Briefing - Schizophrenia, bipolar disorder, schizo-affective disorder and clinical depression
Schizophrenia, bipolar disorder, schizo-affective disorder and clinical depression are the severe mental illnesses explained here. This does not mean that other conditions are not regarded as serious. For more details of other related publications that that explain this issue, see the list at the end of this briefing.
Schizophrenia
Schizophrenia is not “split personality.” It represents a breakdown of communication between different parts of the brain. The symptoms of schizophrenia include:
- Hallucinations and delusions
- Slowness to think, speak or move
- Disrupted thought patterns
- Inappropriate emotional responses such as laughing at sad situations
- Trouble in communicating thoughts and feelings.
During an acute psychotic episode, the person may experience panic, anger with over-activity and periods of complete withdrawal and self-neglect.
Any or all of these can leave the person experiencing them socially isolated and they may withdraw from the world around them. They may also experience depression as a result of these difficulties and learning to cope with them.
Facts and figures: schizophrenia is estimated to cost the NHS around £1 billion, or 5% of its total budget, more than any other mental illness 1. About one third of ‘street homeless’ people in the UK are thought to have a diagnosis of schizophrenia 2.
Bipolar disorder
In bipolar disorder or bipolar affective disorder, also known as manic depression, people experience episodes of both mania (highs) and depression (lows), often for lengthy periods and sometimes with many years between episodes.
Periods of mania can lead to increased energy, over-activity, racing thoughts and speech, reduced sleep, and loss of normal social inhibitions. People may go on spending sprees or start unrealistic projects.
For some people experiencing mania there is irritability, or feelings of anger and inappropriate aggression rather than high mood. Self-neglect – in extreme cases, forgetting to eat, drink or wash – can result in severe dehydration or starvation.
Facts and figures: around one in a hundred people will experience bipolar disorder in their lifetime 3. There are 370 hospital admissions per 10,000 of the population per year for manic depression – yet only 3% of these are for first-time admissions, reflecting the recurrent nature of the illness 4.
Schizo-affective disorder
Schizo-affective disorder is the medical term used where the symptoms of depression or mania and symptoms of schizophrenia are present at the same time or within a few days of each other. This is quite common and usually the schizophrenia symptoms are more obvious. Where the mood disorder is more pronounced the condition is more often called depressive or manic psychosis.
Facts and figures: About one in every two hundred people (1/2 percent) develops schizoaffective disorder at some time during his or her life 5. Schizoaffective disorder effects more women than men, and the average age of onset is usually in the late 20s. As many as 20% of people with severe and persistent mental illness may have schizoaffective disorder.
Clinical depression
In clinical or severe depression the lows are much more severe and persistent than in common depressions. People who are effected may also experience psychosis, usually with strong feelings of guilt or persecution. They may hear critical voices in their head. The symptoms of severe depression include:
- A low mood
- Loss of interest in life or pleasurable pursuits
- Reduced attention and concentration levels
- Thoughts of guilt and worthlessness
- Low self-esteem and reduced energy levels.
These can lead to feelings of hopelessness and suicidal thoughts. Physical symptoms include:
- Loss of appetite and weight
- Digestive problems
- Disturbed sleep patterns
- Reduced activity and interest.
Facts and figures: around one in 20 people will experience clinical depression at any one time – by 2020, the World Health Organisation estimates it will be second only to heart disease as the second largest international health burden.
References
- Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia, National Institute for Clinical Excellence, June 2002
- Kavanagh S, & Opit L, ‘The prevalence of schizophrenia amongst the homeless and prison populations in England’, Personal Social Services Unit, 1994
- World Health Organisation, 1995
- The Bipolar organisation (previously The Manic Depression Fellowship)
- University of California (UCLA) Neuropsychiatric Institute (NPI) website.
National Alliance for the Mentally Ill (NAMI) Vermont website.
