Shattered lives

This news has been read 4368 times!

Kurt Dixon is a Licensed Clinical Psychologist working at Fawzia Sultan Rehabilitation Institute www.fsrikuwait.org and can be contacted at [email protected] or 25720338.

— Editor

By Kurt Dixon

Schizophrenia is also known as a formal ‘thought disorder’. Having a ‘formal thought disorder’ is a typical symptom of schizophrenia. This is most noticeable in conversation where words either sound jumbled or ideas do not make sense. Speech may therefore appear incoherent or disorganized. Schizophrenia is a syndrome (collection of symptoms) which includes positive, negative and cognitive symptoms. The brains of people diagnosed with schizophrenia are structured in such a way that makes it very hard for them to determine what is real or not and the severity of that experience differs from one person to the next. Most people’s brains function ‘normally’ which means that we are able to tell the difference between our thoughts, fantasies, dreams etc., but people who are diagnosed with schizophrenia have problems with this.

Positive symptoms include hallucinations (auditory and visual), delusions (beliefs that are not true such as ‘they are out to get me’, having a thought disorder, and movement disorders (repetitive movements and in rare cases catatonia where the person seems to be ‘frozen’). Some patients have what is called bizarre delusions such as, ‘there is a micro-chip in my heart/brain’ and this is almost certain of a diagnosis of schizophrenia). Positive symptoms are called such because these are ‘extra’ or additional experiences that the patient has.

Negative symptoms refer to those that impact on the individual’s ability to engage socially with others. Patients often spend time alone because of being unable to sustain a conversation. A client that I had seen once in therapy described it as such: “I am literally trying to organize the words in my head so that I can have this conversation with you.” People with schizophrenia have very little expression in their voice, show little or no emotion, and find it very hard to go out and do a simple thing like shopping or even making a phone call. Some patients will tend to want to sleep quite a lot and life can seem very routine or mundane. There is no or very little desire to seek out pleasurable or social activities. This is also partly due to the fact that patients have excessive fears and anxieties and the ‘outside’ world seems very frightening to them because of their brain’s inability to organize experiences in a meaningful way. So, in contrast to positive symptoms, negative symptoms are behaviors and social skills that are absent.

Cognitive symptoms such as memory retention, being able to plan and execute tasks and paying attention all make it very difficult to go about daily living.

There is no one cause of schizophrenia and there is still a lot of ongoing research into this condition. One popular theory is called the ‘stress-diathesis’ model which means that there are certain individual predispositions that are influenced by environmental factors that are known to trigger symptoms. So, an individual’s genetic predisposition together with other environmental stressors such as stressful family relationships, early traumas, drug use etc., may put them at risk for the development of schizophrenia. Other risk factors are individuals who have relatives who have a mental disorder. Drug abuse can also trigger schizophrenia in individuals who are at risk. Although sometimes, people who abuse drugs can have brief psychotic symptoms that present like schizophrenia when in fact it is not. These symptoms usually dissipate after the drug use has ended.

Schizophrenia is diagnosed mostly in men and the average age of onset is early adulthood. The onset can be acute or gradual. In other words, it can develop over a very short time period or over a long time period. This is also known as a prodromal period where the individual starts to sense that they are unable to maintain activities of daily living and realize that their thoughts are becoming disorganized and/or they may also start to have strange experiences and beliefs. This can be very frightening and also very hard to talk about to anyone. What usually happens is a gradual withdrawal from social life where the person becomes more isolated. This is first usually noticed by relatives. A ‘sudden’ change in personality and increased irritability is also reported. It can be very hard to accept that there is this drastic loss of functioning. Some people who were regarded as ‘high functioning’ where they held very important occupational positions, find this particularly difficult to deal with.

Schizophrenia is treated using antipsychotic medications which helps to relieve the symptoms. Usually this is not adequate and many psychiatric units have psycho-social interventions which include highly structured programs providing patients with a sense of community and meaning. Adherence to medications can also be challenging because of the side-effects and the level of motivation required to adhere to the medication regime. Side-effects usually should disappear once an individual’s body becomes accustomed to it. It may take a few trials of different medications before the correct dosage is found most favorable to the individual. It is important that a close working relationship be maintained with the psychiatrist with regards to medications and managing the side-effects. Psychotherapeutic interventions in conjunction with medication can also be effective to help the individual talk about the loss of functioning and also assist with managing positive and negative symptoms. It might also be the one space where the individual feels accepted and not judged for their condition and may also help build self-esteem.

Unfortunately, the treatment of schizophrenia is less than optimal in many countries and individuals can often go without effective treatment. They have been known to do better in communities where they feel accepted and supported even if these are communities which are under resourced. So, besides medication, social support is also a very important part of the treatment because living with schizophrenia is a life-long condition.

For more information you can visit the following website: Www.nami.org

This news has been read 4368 times!