Cherisse Moe

Rough­ly one per cent of the pop­u­la­tion suf­fers from schiz­o­phre­nia, says Dr Var­ma Deyals­ingh, sec­re­tary of the As­so­ci­a­tion of Psy­chi­a­trists of T&T. But the neg­a­tive stig­ma at­tached to the dis­ease pre­vents al­most half of suf­fer­ers from seek­ing much need­ed help even though treat­ment is avail­able. "There is a lot of dis­crim­i­na­tion to­wards the men­tal­ly ill in T&T. Peo­ple are al­ways hes­i­tant to seek treat­ment or ad­mit that they have schiz­o­phre­nia be­cause a lot of times peo­ple just don't un­der­stand it," he said. "And then there are those cas­es where suf­fer­ers aren't even aware or be­lieve that they a men­tal­ly ill. They have delu­sions and false be­liefs. That's a se­ri­ous prob­lem. Some­times it's the fam­i­ly mem­bers and co-work­ers who have to rec­om­mend that they get treat­ment."

Schiz­o­phre­nia is a chron­ic, se­vere and dis­abling brain dis­or­der which re­quires life­long treat­ment. Con­trary to pop­u­lar be­lief, schiz­o­phre­nia, which af­fects men and women equal­ly, is not a split per­son­al­i­ty or mul­ti­ple per­son­al­i­ty. Doc­tors say it refers to a dis­rup­tion of the usu­al bal­ance of emo­tions and think­ing. Peo­ple with schiz­o­phre­nia may hear voic­es oth­er peo­ple don't hear. They may be­lieve that oth­ers are out to get them, or that peo­ple are read­ing their minds. Men­tal-health ex­perts have long known that schiz­o­phre­nia runs in fam­i­lies but they are not sure what caus­es it and so a cure re­mains elu­sive. Men­tal-health dis­or­ders like schiz­o­phre­nia con­tin­ue to be swept un­der the rug. As a re­sult, suf­fer­ers are of­ten alien­at­ed and fam­i­ly mem­bers avoid the top­ic at all costs.

With health pro­fes­sion­als around the world work­ing on dis­cov­er­ing more about it, the out­look for peo­ple with schiz­o­phre­nia con­tin­ues to im­prove. Deyals­ingh said re­searchers are de­vel­op­ing more ef­fec­tive med­ica­tions and us­ing new re­search tools to un­der­stand the caus­es of schiz­o­phre­nia. Al­though there is no cure, he said some peo­ple with schiz­o­phre­nia im­prove enough to lead in­de­pen­dent, sat­is­fy­ing lives.

"We do know that en­vi­ron­men­tal and psy­cho­log­i­cal prob­lems, and even so­cial ills, can trig­ger schiz­o­phre­nia in peo­ple ge­net­i­cal­ly at risk for it.

"Long ago, schiz­o­phre­nia med­ica­tion had a lot of side ef­fects. Pa­tients would be walk­ing around very se­dat­ed, like zom­bies. Now there are new med­ica­tions which re­lieve acute symp­toms in 80 per cent of the cas­es." In ad­di­tion to an­tipsy­chot­ic drugs, Deyals­ingh al­so rec­om­mends py­choso­cial re­ha­bil­i­ta­tion and fam­i­ly ther­a­py to pro­vide the pa­tient with the best chances of lead­ing a ful­fill­ing life.

He added, "What we've found is that if you use med­ica­tion alone you can get some ben­e­fits, but by com­bin­ing the three, pa­tients can re­duce the risk of a re­lapse by as much as 50 per cent. That is sig­nif­i­cant." Deyals­ingh said while a schiz­o­phrenic per­son may not al­ways be vi­o­lent, he or she has a high risk of de­vel­op­ing de­pres­sion and sui­ci­dal thoughts. "They may be fear­ful to go out in­to the world, think­ing peo­ple are spy­ing on them or against them. They iso­late them­selves and run the risk of shut­ting peo­ple out and not tak­ing their med­ica­tion." Mar­riage and fam­i­ly ther­a­pist Dr Pearl Brown echoed sim­i­lar sen­ti­ments. She said it is com­mon for pa­tients to suf­fer from low self-es­teem and feel alien­at­ed, as it isn't easy deal­ing with a men­tal-health prob­lem-"es­pe­cial­ly in T&T," she added.

"How peo­ple treat and see you im­pacts on how you feel about your­self. That's very im­por­tant to be able to sur­vive in this world. "I have clients who have men­tal ill­ness­es (bipo­lar dis­or­der and schiz­o­phre­nia) so I know that it's very im­por­tant for those around them to be sup­port­ive." Cop­ing with schiz­o­phre­nia, she point­ed out, is a chal­leng­ing task, not on­ly for the pa­tient but the en­tire fam­i­ly, as the be­hav­iour of schiz­o­phrenic pa­tients is dif­fi­cult to pre­dict. "I have found that the per­son needs not on­ly med­ica­tion but coun­selling. "The fam­i­ly has to adapt to the ill­ness and be aware of its con­se­quences. They should meet with a psy­chi­a­trist who will tell them what kind of be­hav­iour they are like­ly to come in­to con­tact with. "It's al­so help­ful if co-work­ers have an idea that this per­son has a dis­or­der and know that it's a dis­or­der that they didn't go out and buy. They were born with it. Un­der­stand­ing and sup­port from them is im­por­tant too."

Types of schiz­o­phre­na

Para­noid

Para­noid schiz­o­phre­nia is the most com­mon form. With this type of schiz­o­phre­nia, the pri­ma­ry symp­toms are delu­sions or au­di­to­ry (hear­ing) hal­lu­ci­na­tions. Peo­ple with this con­di­tion have grandiose delu­sions. For ex­am­ple, they may be­lieve that oth­ers are de­lib­er­ate­ly ha­rass­ing them or spy­ing on them. Au­di­to­ry hal­lu­ci­na­tions can in­clude hear­ing "voic­es" that may warn of im­pend­ing dan­ger or the hear­er to do things.

Dis­or­gan­ised

Peo­ple with this schiz­o­phre­nia type of­ten have un­usu­al thought process­es.

One dra­mat­ic form is dis­or­gan­ised think­ing, in which the per­son may have dif­fi­cul­ty or­gan­is­ing thoughts or con­nect­ing them log­i­cal­ly. Speech may be gar­bled or hard to un­der­stand. An­oth­er form is "thought block­ing," where the pa­tient stops abrupt­ly in the mid­dle of a thought. When asked, he may say it felt as if the thought had been tak­en out of his or her head. Fi­nal­ly, the in­di­vid­ual might make up un­in­tel­li­gi­ble words. A per­son with this form of schiz­o­phre­nia al­so has dis­or­gan­ised be­hav­iour and what psy­chi­a­trists de­scribe as flat or in­ap­pro­pri­ate af­fect (such as an im­mo­bile fa­cial ex­pres­sion and a mo­not­o­nous voice).

Cata­ton­ic

Peo­ple with this type of schiz­o­phre­nia can be clum­sy and un­co-or­di­nat­ed. They may al­so show in­vol­un­tary move­ments, gri­mac­ing, or un­usu­al man­ner­isms. They may re­peat cer­tain mo­tions over and over or, in ex­treme cas­es, may be­come cata­ton­ic. Cata­to­nia is a state of im­mo­bil­i­ty and un­re­spon­sive­ness that was more com­mon when schiz­o­phre­nia treat­ment was not avail­able. For­tu­nate­ly, cata­to­nia is now rare.

Resid­ual

This can oc­cur in peo­ple with long-term schiz­o­phre­nia. With this schiz­o­phre­nia type, a per­son no longer shows pos­i­tive symp­toms (hal­lu­ci­na­tions, delu­sions, dis­or­gan­ised speech, and gross­ly dis­or­gan­ised or cata­ton­ic be­hav­iour), but still shows neg­a­tive symp­toms, which can in­clude lack of plea­sure in every­day life and speak­ing in­fre­quent­ly. Peo­ple with resid­ual schiz­o­phre­nia of­ten ne­glect ba­sic hy­giene and need help with every­day liv­ing ac­tiv­i­ties.

Quick facts

A per­son is about ten per cent more like­ly to de­vel­op this men­tal ill­ness if he/she has a first-de­gree rel­a­tive with the dis­or­der, such as a par­ent, broth­er, or sis­ter. Peo­ple who have sec­ond-de­gree rel­a­tives (aunts, un­cles, grand­par­ents, or cousins) with the dis­ease al­so de­vel­op schiz­o­phre­nia more of­ten than the gen­er­al pop­u­la­tion. The risk is high­est for the iden­ti­cal twin of a per­son with schiz­o­phre­nia-a 40 to 65 per cent chance.

Sources:

www.may­oclin­ic.com

schiz­o­phre­nia.emedtv.com