One cannot speak about schizophrenia without, at some point in time, referring to depression. Depression and schizophrenia are more than just oftentimes co-morbid illnesses. The melancholy surrounding the life-altering experiences and diagnosis of schizophrenia can began as despair and grief and sometimes become nothing more. But as many of us know, it can grow to proportions that become what would be labeled “major depression.” Why does this happen, what are the consequences, and how can we unravel the complex knot that binds us to hopelessness?
The Link Between Schizophrenia and Depression
It is estimated that at minimal half of people who deal with schizophrenia will work through a period of true depression as well. The Center for Disease Control says that one in ten adults in the United States will report feeling depressed. We could safely suspect that the true number of people in the world who experience depression is over that 10% mark. Figure that around 15% of the general population copes with depression in their life time at some point and then compare this to the ~50% of people living with schizophrenia who feel depressed. There is an obvious correlation between schizophrenia and depression.
We must take care not to mistake correlation and causation. The relationship between schizophrenia and depression is not completely understood, but this high of a correlation suggests that there probably are common causes between the two. One of the earliest warning signs of impending schizophrenia is depression and it is said that people who are ultimately diagnosed with schizophrenia can report depression for up to four years prior to the diagnosis. Another key in this mystery is that only about 9% of people who are stable and are keeping their symptoms in check with steady medication report feeling the effects of depression. There is a definitely relationship between depression and schizophrenia.
Possible Causes of Depression Within Schizophrenia
There are reasons within schizophrenia that could cause a person to experience depression that would be correlative and not causative. And in order to treat this type of depression we must understand what it is that is supporting the experience. Here are some possibilities:
- Schizoaffective Disorder – This mental illness resembles a mixture of schizophrenia and mood instability. The person can experience depression but also periods of mania, similar to bipolar disorder. In this case, the medication and therapy must target both cluster of symptoms and not just one or the other.
- Similar Symptoms – Many of the symptoms of schizophrenia resemble those of depression. A lack of desire to interact socially, and a general disinterest and indifference regarding most areas of life are expected in schizophrenia, but not generally always depressive in nature.
- Substance Abuse – Upwards to 30% of individuals suffering from mental illness will self-medicate or escape through substance abuse. Many of these substances that are used in manners and quantities not approved by medical professionals can cause the symptoms of depression. Until substance abuse stops, the root cause cannot be isolated.
- The Reality of the Diagnosis – Once schizophrenia is diagnosed, this can send the individual into an adventure internally in their mind through realms of sad possibilities and feelings of condemnation. This could cause depression and may pass in time as the person adjusts to their new lifestyle.
- Medication Treatment – If the individual is treating other illnesses or health difficulties with medication, it is possible that those medications are causing the depression. It is also possible that the person is reacting to the medications being used to treat the schizophrenia as well.
Treating Schizophrenia and Depression Together
If the above or other possible underlying causes are isolated, then the individual can be treated using specific methods tailored to these causes. Usually a psychologist or psychiatrist will recommend some combination of psychotherapy, antidepressant medication, social support and interaction, and an attempt to engage in enjoyable activities.
Treating schizophrenia and depression as early as possible can help stop the depression from developing further and begin to reverse it. Compared to those feeling depression alone, schizophrenics who also experience depression are three times as likely to make an attempt on their own lives. The two illnesses separately are very difficult to cope with, but coping with schizophrenia and depression together can be overwhelming.
Negative Symptoms in Schizophrenia and Depression
As mentioned above, there are similar symptoms in schizophrenia and depression that could cause an external onlooker to mistake one for the other or believe that both or co-occurring when they are not. Largely, it is very difficult to divide the negative symptoms of schizophrenia, especially catatonic schizophrenia, and those of depression. For instance, a person dealing with catatonic schizophrenia may feel a very low level of energy, minimal interest, anhedonia, decreased motor activity, disrupted concentration and cognitive activity, and a feeling of despair or helplessness. Is it dysphoria associated with negative symptoms of schizophrenia or is it truly depression? It is difficult to determine.
We now understand the deep correlation between the possible causes of depression and schizophrenia. We also understand why there is so much confusion surrounding the causes of these two illnesses together with one another. In order to treat depression in someone experiencing schizophrenia, we must first determine as well as we can what the cause of the depression is and then we must devise and follow strictly a treatment plan involving therapy, support, and medication.
Here is my tip, having been diagnosed with major depression and having conquered it:
Do not wait for the symptoms of depression to pass before you attempt to re-engage yourself in your life. Live as if you were not depressed first, and then you will find the symptoms slowly falling away and subsiding into the background. When you no longer think about how you feel depressed, you are well on your way!
Remember, if at any point you feel like harming yourself is the only escape from these feelings, please seek help. Let a friend, family member, or loved one know and ask them to help you get in touch with a medical professional. There are many ways to conquer these illnesses and it is never as helpless as it feels!