What Is Hebephrenic Schizophrenia?
[MUSIC PLAYING]
JOHN WHYTE: Hello, I'm Dr. John
Whyte, the chief medical officer
for WebMD.
Schizophrenia is a chronic brain
disorder that affects how
a person thinks, feels,
and behaves.
And it requires
lifelong treatment.
With medication, many people
can lead
productive and rewarding lives.
But getting diagnosed
and treated is often difficult.
I'd like to introduce you
to Dana Pettaway, who can share
her experience as a caregiver
to her son, who was diagnosed
with schizophrenia just
after high school.
Dana, thanks for joining me.
DANA PETTAWAY: Hi, John.
Thank you for having me.
JOHN WHYTE: What were
the challenges to getting
the right diagnosis
for your son?
DANA PETTAWAY: Yeah, just
after my son graduated,
he started to have symptoms
of paranoid delusions
and auditory hallucinations.
He thought that he needed
to leave the country to get off
the grid.
And he thought we had cameras
in the house.
He spoke a lot to himself.
And so therefore, I decided
to try and seek mental health
help for him.
But I had no idea how to do
that.
Also, he didn't really believe
that he was sick,
and so he spent a lot of time
just convincing them
that he just had an alcohol use
disorder or a substance use
disorder.
So they really weren't sure
exactly what he had.
Also, he hid his symptoms.
The doctors gave him differing
diagnoses.
He started out
with unspecified psychosis.
And then finally, we found
a diagnosis that was
correct of schizophrenia.
JOHN WHYTE: Tell us how you were
able to get your son
the treatment he needs.
DANA PETTAWAY: At first, it was
very difficult.
He would disappear.
He would be defiant.
But I resorted to bribery,
telling him that he could have
money, pair of shoes,
what have you.
And then also, I had to use
tough love.
I had to actually kick him out
of the house,
so he was
homeless for a little while
until he finally relented.
When he was hospitalized
in involuntary holds,
he would not sign ROIs so that I
could let them know what was
going on with him.
And so he would languish
without medication
and without treatment,
because as an adult,
he didn't have to accept
treatment, even being
in an involuntary hold.
And the law just really doesn't
allow for a caregiver
to advocate for their child
as an adult. So it took a lot
of doing to finally get him
assistance.
He finally realized that he
needed to do something.
So he agreed to go to treatment.
And the treatment that he
received at that point
was through psychiatric help
and medications.
JOHN WHYTE: Dana, what's
your role as a caregiver?
DANA PETTAWAY:
So as a caregiver, I basically
do everything.
He's an only child,
and I'm a single mother.
So since he had not started
going to college yet,
and he hadn't started going out
on his own,
I was responsible for his food,
clothing, and shelter,
and an additional burden
of making sure
he got medications, got
to his appointments on time,
and that he also got
additional support group
help as well.
JOHN WHYTE: What advice do you
have for other caregivers?
DANA PETTAWAY: Other caregivers
that are dealing with this
should know that it's OK to not
be OK.
It's also OK to seek help.
Additionally, getting
psychoeducation, really learning
what mental illness is all
about, and seeking out
local agencies for support.
JOHN WHYTE: Thanks for sharing
your story with us.
DANA PETTAWAY: Thank you
for having me.
[MUSIC PLAYING]
Hebephrenic schizophrenia, also known as disorganized schizophrenia, is a type of schizophrenia that mainly shows up as disorganized thinking, speech, and behavior. People with this type often have trouble organizing their thoughts, which can lead to behaviors that seem random or out of place, like laughing during a sad moment. It can also affect your speech, which often makes it harder for others to understand you.
Disorganized schizophrenia vs. paranoid schizophrenia
Paranoid schizophrenia is an outdated term for a type of schizophrenia that involves strong paranoia and delusions. Since 2013, psychiatrists have defined schizophrenia more broadly as a mental health disease, with a range of related types that cause psychosis. Disorganized schizophrenia is one of these types. Unlike other types, people with disorganized schizophrenia usually don’t have hallucinations. Instead, they show disorganized behavior and speech.
What Causes Disorganized Thinking?
Researchers don’t know exactly what causes schizophrenia, but they suspect that changes in the brain’s structure and chemistry play a role in the disorganized thinking that often shows up with the disease. These changes could include issues with brain development, an imbalance of important brain chemicals, or problems with the networks connecting the different parts of the brain.
While the exact reason for these changes aren’t fully understood, scientists think that things like your genetics (including a family history of the disease), using certain drugs, stressful life experiences, or complications that can happen during pregnancy might increase your chances of developing schizophrenia.
Hebephrenic Schizophrenia Symptoms
A person with hebephrenic (disorganized) schizophrenia may have the following symptoms:
- Disorganized thinking or speech patterns
- Unusual reactions to situations, called “negative symptoms,” where a person seems emotionally flat or disconnected
- Facial expressions that don’t match a situation
- Struggling to focus or complete a task
- Behaviors like wandering aimlessly or laughing to oneself
Examples of Disorganized Thinking
Disorganized thinking usually shows up as scattered, illogical, or hard-to-follow thoughts that make conversations difficult. For example, someone might start talking about what they had for dinner, then suddenly switch to an unrelated topic. Their responses can also veer off topic: When asked a direct question like “What did you do this weekend?” they might answer with random or unrelated details. Disorganized thinking can also make people speak in ways that sound like “word salad,” where they use a mix of words that don’t form clear sentences.
Disorganized thinking also affects how people socialize. Because their brain works differently, a person with disorganized schizophrenia may miss social cues or not be able to connect the right emotions to the situations. As a result, someone might laugh or become agitated in situations where others are calm or serious.
How Is Disorganized Thinking Diagnosed?
Disorganized thinking on its own is not an official diagnosis, but people with symptoms of it can be looked at by a doctor or mental health care specialist for schizophrenia. There aren’t any specific tests that can diagnose schizophrenia, but your doctor will do a mental health assessment by asking questions about your thoughts, moods, and habits and observing your behavior.
Doctors may also perform a physical exam or order image tests, blood work, or brain activity tests to rule out other conditions.
Disorganized schizophrenia diagnostic criteria
To be diagnosed, you must have at least two of its main symptoms of schizophrenia for more than a month. These symptoms can include false beliefs (delusions), seeing or hearing things that aren’t there (hallucinations), disorganized thinking or speech, unusual movements, or losing the ability to handle daily tasks. The symptoms also need to significantly affect your relationships and day-to-day life.
Disorganized Thinking Treatment
While schizophrenia can’t be cured, the disorganized thinking that it can cause it is usually treatable with a combination of the following:
- Medications: Your doctor may prescribe antipsychotic medication, which helps change how the cells in your brain communicate with each other. These medications can be combined with others to better manage your symptoms.
- Therapy: Talk therapy can help you learn new thought patterns and address other challenges that may come with schizophrenia, like anxiety or substance use.
- Social skills training: This type of training helps you improve your communication, gradually preparing you to participate more in day-to-day activities.
- Electroconvulsive therapy (ECT): This treatment uses electrical currents to stimulate parts of the brain and improve brain function. Doctors typically only recommend ECT if other treatments haven’t worked.
Living With Disorganized Thinking
Schizophrenia affects everyone differently. There may be times when your symptoms worsen, but there can also be periods where they’re much lighter. Taking care of yourself — especially during low periods — can feel like a challenge, but the following tips may help:
- Take your medication. If your doctor prescribed medication, taking it as directed is the best way to manage your symptoms — even if you start feeling better. If you have any side effects or concerns, talk to your doctor about other options.
- See your doctor regularly. Regular checkups keep your treatment on track and allow for changes to your care plan when needed.
- Avoid drinking and drugs. Alcohol, drugs, and even nicotine can interfere with your medication and make symptoms worse. If you need help quitting, your doctor can connect you with resources.
- Set goals. Setting realistic goals for your treatment can help you stay focused, track your progress, and build confidence.
- Learn relaxation and stress management techniques. Practices like deep breathing, meditation, or exercise can help with stress, making it easier to manage some symptoms.
- Join a support group. Connecting with others who understand your experiences can offer emotional support and helpful tips for living with schizophrenia. These groups may also be able to help you access resources like affordable housing and transportation.
Caring for Someone With Disorganized Thinking
Disorganized schizophrenia can be tough on friends and family, too. If someone you know has been diagnosed, a good first step is to ask how you can support them. Offering your understanding and connection can help them feel less alone in handling their diagnosis. Encourage them to stick with their treatment plan and keep up with doctor visits.
When talking with someone who has disorganized thinking, avoid judgment or arguments. Instead, stay patient and keep the environment calm. Since people with schizophrenia are more likely to die by suicid00e, call for help right away if they mention self-harm.
Consider joining a support group or finding resources for caregivers. This can make it easier to care for yourself while helping your loved one.
Takeaways
Hebephrenic schizophrenia can be a tough diagnosis for both individuals and their loved ones. While there’s no cure, it is possible to live a happy and fulfilling life with the right treatment. If you or someone you know has schizophrenia, keeping up with regular doctors visits and finding extra support, either through a support group or social services, can make managing the condition easier.
Disorganized Thinking FAQs
Is "word salad" a schizophrenic symptom?
Schizophrenia causes disorganized thinking, leading to scattered and disconnected thoughts. This can show up in speech as “word salad,” where sentences are spoken without clear structure or meaning.
How do you spot a schizophrenic episode?
If you notice strong symptoms like hallucinations, delusions, disorganized thinking and speech, or unusual behaviors, it may be because of a schizophrenic episode. If someone shows these signs, especially if they seem disconnected from reality or mention self-harm, seek help immediately.
