Psychosis/ schizophrenia
What is schizophrenia ?
Schizophrenia is the name given to the mental illness experienced by people who have extremely disturbed thoughts and feelings.
Their interpretation of the outside world becomes disrupted. They may hear and see things that aren't there, and act in unusual ways in response to these. These are all part of a group of symptoms that occur in psychotic illnesses.
It usually starts when people are in their late teens or early twenties, and affects about 1 in 100 people.
A third of people will only ever experience one episode; another third have further episodes with periods of remission in between and the remainder will develop a chronic condition that they have to live with for the rest of their lives.
Signs and symptoms
There are two groups of symptoms in schizophrenia. These are referred to as "positive" and "negative".
The positive symptoms are abnormal experiences and the negative ones are loss of normal behaviour. Depression, substance misuse, and some physical illnesses may be more common in people with schizophrenia than others.
Positive symptoms
- Feelings of being controlled by outside forces - thoughts and actions taken over
- Hearing, seeing, smelling or feeling things which aren't there (hallucinations)
- False and unusual beliefs (delusions)
Negative symptoms
- Tiredness
- Loss of energy, concentration, motivation
- Difficulty in carrying out every day tasks
- Difficulty in maintaining relationships
Schizophrenia is not
- A "split personality"
- Alternating between a calm personality and an out of control one like Dr. Jekyll and Mr Hyde. This is a myth.
- About danger and violence. People with schizophrenia are not violent and are more likely to harm themselves than someone else.
What causes schizophrenia?
Schizophrenia is a difficult form of mental distress to define, and its causes are not clear cut.
- There is a possibility of a genetic cause
- Some impairment in the way the brain has developed may be a factor, or some disruption to the brain's bio-chemistry
- Stressful life events like the death of a spouse or starting a new job can act as triggers. Poverty and racial harassment can be other contributory factors.
- Some "street" drugs such as E, acid , speed are thought to trigger schizophrenic episodes in some people. Cannabis in particular is thought to exacerbate mental health issues especially schizophrenia if someone is prone to it.
What can you do about it ?
Schizophrenia is a treatable illness. When they first become ill a person will usually be treated in hospital so that a diagnosis and assessment can be made.
Medication
The treatment will include medication to alleviate the most disturbing symptoms of the illness. These can be neuroleptics, anti-psychotics or major tranquillisers.
Most people need to take their drugs on a long term basis to lessen the risk of onset of another schizophrenic episode.
Unfortunately side-effects can occur with this medication. Common problems include:
- Difficulty with movement - stiffness, shakiness and restlessness.
- Sleepiness
- Weight gain
- Problems with sexual activity
- Tardive dyskinesia - This occurs when people have taken the drugs for a long time, and includes involuntary movements of the face, mouth and tongue, and sometimes the limbs.
Although the side-effects are unpleasant, other drugs can be taken to reduce their effect. It's also important to consider the damaging effect the illness will have on a person's life if they don't take the medication.
Cognitive behavioural therapy
As well as medication, cognitive behavioural therapy, family interventions, social skills training, social and work rehabilitation programmes have been developed that enable most people with schizophrenia to carry on with their every day lives and relationships.
Relapse prevention
Cognitive behavioural therapy techniques can be particularly helpful in identifying the early signs of relapse, so that patients and families can learn to recognise and seek help as soon as the first signs of relapse appear, so helping to prevent a major psychotic episode developing.
Cognitive strategies can also be used to help individuals manage any voices or unusual thoughts they may have so that they can develop coping skills for dealing and living with them.
Family and friends
Family and friends also play an important role in the treatment of schizophrenia. They can provide practical help and support by:
- Helping with understanding and coping with the illness
- Rebuilding confidence
- Tackling risk factors, such as stress, that could lead to a reoccurrence of the illness.
- Providing support to continue with education and employment.
Mental health teams
The local Community Mental Health Team or Crisis Resolution and Home Treatement Team should also be involved in offering support and providing links between the family and specialist services.
With support, most people will be able to continue to lead ordinary independent lives within the community.
