Question

I was put on Zoloft about 8 months ago for depression. I was having trouble with sleeping, mild panic attacks, and my emotions were up and down. My question - is there a link between depression and schizophrenia? My mother and her brother (my uncle) were both diagnosed with schizophrenia.

Answer

Schizophrenia is a psychotic disorder - that means there is a loss of touch with reality. Many researchers have tried to establish a "link" between depression and schizophrenia. To date, no clear link has been established.

The relationship between depression and schizophrenia can be looked at from both sides. If you start with schizophrenia and the patient is "sad" because he/she is having extreme difficulty in coping with day-to-day life, it's easily seen how depression could enter the picture. In that case it would be outside influences, and not heredity or a disturbance of brain biochemistry causing depression. Sometimes schizophrenics are treated with antidepressant medications concurrently with the anti-psychotic drugs that they take.

On the other side of the coin, a person with major depression (an 'endogenous' depression, meaning one that arises from within) who is unable to function may severely withdraw from reality and have what is called a 'psychotic break'. Many cases like this are diagnosed as schizophrenia and a small percentage of them probably are true schizophrenia.

Schizophrenia is defined as a disorder of unknown cause, characterized by symptoms that significantly interfere with normal functioning, involving disturbances in feeling, thinking, and behavior. The disorder is chronic and generally has an early 'warning' or premonitory phase, an active phase with delusions, hallucinations, or both, and a residual phase in which the symptoms abate, and may even completely disappear.

The risk of getting schizophrenia in the general population is about 1%. If you have a first-degree relative (e.g. mother, brother) with the disorder, your risk is 10-12%, while if a more distant relative has the disorder your risk is about 2%.

Sertraline (Zoloft) is typically used to treat minor mood disorders and depressed mood, as opposed to 'major depression', which requires more powerful medication. Major depression results in the patient becoming non-functional with the need for admission to an inpatient facility. Most cases of 'depression' are not major depression, and should more properly be called a depressive state. I strongly recommend that you discuss this more thoroughly with your general physician and ask his opinion if supportive psychotherapy may be needed.