Schizophrenia occurs in individuals living in Anguilla. This chronic mental disorder confuses many individuals, and some persons are even afraid of those with schizophrenia. With treatment, many individuals with schizophrenia can make positive contributions to the community. Schizophrenia is a chronic condition requiring lifelong treatment.
What is schizophrenia?
Schizophrenia is a severe brain disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behaviour. Schizophrenia is not a split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking. People with the condition may hear voices, see imaginary sights, or believe other people control their thoughts. These sensations can frighten the person and lead to erratic behaviour. Although there is no cure, treatment can usually manage the most serious symptoms.
What are some common symptoms of schizophrenia?
Symptoms might vary from one individual to another and might also vary in severity. Common symptoms include the following:
• Hallucinations: hearing or seeing imaginary things
• Delusions: wildly false beliefs
• Paranoia: the fear that others are plotting against you
Some signs, such as lack of enjoyment in everyday life and withdrawal from social activities, may mimic depression.
People with schizophrenia may have trouble organizing their thoughts or making logical connections. They may feel like the mind is racing from one unrelated thought to another. Sometimes they have “thought withdrawal” – a feeling that thoughts are removed from their head, or “thought blocking,” when someone’s flow of thinking suddenly gets interrupted.
The disease has a major impact on behaviour in many ways. People may talk and not make sense, or they make up words. They may be agitated or show no expression. Many have trouble keeping themselves or their homes clean. Some repeat behaviors such as pacing. Despite myths, the risk of violence against others is extremely small.
Who gets schizophrenia?
Anyone can get this disorder. People of all social groups can develop this condition. It is equally common among men and women and among ethnic groups. Symptoms usually start between ages 16 and 30. Schizophrenia rarely starts during childhood or after age 45. People with schizophrenia or other psychotic disorders in their family may be more likely to get it.
What causes schizophrenia?
Experts in this field are still not sure what causes schizophrenia. A person’s genes, experiences, and setting may all be involved. There are many theories, and include how active and how well certain areas of the brain work. There may be structural differences in the brain as well contributing.
Diagnosis
At this time there is no test to diagnose this chronic disorder. Diagnosis is usually based on clinical history and examination. Usually common medical disorders that have some of these symptoms must be ruled out with a series of tests and investigations. In teenagers, a combination of family history and certain behaviours can help predict the start of schizophrenia. These behaviours include withdrawing from social groups and expressing unusual suspicions, but that is not enough for a diagnosis.
Treatment
Treatment can be challenging at times, but even the most difficult case can be managed successfully. There is no cure for this disorder but many of the symptoms can be controlled, often with a combination of medications and counseling.
Medications
Prescription drugs can reduce symptoms such as abnormal thinking, hallucinations and delusions. Some people have troubling side effects, including tremors and gaining lots of weight. Drugs may also interfere with other medicines or supplements. But, in most cases, medication is a must to treat schizophrenia.
Counseling
Counseling can help people develop better ways to recognize and handle their problem, behaviours and thoughts, and improve how they relate to others. In cognitive behavioural therapy (CBT), people learn to test the reality of their thoughts and better manage symptoms. Other forms of therapy aim to improve self-care, communication and relationship skills.
Rehabilitation
Rehabilitation programs for schizophrenia teach people how to do everyday things like use public transportation, manage money, shop for groceries or find and keep a job. These programmes work best when someone receives proper medications and also gets therapy. Rehabilitation programmes are sadly lacking in Anguilla at this time.
Relapse/compliance
People with schizophrenia sometimes quit their medications because of side effects or not understanding their illness. This raises the risk of serious symptoms returning which can lead to a psychotic episode (in which someone loses touch with reality). Regular counseling can help people stick with their treatment and avoid a relapse or the need for hospitalization.
Schizophrenia and work
Many individuals with schizophrenia, once they are on treatment, can be gainfully employed. In Anguilla, and many other countries, individuals with schizophrenia often have trouble finding or keeping a job. This is partly because the disease affects thinking, concentration and communication. But it also stems from the fact that symptoms start in young adulthood, when many people are starting their careers. Vocational training can help people develop practical job skills.
Schizophrenia and illegal drugs
People with schizophrenia are much more likely than other people to abuse alcohol or illicit drugs. Some substances, including marijuana and cocaine, can make symptoms worse. Drug abuse also interferes with treatments for schizophrenia. If you know someone who is dealing with substance abuse, encourage them to seek professional help.
Pregnancy
Women with schizophrenia who plan to get pregnant should talk with their obstetrician to make sure that their medications are safe to take during pregnancy. Studies of schizophrenia drug safety during pregnancy are encouraging. Individuals with schizophrenia who become pregnant should be under the care of trained professionals at all times during the pregnancy.
What can you do for a friend or relative with schizophrenia?
It can be hard to convince someone with schizophrenia to get help. Treatment often begins when a psychotic episode results in a hospital stay. Once the person is stabilized, family members can do these things to help prevent a relapse:
• Encourage the person to stay on medication
• Accompany him/her to his/her follow-up appointments
• Be supportive and respectful
• Do not stigmatize him/her or discriminate against his/her
Conclusion
Schizophrenia is a chronic brain disorder that, once properly diagnosed, can be successfully managed. With support, medication and therapy, many individuals with schizophrenia are able to function independently and live fulfilling lives – and contribute much to the community. In this century individuals with schizophrenia should not be housed in a prison!
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
