For my final project, I decided to research schizophrenia. According to the National Institute of Mental Health, Schizophrenia is a “chronic and severe mental disorder that affects how a person thinks, feels, and behaves.” The five main subtypes of schizophrenia are as following: Schizoaffective Disorder. Childhood Schizophrenia, Catatonic Schizophrenia. Childhood Schizophrenia, Disorganized Schizophrenia, and Paranoid Schizophrenia. While the subtypes all have varying levels of severity, they all share a few of the same symptoms. Schizophrenics tend to have hallucinations and delusions, and often their personalities and attitudes change as well. A schizophrenic may develop something called the “flat affect,” and have reduced facial emotions or voice tone. They may also have reduced feeling of pleasure in everyday life as well as problem with starting and finishing activities. Sometimes, the beginning phases of schizophrenia are thought to be depression. There is no known cause for schizophrenia, although it is believed that genetic and environmental causes can cause an individual to be more at risk of developing the disorder. Medical anthropology is important to help us understand this illness as it is treated in many different ways. Most Western cultures treats schizophrenia with medications and behavioral and cognitive therapy while many non-western nations try to cure schizophrenia by using shamans and other holistic heroes. It is important to note the differences in treatment between cultures. For example, while schizophrenia is considered to be a mental illness in the United States, many African cultures believe that schizophrenia is caused by the possession of multiple spirits.
Understanding the biological causes of schizophrenia are important as genetics may play a large role in the likelihood of an individual to develop schizophrenia. While a specific gene has not been found, a study showed that mutations on chromosomes 1, 6, 8 12, 13, and/or 22 have led to an increased chance of a person developing schizophrenia or bipolar disorder. Since schizophrenia is hereditary, these mutations also increase the likelihood of an individual’s child to also be affected with the mental disorder. Referring to the McElroy PDF, approaching schizophrenia from an ecological perspective is also important as it is important to deduce how the environment a person is living in can increase their chance of developing the disorder. Even if an individual has a predisposition to developing schizophrenia, it is possible that they never will. However, if a person live in a party-rich environment, exposure and usage of hallucinogens may cause schizophrenia to have a faster onset in the individual. If scientists are able to find out what environment is best for people who either already suffer with or are predisposed to develop schizophrenia, then it is possible that they will be able to prevent the onset of schizophrenia—or at the very least help with the treatment of it.
The ethnomedical approach has to do with understanding schizophrenia in relation to the cultural definition, and how it is treated using cultural practices. As I mentioned earlier, since schizophrenia is consider to be a mental disorder to western countries, it is often treated with medication and intense psycho-social therapy to help treat the illness. In African nations, mental illnesses are seen as a form of punishment. Therefore, when an individual develops schizophrenia, they are often treated disgracefully. The reason most Africans choose to consult with a spiritual healer rather than a medical doctor is because of the lack of cultural understanding between then and their doctors. Africans believe that religious and spiritual treatments are more important for mental health treatment than medications, and therefore prefer shamans to medical doctors. Even though the “A Doctor for Disease, a Shaman for the Soul” article is in regards to the Hmong people, it is a good example of how traditional people want traditional medicine. Also, even if Africans want medical treatment, it is often extremely difficult to raise the funds for them to go to a clinic. Most Africans live below the poverty line in Africa and are unable to come up with the cash provided for treatment. If they were to see a traditional healer in the village, they are able to trade their possessions and animals for treatment.
The experiential approach is also an effective method for approaching schizophrenia as it is an individualized disease. This approach focuses more on how patient views their disease than how society as a whole view it. There are three different narratives involved with the approach: the Chaos Narrative, the Restitution Narrative, the Quest Narrative, and the Chaos Narrative. If a medical anthropologist can figure out which of the three ways an individual views their illness, then it will help them figure out how the affected individual is treating the illness, how it is affecting their daily life, and how the people around them have reacted to the illness. For example, in the True Life episode that involved two individuals who were dating HIV, they both had different narratives I the show. Besides her ex-boyfriend, the girl had a supportive system of friends and family, and she was managing her illness well; therefore she had a quest narrative. The boy, on the other hand, was having a tough time coming to grips with his illness, and he struggled to form relationships with others; which I saw to be a chaos narrative.
The critical approach is the approach most directly linked with using biomedicine to help treat schizophrenia. The critical approach involves how environmental factors affect the body, and how stimulation from the environment causes our brains to react in certain ways. This reaction can cause an individual with schizophrenia to be triggered, thus the critical approach is helpful in determining the different triggers linked to schizophrenia. Knowing what environments are best suited for individuals with schizophrenia is important as solely using medication may not always be enough to help keep the hallucinations at bay. This is why biomedicine is the most effective way of treating schizophrenia, as it involves both medication and the management of environmental illnesses so that an affected individual can live life as normally as possible.
The next approach is the applied approach. As said in the “Why Anthropologists join an Ebola Outbreak Team” article, it is important that that cultural and societal influences are important to take into consideration when approaching an illness as there is a “dynamic nature of culture.” By immersing themselves in a different culture, medical anthropologists can deduce how different cultures view schizophrenia. By doing this, they may be able to find a treatment that the local people agree with. In the article regarding shamans in Californian hospitals, it talked about how important it was for medical factors to realize that cultural practices for treatment were different. The applied approach allows anthropologists to gain information on how schizophrenia is treated in other societies, and by using this information they may be able to figure out a way a medical doctor can treat the disorder while still respecting cultural traditions.
I believe that the biological and ecological approaches to medical anthropology are the most effective in treating the disorder. This is because it is important to know the characteristics that may indicate that an individual may be genetically predisposed into developing schizophrenia as they may be able to avoid things that may trigger the disorder, such as hallucinogenic drugs. Also, it is important to know how the disease is passed on through the generations and what environmental factors may cause schizophrenia to present itself in an individual. While I believe that the applied approach may be the best way to learn about an illness, I do think that the biological and ecological approaches as the most effective methods to treat the illness as anthropologists would then be able to communicate the information they learned about a culture to to medical doctors who may be able to finds better treatments for schizophrenia, and hopefully a cure.
“National Institute of Mental Health”. Last modified February 2016.http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
Nordqvist, Christopher. “What are the different types of schizophrenia? How many subtypes of schizophrenia are there?.” Medical News Today. Accessed August 20, 2016. http://www.medicalnewstoday.com/articles/192770.php.
“Schizophrenia.” NAMI: National Alliance on Mental Illness. Accessed August 18, 2016. http://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia.
Versola-Russo, Psy.D, Judy. “Cultural and Demographic Factors of Schizophrenia.” The International Journal of Psychosocial Rehabilitation. Accessed August 20, 2016. http://www.psychosocial.com/IJPR_10/Cultural_Demographic_Factors_of_Sz_Russo.html.
Wagner, Jonathan H. “Genetic Vulnerability Factors and Schizophrenia .” schizophrenia.com. Accessed August 20, 2016. http://www.schizophrenia.com/research/genvul.htm.