Early Diagnosis of Schizophrenia May Help Mitigate Negative Effects on Brain
Playing the violin has been a big part of Bethany Yeiser’s life. Yeiser was a talented musician and a bright student throughout her high school and college years, studying science and traveling internationally with much promise for her future.
But her music and pathway to success gradually seemed to come to a halt. She recalls experiencing her first symptoms of schizophrenia shortly after she returned from a trip to Africa during her senior year of college at the University of Southern California.
"I remember that senior year, my mind was like a broken record, going back again and again to what I saw in Africa, it was like a cloud," Yeiser said. "My parents had no idea what was going on. I had had this huge personality change. I wasn’t myself anymore. It wasn’t making sense."
While the exact causes behind schizophrenia are hard to pinpoint, doctors do know most people with schizophrenia begin showing symptoms at a young age, like Yeiser, in their late teens and early twenties.
More and more, psychiatrists are recognizing the importance of identifying schizophrenia symptoms early.
"It is important for people who are diagnosed with schizophrenia, usually happening in their late teens and early twenties, to get treatment as early as possible," said Dr. Jaymie Shanker, a psychiatrist at Signature Health. "Because it seems that when we stabilize the illness early, they go on to develop fewer later symptoms of schizophrenia, and they have a better functional outcome."
Shanker says early “warning signs” of schizophrenia parents can look out for include a change in personality, as well as problems with socializing, hygiene, and school performance.
The actual symptoms of schizophrenia once the disease develops include episodes of psychosis – which involve a break from reality – auditory or visual hallucinations, delusions, paranoid thoughts, disorganized thinking and behavior, social withdrawal, and lack of motivation.
Shanker says early recognition and treatment is important because with each recurring episode of psychosis in schizophrenia, the brain has a harder time recovering from it.
"The brain seems to change with each episode of psychosis – change for the worse – has a harder time recovering back to baseline level," she said.
For Yeiser, personality changes and lack of focus in her senior year transitioned into worsening symptoms, including hallucinations.
"One day I looked in the mirror, and I saw my face. But it was a cross between my face and Lisa from the show the Simpsons," Yeiser said. "Very scary, very bizarre."
Yeiser dropped out of college, cut off contact with her parents, and became homeless in Los Angeles for 4 years, sleeping in libraries and outside in churchyards.
"I remember one morning, I woke up, the voices were worse than ever, I was screaming at the voices, running around the churchyard following the voices," she said. "Some police officer who I did not see coming came and pulled my hands behind my back and I was in handcuffs. I asked what was happening, and he told me I was being taken for an evaluation at a psych hospital."
Her parents flew out immediately to meet her, and they begged her to work with the doctors. After initially refusing treatment, she finally agreed. It was after the trial and error of several different anti-psychotic medications that Yeiser was able to find the right medicine for her, which she’s been on for 10 years now.
Dr. Erik Messamore is a psychiatrist who runs the Best Practices in Schizophrenia Treatment program at Northeast Ohio Medical University. He says that about half of people with mental illness like schizophrenia or bipolar disorder are not in treatment like Yeiser. But Messamore says it’s important to break down stigma and understand that those who do receive treatment can live normal lives.
"At least half of the people who are recognized early and given the right kind of treatment can eventually have either no dose medicines or extremely low dose medicines," Messamore said. "And the other half will have generally very significantly improved life quality and ability to function."
In addition to improving the recognition of early symptoms and managing schizophrenia as a chronic disease with medication, psychiatrists are now often taking a holistic approach to treatment of the disease.
Like programs known as ACT – or Assertive Community Treatment – teams, in which a group of specialists work together to treat schizophrenia patients, help them find jobs, and integrate them into society.
"We put them all together in one team and we see them many times a week," Shanker said. "And there has been data showing that that can help somebody get better."
Because Bethany Yeiser received treatment relatively early on in her 20s, she has been able to return to a fairly normal and successful life, and was even able to go back and finish school.
But perhaps the most fulfilling part of her recovery has been playing the violin again.
"Today it’s one of the most precious things I have, you know, my violin," Yeiser said. "And to me it’s really a symbol of my recovery. Every time I play I’m grateful for it, and I’m grateful for the life I’ve reclaimed thanks to medication and treatment."