Articles
Understanding
and Help for Schizophrenia
By Dr. Bill Gaultiere
"Did
you ever think you heard something and turn to discover nothing
there?" asks John Gillen on mentalwellness.com. "We all have.
But have you ever heard voices that seemed to be inside your
own head? Voices telling you that you smell bad or that you
should leap in front of a bus?"
John
suffers from Bipolar disorder and Schizophrenia. He started
hearing frightening voices like this in his head when he was
14 years old and into his 20's. At times the voices were so
unbearable that he tried to literally run away from them by
taking trains or buses to far away cities. But always the
voices came too. Until John ran for help and got on the right
mix of medications.
In
fact, recently John said, "My life has changed dramatically
because of these medications. I no longer wait for the voices
to tell me what to do. I set my own goals. I've moved into
my own apartment and attend a day program. And I'm hoping
to go back to school this summer to become a chef."
Unfortunately,
the mentally ill, like John, are routinely misunderstood,
mistreated, discriminated against, and made fun of. This shouldn't
be. What they need is medical treatment and ongoing support
from family, friends, and community services. The mentally
ill want nothing more than to live a "normal" life, to be
accepted and to make a contribution. To achieve some semblance
of normalcy they and their caregivers need to educate themselves
about mental illness and develop a support system. Towards
these ends, here's a summary of basic information and helpful
resources.
Facts
on Schizophrenia
-
1.5%
of population or 3 million adults in the U.S. have Schizophrenia
or another severe mental illness.
-
Years of research have shown schizophrenia to be a biologically
based brain disease in which dopamine and serotonin levels
are elevated.
-
The government pays 64% of the $30 to 65 billion per year
that is spent treating schizophrenics.
-
Age 16 to 30 is the typical age of onset for schizophrenia.
-
80%
of schizophrenics relapse if they stop taking medication
(30% relapse while on medication).
-
70-90% of adults with severe mental illness are unemployed.
· 33%-50% of the homeless are schizophrenic.
-
Schizophrenics are 100% more likely to get in a motor vehicle
accident.
-
Schizophrenics have more infections, heart disease, type
II (adult onset) diabetes, and female breast cancer. (Perhaps
because they're less able to explain their symptoms to doctors,
their symptoms are wrongly attributed to their mental illness
by doctors, and they have an increased pain threshold.)
-
20% of schizophrenics attempt suicide and 10% commit suicide
(the #1 cause of premature death for schizophrenics).
-
After 10 years of treatment, 25% of schizophrenics recover
completely, 25% improve considerably, 25% improve modestly,
15% do not improve, and 10% have died.
Symptoms
of Schizophrenia
Schizophrenia is a dysfunction of the thinking processes
leading to psychotic symptoms, confusion, and withdrawal from
the outside world. A diagnosis is made after at least six
months of psychotic symptoms (hallucinations and/or delusions)
and severe impairment in functioning at school or work and
in relationships. Often the symptoms are divided into "positive"
(disturbances added by the illness) and "negative" (psychological
capacities lost).
-
Positive
Symptoms: ·
- Hallucinations: hearing, seeing, or smelling things that
aren't there.
- Delusions: paranoia (that others are controlling, monitoring,
or threatening them or are reading their minds); grossly
exaggerated self-opinions, belief that they can control
others' thoughts. ·
- Confusion about what is real or imaginary; déjà vu; preoccupation
with religion; superstitious. ·
- Odd thoughts or speech, thoughts racing or slowed, talk
on things irrelevant to context.
-
Negative Symptoms:
- Flat emotions; little facial expression, monotone speech;
lack spontaneity; poor rapport.
- Lack of initiative or motivation, passively go along in
social situations with disinterest or mechanically.
- Social withdrawal; no close friends.
Other
Schizophrenia Disorders
- Schizoaffective
Disorder: Major Depression (or Mania) and Positive Symptoms
of Schizophrenia.
- Schizoid
Personality Disorder: a pervasive pattern of detachment
from social relationships and a restricted range of expression
of emotions in interpersonal settings.
- Schizophreniform
Disorder: Schizophrenia symptoms for only one month.
- Schizotypal
Personality Disorder: a pervasive pattern of social and
interpersonal deficits marked by acute discomfort with,
and reduced capacity for, close relationships as well as
by cognitive or perceptual distortions and eccentricities
of behavior.
Other
Psychotic Disorders
-
Brief Psychotic Disorder: Some Schizophrenia symptoms for
less than one month.
-
Delusional Disorder: Nonbizarre delusions (i.e., involving
situations that occur in real life, such as being followed,
poisoned, infected, loved at a distance, or deceived by
spouse or lover, or having a disease) of at least 1 month's
duration.
-
Major
Depression (or Mania) with Psychotic Features
-
Psychotic Disorder Due to a General Medical Condition, a
delirium, or a dementia
-
Shared
Psychotic Disorder: person develops a delusion in the context
of a close relationship with someone who has an established
delusion.
-
Substance-Induced
Psychotic Disorder
-
Substance-Induced
Delirium
Treatment
Considerations
Schizophrenia
is not considered curable, but it is treatable. The goals
of treatment are to eliminate or reduce psychotic symptoms
and to increase the level of functioning. With medication
compliance, education about the illness, and an ongoing support
system there is help and hope. Here are some important points
to consider:
-
The
sooner schizophrenic patients are treated after the emergence
of psychotic symptoms the faster and more completely they
recover.
-
Getting
and staying on medication helps to minimize the Schizophrenic's
symptoms and improve functioning. It usually takes time
between doctor and patient to find the right medication(s).
Most common medications currently used are Zyprexa, Risperdal,
Clozaril, Seroquel, Dogmatil, and Haldol.
-
Avoiding or reducing relapses is essential because psychotic
episodes can be damaging to the patient's brain and psyche.
-
Educating patients about their disease and helping them
accept their disability and develop self-care and coping
skills are important.
-
Family
therapy or supportive (not uncovering) psychotherapy can
also be helpful.
-
Developing peer support amongst others with mental illness
or disabilities is valuable.
Helpful
Resources for Schizophrenics and their Families
-
-
-
Internet
Mental Health: information, diagnosis on all psychological
disorders, peer counseling, and more for the mentally ill
(http://www.mentalhealth.com).
-
Medic Alert: medallion necklace with toll-free number to
Medic Alert who gives emergency responders information about
the patient's diagnoses and medications, along with the
name and phone numbers of the patient, their physician,
and a family member or friend who can take them home (1-800-432-5378).
-
-
-
-
National Alliance for the Mentally Ill: offers support groups,
12 week course, and information for family members (1-800-950-NAMI
or http://www.nami.org/).
-
Schizophrenic's Anonymous: support groups (1-800-482-9534).
-
*Information
for this article is based on clinical experience and training
along with facts gathered in February 2000 from Schizohrenia.com,
the National Institute of Mental Health, MentalWellness.com,
Internet Mental Health, the National Alliance for the Mentally
Ill, and The Wall Street Journal (August 25, 1999).
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