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Nasira (not the real name) is a 29-year-old mother of two. Two years ago, she started telling her relatives and friends that she was being controlled by external forces. She also repeatedly said that she heard voices that controlled her and disturbed her. The family’s response was that someone had done ‘jadoo’ on her or may be it was ‘nazar’. So she was sent to all sorts of quacks who burnt black chicken head, burnt chillies, made her all sorts of concoctions to drink. She was even given an unusual ‘taveez’ and all sorts of ‘sadka’ were given but nothing helped her. The family was told to take her to a psychiatrist and after much resistance from the patient and her family, it was diagnosed that she is schizophrenic.
Schizophrenia is a severe, lifelong brain disorder. People who have it may hear voices, see things that aren’t there or believe that others are reading or controlling their minds. It often interferes with a person’s ability to think clearly, to distinguish reality from fantasy, to manage emotions, make decisions, and relate to others. Most people with schizophrenia contend with the illness chronically or episodically throughout their lives, and are often stigmatized by lack of public understanding about the disease.
Symptoms of Schizophrenia
The symptoms of schizophrenia are generally divided into three categories — Positive, Negative, and Cognitive.
l Positive symptoms, or ‘psychotic’ symptoms, include delusions and hallucinations because the patient has lost touch with reality in certain important ways.
l Negative symptoms include emotional flatness or lack of expression, an inability to start and follow through with activities, speech that is brief and devoid of content, and a lack of pleasure or interest in life. ‘Negative’ does not refer to a person’s attitude but to a lack of certain characteristics that should be there.
l Cognitive symptoms pertain to thinking processes. For example, people may have difficulty with prioritizing tasks, certain kinds of memory functions, and organizing their thoughts.
Schizophrenia also affects mood. While many individuals affected with schizophrenia become depressed, some also have apparent mood swings and even bipolar-like states. When mood instability is a major feature of the illness, it is called schizoaffective disorder, meaning that elements of schizophrenia and mood disorders are prominently displayed by the same individual.
Causes of Schizophrenia
Scientists still do not know the specific causes of schizophrenia. It seems to be caused by a combination of problems including genetic vulnerability and environmental factors that occur during a person’s development.
Recent research has identified certain genes that appear to increase risk for schizophrenia. Like cancer and diabetes, the genes only increase the chances of becoming ill; they alone do not cause the illness.
Treatment
While there is no cure for schizophrenia, it is a treatable and manageable illness. However, people sometimes stop treatment because of the medication’s side effects, the lack of insight noted above, disorganized thinking, or because they feel the medication is no longer working. Here are a few examples of supports and interventions:
l Recovery Support/Relapse Prevention: There is increasing recognition of the benefits of learning from “someone who has been there.” Peer to Peer Programme is designed to help individuals learn from those who have become skilled at managing their illness.
* Family Support: Care-givers benefit greatly from Family-to-Family Education Programme, taught by family members who have the knowledge and the skills needed to cope effectively with a loved one with a mental disorder.
* Hospitalization: Individuals who experience acute symptoms of schizophrenia may require intensive treatment, including hospitalization.
* Medication: The primary medications for schizophrenia are called antipsychotic. Antipsychotic medicines help relieve the positive symptoms of schizophrenia by helping to correct an imbalance in the chemicals that enable brain cells to communicate with each other. As with drug treatments for other physical illnesses, many patients with severe mental illnesses may need to try several different antipsychotic medications before they find the right one, or the combination of medications, that works best for them.
All medications have side effects that can often be treated by changing the dose of the medication, switching to a different medication, or treating the side effect directly with an additional medication.
* Psychosocial Rehabilitation: Research shows that people with schizophrenia who attend structured psychosocial rehabilitation programmes and continue with their medical treatment manage their illness best.
Substance use, counselling, housing, work and educational skill development are among other supports frequently required to maximize a person’s prospects for a higher functional level. |
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