Exploring The History Of Schizophrenia

Medically reviewed by Nikki Ciletti, M.Ed, LPC and Julie Dodson, MA, LCSW
Updated December 16, 2024by BetterHelp Editorial Team

Schizophrenia can be seen as a complex mental illness with intricate origins. Unlike ancient disorders such as melancholia or mania, the concept of schizophrenia is relatively new. Though its classification and understanding have evolved over time, schizophrenia continues to present challenges in diagnosis, treatment, and societal perception. The disorder may first have been documented in ancient Egyptian texts and was given the name “dementia praecox” in 1893. Today, it’s referred to as “schizophrenia spectrum disorder” and can often be treated with a combination of medication and therapy.

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Schizophrenia is treatable

What is schizophrenia?

Schizophrenia is a psychiatric disorder that can significantly affect both physical and mental well-being by disrupting brain function. Schizophrenia can impact cognition and impair a person’s memory, sensory perceptions, and behaviors.

Similar to other mental health conditions like depression and bipolar disorder, schizophrenia symptoms tend to appear episodically, progressing through active and residual phases. The active phase usually involves intense symptoms like hallucinations and unusual thoughts. The residual phase follows and typically features lingering but less severe symptoms, such as impaired thinking and reduced motivation.

Symptoms of schizophrenia: Delusions, negative symptoms, and more

Along with the disruption of typical daily function, active schizophrenia symptoms can lead to risky behavior and difficulty with thought organization. Individuals experiencing psychotic symptoms related to schizophrenia may not recognize their symptoms, but observers often do. 

Primary symptoms of schizophrenia

The disorder usually manifests through five primary clinical symptoms:

1. Delusions: Persistent false beliefs that cannot be changed, even with evidence to the contrary

2. Hallucinations: Sensory perceptions of nonexistent stimuli

3. Disorganized speech: Difficulty organizing coherent thoughts 

4. Disorganized movements: Unusual behaviors that deviate from established norms

5. Negative symptoms: The reduction or loss of expected behaviors, such as motivation and socialization

The impact of positive and negative symptoms

As a result, individuals with schizophrenia may experience suspicion, neglect personal hygiene, face depression and anxiety, and turn to substances for relief.

The origins of schizophrenia and early understanding of mental illness

Though symptoms of psychotic disorders and conditions similar to schizophrenia have been documented in many historic texts, the condition remains one of the most complex and misunderstood mental health disorders. The earliest origins of schizophrenia appear to date back thousands of years. In fact, a condition similar to schizophrenia was described in “The Ebers Papyrus,” an ancient Egyptian medical manuscript dating back to 1550 BC.

Early views on mental illness

However, in many ancient cultures, including Egypt and Greece, mental illness was often attributed to religious, spiritual, or supernatural causes. Throughout the Middle Ages, symptoms of schizophrenia were commonly viewed as proof of demonic possession.

Though some early scholars, such as Hippocrates, speculated that conditions like schizophrenia were rooted in biology, symptoms of schizophrenia were typically written off as “madness” and considered untreatable. These archaic misconceptions often led to the unethical and inhumane treatment of people with mental disorders. 

The history of schizophrenia

In the mid-19th century, European psychiatrists noticed a troubling trend: young individuals experiencing a gradual mental deterioration in psychiatric facilities. In 1893, Emil Kraepelin introduced the term "dementia praecox" to describe this condition. As Kraepelin continued to refine his understanding of what would eventually be referred to as schizophrenia, he acknowledged that there were various manifestations of the disorder, all sharing a common thread of cognitive decline and impaired control over actions, especially in advanced stages. 

The origin of the term “schizophrenia”

It wasn't until 1900 that Swiss psychiatrist Eugen Bleuler coined the term “schizophrenia.” Despite this terminology shift, schizophrenia remained largely misunderstood, contributing to pervasive stigma and the common practice of institutionalization well into the 20th century. Treatments during this period were often brutal and ineffective, including insulin coma therapy, Metrazol shock, electroconvulsive therapy, and even surgery, such as frontal lobotomy. The rise of eugenics further marginalized individuals with schizophrenia, subjecting many to forced sterilization.

A turning point for schizophrenia

However, advancements in medicine brought hope with the development of progressive antipsychotics like chlorpromazine in the 1950s. This generally marked a turning point, leading to widespread deinstitutionalization in the 1960s. Despite their side effects, many of these early medications are still in use today and are commonly referred to as “typical antipsychotics.”

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Moving past the dark history of schizophrenia

Though mental illness and schizophrenia may continue to face stigma to this day, the dark history of schizophrenia can highlight the evolution of psychiatric understanding and treatment, from early misconceptions and harsh interventions to the gradual acceptance of more humane and effective approaches.

The current state of schizophrenia

In recent decades, there have been significant advancements in schizophrenia research, diagnostic criteria, and treatment. The development of more sophisticated antipsychotic medications in the 1990s has improved the management of symptoms for many individuals. However, challenges tend to persist in mental health care, contributing to ongoing stigma surrounding the disorder. 

While progress has been made, there may still be a need for further research to better understand the complexities of the disorder and enhance treatment options. Tracy McDonough, a psychology professor and president of the Schizophrenia Oral History Project, notes that this stigma may be deeply rooted in the historical perceptions of schizophrenia. 

Modern treatment options

In our modern age, schizophrenia can typically be managed with assistance from mental health professionals. With proper medical care, schizophrenia patients can manage severe symptoms, including agitation, hallucinations, and delusions. 

Medication, therapy, and self-care

Treatment often involves a combination of medication, self-help strategies, supportive services, and therapy. Traditional antipsychotics like haloperidol and chlorpromazine, as well as newer atypical antipsychotics such as quetiapine and risperidone, are commonly prescribed to alleviate symptoms. Although these medications can carry side effects, regular monitoring by a healthcare provider can help mitigate risks. 

Please note that the information in this article does not constitute medical advice, and you should always consult your doctor or psychiatrist before starting, stopping, or changing the way you take any form of medication.

The benefits of combining treatment approaches

Additionally, scientific research suggests that combining medications with non-pharmacological treatments like yoga and cognitive behavioral therapy (CBT) could offer a more comprehensive approach to managing schizophrenia symptoms. Psychotherapy, such as CBT, can be particularly beneficial for individuals with schizophrenia, as it may help them develop coping mechanisms, social skills, and problem-solving abilities while reducing symptom severity and the risk of relapse.

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Schizophrenia is treatable

Convenient support through online therapy

In addition to traditional in-person therapy, the rise of online therapy has created increased availability of flexible support. Online therapy can be reached from anywhere with an internet connection, and clients can choose between video, live chat, or a phone call to speak with their therapist. The online format may also allow for more flexible scheduling, as appointments can sometimes be made outside typical business hours. 

Research into the effectiveness of online approaches

While the effectiveness of online therapy for schizophrenia may require further research, studies show that online CBT is usually equally as effective as in-person therapy for treating other mental health conditions, such as anxiety and depression. Those currently experiencing acute psychotic symptoms may need to seek in-person care. Overall, current schizophrenia research suggests that a significant portion of individuals with schizophrenia can achieve functional recovery with appropriate treatment, allowing for improved symptom management, relationships, and quality of life.

Takeaway

As schizophrenia remains a complex mental illness, many continue to combat stigma and advocate for inclusive, compassionate approaches to mental health care. However, despite its historical misunderstandings and stigma, advancements in research and treatment can offer hope for those affected. By combining medication with therapy and other supportive services, individuals with schizophrenia can achieve functional recovery, enabling them to effectively manage symptoms, maintain relationships, and pursue meaningful lives. Therapy, particularly cognitive behavioral therapy (CBT), may help individuals develop coping strategies, improve social skills, and reduce symptom severity. The emergence of online therapy can further expand the availability of support services for those living with this disorder.
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