessary for effective therapy, but is not the focus of the treatment. It is based on aspects of stoic philosophy and is a collaborative effort between the therapist and the client. Using the Socratic Method, DBP is structured and directive, based on an educational model. CBT theory and techniques rely on the Inductive Method.

CBT does not exist as a distinct therapeutic technique. The term “cognitive-behavioral therapy” is a very general term for the classification of therapies with similarities. There are several approaches to CBT, including:

• Rational Emotive Behavior Therapy
• Rational Behavior Therapy
• Rational Living Therapy
• Cognitive Therapy
• Dialectic Behavior Therapy

Most CBTs have the following characteristics:

• CBT is based on the Cognitive Model of Emotional Response. CBT is based on the idea that our thoughts cause our feelings and behaviors, not external things like people, situations, and events. The benefit if this fact is that we can change the way we think to feel – act better even if the situation does not change.
• CBT is Brief and Time-Limited. CBT is considered among the most rapid in terms of results obtained. The average number of sessions clients receive (across all types of problems and approaches to CBT) is only 16. Other forms of therapy, like psychoanalysis, can take years. What enables CBT to be briefer is its highly instructive nature and the fact that it makes use of homework assignments. CBT is time-limited in that we help clients understand at the very beginning of the therapy process that there will be a point when the formal therapy will end. The ending of the formal therapy is a decision made by the therapist and client. Therefore, CBT is not an open-ended, never-ending process.
• A sound therapeutic relationship is necessary for effective therapy, but not the focus. Some forms of therapy assume that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but that is not enough. CBT therapists believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT therapists focus on teaching rational self-counseling skills.
• CBT is a collaborative effort between the therapist and the client. CBT therapists seek to learn what their clients want out of live (their goals) and then help their clients achieve those goals. The therapist’s role is to listen, teach, and encourage, while the client’s role is to express concerns, learn and implement that learning.
• CBT is based on aspects of stoic philosophy. Not all approaches to CBT emphasize stoicism. Rational Emotional Behavioral Therapy, Rational Behavior Therapy, and Rational Living Therapy emphasize aspects of stoicism. CBT does not tell people how they should feel. However, most people seeking therapy do not want to feel the way they have been feeling. The approaches that emphasize stoicism teach the benefits of feeling, at worst, calm when confronted with undesirable situations. They also emphasize the fact that we have our undesirable situations whether we are upset about them or not. If we are upset about our problems, we have two problems – the problem, and our upset about it. Most of us want to have the fewest number of problems possible. So, when we learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a better position to make use of our intelligence, knowledge, energy, and resources to resolve the problem.
• CBT uses the Socratic Method. Cognitive-behavioral therapists want to gain a very good understanding of their client’s concerns. They encourage their clients to ask questions of themselves, like, “How do I really know that those people are laughing at me?” “Could they be laughing at something else?”
• CBT is structured and directive. CBT therapists have a specific agenda for each session. Specific techniques/concepts are taught during each session. CBT focuses on the client’s goals. CBT does not tell the client what their goals “should” be, or what they “should” tolerate. It is directive in the sense that it teaches the client how to think and behave in ways to obtain what they want. Therefore, CBT therapists do not tell the client what to do – rather, they teach the client how to do.
• CBT is based on an educational mode. CBT is based on the scientifically supported assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help you unlearn your unwanted reactions and to learn a new way of reacting. The educational emphasis of CBT has an additional benefit – it leads to long term results. When we understand how and why we are doing well, we know what to do to continue doing well.
• CBT theory and techniques rely on the Inductive Method. A central aspect of Rational thinking is that it is based on fact. Often, we upset ourselves about things, when, in fact, the situation is not like we think it is. If we knew that, we would not waste our time getting upset. Therefore, the inductive method encourages us to look at our thoughts as being hypotheses or guesses that can be questioned or tested. If we find that our hypotheses are incorrect (because we have new information), then we can change our thinking to be in line with how the situation really is.

Dialectical Behavior Therapy (DBT) is a specific type of cognitive behavioral psychotherapy that emphasized the psychosocial aspects of treatment. The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT teaches that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level emotional stimulation, and take a significant amount of time to return to baseline arousal levels.

People who are diagnosed with Borderline Personality Disorder (BPD) sometimes experience extreme swings in their emotions, see the world in black-and-white shades, and seem to always be jumping from one crisis to another. Because few people understand such reactions – most of all their own family and a childhood that emphasized invalidation – they do not have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in this task.

Characteristics of DBT

• Support-oriented: It helps a person identify their strengths and builds on them so that the person can feel better about self and their life.
• Cognitive-based:  DBT helps identify thoughts, beliefs, and assumptions that make life harder.  This requires constant attention to relationships between clients and staff.  In DBT, clients are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with the client.  DBT requires clients to complete homework assignments, to role-play new ways of interacting with others, and to practice skills such as soothing yourself when upset.  These skills, a crucial part of DBT, are taught in weekly sessions, reviewed in weekly homework groups, and referred to in every group.  The individual therapist helps the person to learn, apply and master the DBT skills.

 
Generally, DBT has two main components:

• Individual weekly psychotherapy sessions that emphasize problem-solving behavior for the past week’s issues and troubles that arose in the person’s life. Self-harm and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process.  Quality of life issues and working toward improving life in general may also be discussed.  Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses (from previous trauma in the person’s life) and helping enhance their own self-respect and self-image.  Both between and during sessions, the therapist actively teaches and reinforces adaptive behaviors, especially as they occur within the therapeutic relationship.  The emphasis is on teaching clients how to manage emotional trauma rather than reducing or taking them out of crises.  Telephone contact with the therapist between sessions is part of DBT procedures.  During the individual therapy sessions, the therapist and client work toward learning and improving many basic social skills.
• Weekly group therapy sessions, generally 2 ½ hours per session and led by the DBT therapist, where clients learn skills from one of four modules:  Interpersonal effectiveness, Distress tolerance/reality acceptance skills, Emotion regulation, and Mindfulness skills are taught.

The four modules of DBT:

• Mindfulness: The essential part of all skills taught in skills group are the core of mindfulness skills.  Observe, Describe, and Participate are the core mindfulness “what” skills. They answer the question, “What do I do to practice core mindfulness skills?”  Non-judgmentally, one-mindfully, and effectively are the “how” skills and answer the question, “How do I practice core mindfulness skills?”
• Interpersonal Effectiveness: Interpersonal response patterns taught in DBT skills training are very similar to those taught in many assertiveness and interpersonal problem-solving classes.  They include effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict.  This module focuses on situations where the objective is to change something (e.g., requesting someone to do something) or to resist changes someone else is trying to make (e.g., saying no).  The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.
• Distress Tolerance: Most approaches to mental health treatment focus on changing distressing events and circumstances.  They have paid little attention to accepting, finding meaning for, and tolerating destress. DBT emphasizes learning to bear pain skillfully.  Distress tolerance skills constitute a natural development from mindfulness skills.  They teach the ability to accept, in a non-evaluative and nonjudgmental way, both oneself and the current situation.  Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval; acceptance of reality is not approval of reality.  Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment.  Four sets of crisis survival strategies are taught:    Distracting, 2.  Self-soothing, 3.  Improving the moment, and 4.  Thinking pros and cons.  Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.
• Emotion Regulation: Borderline and suicidal individuals are emotionally intense and labile – frequently angry, intensely frustrated, depressed and anxious.  This suggests that borderline clients might benefit from help in learning to regulate their emotions.    DBT skills for emotion regulation include:
  • Identifying and labeling emotions
  • Identifying obstacles to changing emotions
  • Reducing vulnerability to “emotion mind”
  • Increasing positive emotional events
  • Increasing mindfulness to current emotions
  • Taking opposite action
  • Applying distress tolerance techniques

A person is diagnosed with a major depression when he or she experiences at least five of the symptoms listed below for two consecutive weeks. At least one of the five symptoms must be either (1) depressed mood or (2) loss of interest or pleasure.

Symptoms include:

• Depressed mood most of the day, nearly every day
• Markedly diminished interest or pleasure in activities most of the day, nearly every day
• Changes in appetite that result in weight loss or gain unrelated to dieting
• Changes in sleeping patterns
• Loss of energy or increased fatigue
• Restlessness or irritability
• Feelings of anxiety
• Feelings of worthlessness, helplessness, or hopelessness
• Inappropriate guilt
• Difficulty thinking, concentrating, or making decisions
• Thought of death, suicide or attempts at suicide

(Sources: National Institute of Mental Health HIMH and National Women’s Health Center.)

Depression is twice as common among women as among men. Twenty percent of women will experience at least one episode of depression across their lifetime. Scientists are examining many potential causes for and contributing factors to women’s increased risk for depression. Biological, life cycle, hormonal and psychosocial factors unique to women may be linked to women’s higher depression rates. Researchers have shown, for example, that hormones affect brain chemistry, impacting emotions and mood.

Before adolescence, girls and boys experience depression at about the same frequency. By adolescence, however, girls become more likely to experience depression than boys. Research points to several possible reasons for this imbalance. The biological and hormonal changes that occur during puberty likely contribute to the sharp increase in rates of depression among adolescent girls. In addition, research suggests that girls are more likely than boys to continue feeling bad after experiencing difficult situations or events, suggesting they are more prone to depression. (Sources: National Institute of Mental Health HIMH and National Women’s Health Center.)

There are several eating disorders:

• Anorexia Nervosa
• Bulimia Nervosa
• Binge Eating Disorder
• Avoidant-Restrictive Food Intake Disorder
• Other Unspecified Eating Disorders (such as Purging Disorder)

They differ based on the types of problems with eating and the factors thought to motivate those behaviors. Eating too little is often present in all of these illnesses but dominates anorexia nervosa and avoidant-restrictive food intake disorder; in binge-eating disorder and bulimia, there may be problems with eating too much and quickly but then too little most of the time. Problems with eating uncontrollably and compulsively called a binge, are part of both bulimia nervosa and binge-eating disorder. Problems with purging behaviors, such as vomiting or laxatives, can be part of all of the illnesses but is required for bulimia nervosa and purging disorder. Motivations surrounding the initiation of eating disorder behaviors vary a lot and may even change in the course of the disorders. For example, anorexia nervosa and bulimia nervosa tend to have a stronger relationship between one’s own physical appearance and self-worth but fear of eating may motivate food restriction in avoidant-restrictive food intake disorder.

A diagnosis of PANDAS or PANS means a child has had a sudden, acute onset in multiple neuropsychiatric domains and the trigger is derived from a misdirected autoimmune response to streptococcus or other bacterial, viral, environmental or immune dysfunction. It is a clinical diagnosis and a diagnosis of exclusion. PANDAS is a subset of PANS when the trigger is known to be streptococcus.

PANDAS is defined by 5 criteria:

• Abrupt, significant onset of OCD and/or Tics
• Includes other neuropsychiatric symptoms
• Prepubertal onset
• Association with streptococcal infection
• Symptoms follow relapsing-remitting course

Diagnostic criteria includes the abrupt, dramatic onset of OCD symptoms or severely restricted food intake; symptoms not better explained by a known neurologic or medical disorder; with 2 or more similarly severe accompanying symptoms:

• Anxiety
• Emotional liability and/or depression
• Irritability, aggression and/or severely oppositional behaviors
• Behavioral and/or developmental regression
• Deterioration in school performance
• Sensory or motor abnormalities
• Somatic signs including sleep disturbances

At the minimum during an initial onset, cases require:

• Throat swab to rule out strep on a 48-hour culture
• Blood labs: Streptozyme, ASO and Anti-dnase B
• Tests to rule out other infections based upon medical history intake
• Use the PANS Survey at each appointment to measure severity and duration of symptoms

 
Research indicates that tonsil and adenoid surgery may be important to consider. The longer a child has been ill, discernment of the autoimmune causation is difficult. Evaluations based on the Consensus Statement should be considered. Additional recommendations may include:

• Antibiotics with a beta-lactam course to treat infection
• Follow up to confirm remission; continued antibiotic or prophylaxis treatment may be necessary
• In severe cases, intravenous immunoglobulin (IVIG) or plasmapheresis
• Residual OCD often benefits from Cognitive Behavioral Therapy (CBT)

PTSD can cause many types of symptoms. The symptoms can be generally grouped into three categories:

• Re-experiencing symptoms:
  • Flashbacks – the trauma is relived over and over and includes physical symptoms such as elevated heart rate and perspiration
  • Nightmares
  • Frightening thoughts

Re-experiencing symptoms may cause problems in a person’s everyday routine.  They can start from the person’s own thoughts and feelings of from outside words, objects or situations that trigger re-experiencing.

Avoidance symptoms:

• Staying away from places, events or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event

Things that remind a person of the traumatic event can trigger avoidance symptoms.  These symptoms may cause a person to change their personal routine.  For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

Hyper-arousal symptoms:

• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping
• Having angry outbursts

Hyper-arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event(s).  They can make the person feel continually stressed and angry, making it difficult to do daily tasks, such as sleeping, eating or concentrating.

It is natural to have some of these symptoms after a dangerous event.  Sometimes people have very serious symptoms that go away after a few weeks.  This is called Acute Stress Disorder (ASD).  When the symptoms last more than a few weeks and become an ongoing problem, it might be PTSD.  Some people with PTSD do not show symptoms for weeks or months.

Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children, these symptoms can include:

• Bedwetting, after having been toilet-trained
• Forgetting how or being unable to talk
• Acting out the scary event during playtime
• Being unusually clingy with a parent or other adult

Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

It is important to remember that not everyone who lives though a dangerous event gets PTSD. In fact, most will not develop the disorder.

Many factors play a part in whether a person will develop PTSD. Some of these are risk factors that make a person more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some of these risk and resilience factors are present before the trauma and others become important during and after a traumatic event.

Risk factors for PTSD include:

• Living through dangerous events and traumas
• Having a history of mental illness
• Getting hurt
• Seeing people hurt or killed
• Feeling horror, helplessness or extreme fear
• Having little or no social support after the event
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, legal proceedings, or loss of a job or home

 
Resilience factors that may reduce the risk of PTSD include:

• Seeking out support from other people, such as friends and family
• Finding a support group after a traumatic event
• Feeling good about one’s actions in the face of danger
• Having a coping strategy, or a way of getting through the bad event and learning from it
• Being able to act and respond effectively despite feeling fear

A number of treatment techniques, sometimes combined with one another, are being used with varying degrees of success, to treat PTSD:

• Cognitive Behavioral Therapy (CBT), to help people recognize their ways of thinking, or “cognitive patterns,” that keep them stuck
• Exposure Therapy, to help people safely face what they fear, in order to learn to cope with it (virtual reality devices are often used to simulate a situation or setting in which the trauma took place)
• Eye Movement Desensitization and Reprocessing (EMDR), which combines exposure therapy with a series of guided eye movements that help people process traumatic memories and change the way they respond to those memories
• Anti-anxiety medications and antidepressants can also ease the symptoms of PTSD; some people with PTSD whose symptoms include insomnia or recurrent nightmares find relief with a medication called prazosin that blocks the effect of adrenaline in the body

In a 20-year study of trauma survivors, Dennis S. Charney, MD, of the Icahn School of Medicine at Mount Sinai and Steven M. Southwick, MD, of Yale School of Medicine identified ten common practices in people who have shown resilience in the face of extreme stress:

• Maintaining an optimistic but realistic outlook
• Facing fear (the ability to confront one’s fears)
• Relying upon one’s own inner, moral compass
• Turning to religious or spiritual practices
• Seeking and accepting social support
• Learning from and imitating sturdy role models
• Staying physically fit
• Staying mentally sharp
• Cognitive and emotional flexibility (finding a way to accept that which cannot be changed)
• Looking for the meaning and opportunity in the midst of adversity

Schizophrenia (/illness/schizophrenia) is a severe and debilitating brain and behavior disorder affecting how one thinks, feels and acts. People with schizophrenia can have trouble distinguishing reality from fantasy, expressing and managing normal emotions and making decisions. Thought processes may also be disorganized and the motivation to engage in life’s activities may be blunted. Those with the condition may hear imaginary voices and believe others are reading their minds, controlling their thoughts or plotting to harm them.

Most people with schizophrenia suffer from symptoms either continuously or intermittently throughout life and are often severely stigmatized by people who do not understand the disease. Contrary to popular perception, people with schizophrenia do not have “split” or multiple personalities and most pose no danger to others. However, the symptoms are terrifying to those afflicted and can make them unresponsive, agitated or withdrawn. People with schizophrenia attempt suicide more often than people in the general population, and estimates are that up to 10 percent of people will complete a suicide in the first 10 years of the illness – particularly young men with schizophrenia.

While schizophrenia is a chronic disorder, it can be treated with medication, psychological and social treatments, substantially improving the lives of people with the condition.

Schizophrenia can have very different symptoms in different people. The way the disease manifests itself and progresses in a person depends on the time of onset, severity and duration of symptoms, which are categorized as positive, negative and cognitive. All three kinds of symptoms reflect problems in brain function. Relapse and remission cycles often occur; a person can get better, worse and better again repeatedly over time.

• Positive symptoms, which can be severe or mild, include delusions, hallucinations and thought disorders. Some psychiatrists also include psychomotor problems that affect movement in this category.  Delusions, hallucinations and inner voices are collectively called psychosis, which also can be a hallmark of other serious mental illnesses such as bipolar disorder.  Delusions lead people to believe others are monitoring or threatening them, or reading their thoughts.  Hallucinations cause a patient to hear, see, feel or smell something that is no there.  Thought disorders may involve difficulty putting cohesive thoughts together or making sense of speech.  Psychomotor problems may appear as clumsiness, unusual mannerisms or repetitive actions, and in extreme cases, motionless rigidity held for extended periods of time.
• Negative symptoms reflect a loss of functioning in areas such as emotion or motivation. Negative symptom include loss or reduction in the ability to initiate plans, speak, express emotion or find pleasure in life.  They include emotional flatness or lack of expression, diminished ability to begin and sustain a planned activity, social withdrawal and apathy.  These symptoms can be mistaken for laziness or depression.
• Cognitive symptoms involve problems with attention and memory, especially in planning and organizing to achieve a goal.  Cognitive deficits are the most disabling for patients trying to lead a normal life.

• Paranoid schizophrenia – feelings of extreme suspicion, persecution or grandiosity, or a combination of these
• Disorganized schizophrenia – incoherent thoughts, but not necessarily delusional
• Catatonic schizophrenia – withdrawal, negative affect and isolation, and marked psychomotor disturbances
• Residual schizophrenia – delusions or hallucinations may go away, but motivation or interest in life is gone
• Schizoaffective disorder – symptoms of both schizophrenia and a major mood disorder, such as depression

Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30. Men tend to experience symptoms earlier than women. Most of the time, people do not get schizophrenia after age 45. Schizophrenia rarely occurs in children, but awareness of childhood onset schizophrenia is increasing.

It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems and irritability – behaviors that are common among teens.

A combination of factors can predict schizophrenia in up to 80 percent of youth who are at high risk of developing the illness. These factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop the disease, this stage of the disorder is called the “prodromal” period.

Currently, schizophrenia is diagnosed by the presence of symptoms or their precursors for a period of six months. Two or more symptoms, such as hallucinations, delusions, disorganized speech, and grossly disorganized or catatonic behavior, must be significant and last for at least one month. Only one symptom is required for diagnosis if delusions are bizarre enough or if hallucinations consist either of a voice constantly commenting on the person’s behavior/thoughts, or two or more voices “conversing.” Social or occupational problems can also be part of the diagnosis during the six-month period.

Research to find markers, such as abnormal brain scans or blood chemicals that can help detect early disease and allow for quicker interventions is now being done. Scientists are also working to understand the genetic and environmental mechanisms that combine to cause schizophrenia. As more is discovered about chemical circuitry and structure of the brains of people with the disease, better diagnostic tools and early intervention techniques can be developed. This is crucial for schizophrenia as it is believed that with every psychotic episode, increased impairment is done to the brain.

While no cure exists for schizophrenia, it is treatable and manageable with medication and behavioral therapy, especially if diagnosed early and treated continuously. Those with acute symptoms, such as severe delusions or hallucinations, suicidal thoughts or the inability to care for oneself, may require hospitalization. Antipsychotic drugs are the primary medications to reduce the symptoms of schizophrenia. They relieve the positive symptoms through their impact on the brain’s neurotransmitter systems. Cognitive and behavioral therapy can then help “retrain” the brain once symptoms are reduced.

These approaches improve communication, motivation and self-care and teach coping mechanisms so that individuals with schizophrenia may attend school, go to work and socialize. Patients undergoing regular psychosocial treatment comply better with medication, and have fewer relapses and hospitalizations. A positive relationship with a therapist or a case manager gives a patient a reliable source of information about the disease, as well as empathy, encouragement and hope. Social networks and family member support have also been shown to be helpful.