Schizophrenia is a mental disorder largely associated with delusion and paranoia affecting one’s cognitive and social functions. People suffering from this condition often consider themselves as victims of some persecutory intentions based on the paranoia and delusion that appear to be the symptoms of schizophrenia. A major impact of schizophrenia is the way the patient withdraws from social interactions and refrains from emotional expression citing persecution and judgment from everyone around them or, in some cases, specific people. Also, they often suffer from confusion and have difficulty clearly expressing their thoughts and in most cases, their speech is quite unclear and with no logical connection at all. Studies have shown that schizophrenia is a disease that affects a minority and in most cases can be treated effectively for a full life. However, there still may be cases when the patients are stigmatized or misdiagnosed based on the little interest that the public has when it comes to understanding and dealing with the schizophrenic patients. Considering that such patients are largely normal except for their social and cognitive inhibitions, understanding the disease and its symptoms is often the best way to determine how to relate with them. Sometimes, it is difficult to establish whether an individual is schizophrenic without having prior knowledge on the matter, and this may put one in a bad position. This paper analyzes schizophrenia as a mental condition, along with its symptoms, risk factors, causes, and treatment options. In addition, the paper also discusses the issue of dealing with the patients from the perspective of parents, friends, teachers, and the community as a whole.
Schizophrenia: The Disease
Keefe & Harvey (2010) noted that a schizophrenic person is among other things characterized by an inability to discern reality from their imagination. They get confused a lot by the things that go on in their minds to the point that there is no distinction between what is real and what is not. It is a common practice to consider such people as demented and thus, out of touch with the real world. It is a cruel label to give them but in most cases, it is actually accurate in that they live in their own worlds and their reality is hampered by the blurriness of the line separating real from unreal. They believe in things that only happen in their imagination, and this makes it difficult for the people around them to relate with and understand what they do or say.
As a mental disorder, schizophrenia does not necessarily imply that someone is insane. The symptoms may include an inability to maintain a train of thought but if managed effectively the patient is able to think rationally and express their thoughts well enough to be understood (Keefe & Harvey, 2010). It can be considered to be a challenge since the patient has to live with paranoid and delusional thoughts culminating in a feeling that they are consistently being persecuted. In some cases, the anxiety that they feel also drives them away from the people that they love, given that they feel they are not being understood or are simply being a burden.
Considering schizophrenia, a lot of people are ignorant of the symptoms and what really goes on in the life and mind of a patient. Schizophrenics are largely normal individuals who cannot maintain their train of thought without medical support and are often paranoid and delusional and thus, need help separating reality from imagination. Rather than being considered infidels or inadequate people, they should receive an adequate treatment along with support from their doctors, families, friends, and the entire community to help them get better and manage their condition more effectively. It would require the community as a whole to get interested in the disease and get informed as much as possible. It is quite disheartening when an otherwise normal individual is labeled as insane when they could be helped back into rationality by being given the right kind and amount of support within the society. Thus, It falls upon the community in its entirety to learn about schizophrenia, so that they can support the patients and enable them to realize their individual potentials and contribute to the society.
Considering that schizophrenia is largely a disease that develops when the patient is in their mid or late 20’s, it is often important for the parents and guardians to watch out for the symptoms in teenagers in that they may be able to recognize it early and avoid deterioration that may make managing it more difficult. The exact cause or point at which the disease develops in an individual is relatively unknown, but some studies have indicated that an individual could be schizophrenic based on the conditions the experienced while still in the womb. It would imply that they need only be exposed to trigger circumstances such as a stressful emotional experience for them to get the full blown symptoms of the condition. In average, the mid and late 20s are stressful for most people, thus, this is when the symptoms start coming out in the open. However, cases in which a teenager would show serious symptoms based on their lifestyle at home or at school. Drugs and peer pressure have also been known as contributing factors when it comes to schizophrenia in teenagers.
Being a chronic disease, schizophrenia is largely symptomatic in that the individual suffering from this condition is likely to have a number of distinct characteristics, which in most cases, would be definitive if diagnosed carefully (Raine, 2006). Amongst the four major symptoms are delusions, hallucinations, disorganized thinking and speech, as well as hampered social engagement. Delusions are considerably false beliefs that are held even in the presence of evidence that proves the contrary. Generally, a delusion is considered a symptom of a mental disorder considering that the patient holds on to their belief despite rational arguments against it. For schizophrenia, the delusions are often serious including persecutory attacks from ‘enemies,’ the ‘government,’ and the ‘church’ among other significant authoritative figures. The individual may also insist that they have a ‘stalker’ or a ‘secret admirer’ or that they are celebrities in the film, sports or music industry. In any case, their beliefs are often unfounded and impossible to get out of their minds considering they think it’s actually true.
Hallucinations are generally experiences that involve things that do not really exist, like voices in one’s head, a conversation with someone who is long dead, a smell that is not real among other things. Schizophrenia is largely attached to voices in the head, otherwise termed as audio hallucination, a condition when the patient frequently hears voices when all is quiet. Other hallucinations may also be experienced, including olfactory and sensory which usually also have the full impact as if they are real. Thus, the patient is likely to argue it out like they really have experiences whatever it is that is on their minds.
Disorganized thinking and speech on the other hand implies the inability of the patient to maintain a train of thought. They often communicate in a way that is difficult to understand considering that the sentences barely have any connection and that questions are not always answered as expected. As a symptom of schizophrenia, disorganized speech is considered a manifestation of disorganized thoughts where the patient is unable to think of one thing at a time but rather mix up various thoughts into one incomprehensible thought.
Hampered social engagement refers to withdrawal from social activity based on one’s inability to form and maintain social relationships or express themselves adequately. Paranoia and anxiety also contribute to the hampered social engagement in that the individual does not trust in anyone’s intentions towards them and are constantly questioning people’s actions and gestures towards them. While there are numerous causes of withdrawal from social activity, schizophrenics are almost always withdrawn thus implying that despite being inconclusive this symptom is an accurate description of individuals with the condition.
Other than these main symptoms, there are a number of characteristics that are associated with schizophrenia including depression and anxiety, sloppiness in the way one dresses, grooms and responds to questions and stimuli, difficulties in paying attention, remembering things, processing information when being talked to and understanding facial expression, as well as general psychosis indications.
Psychologists believe that there is no particular factor known to cause schizophrenia, however, studies show a connection between the condition and a number of factors such as genetics, brain development, neurotransmitters and complications during birth or pregnancy (Raine, 2006). While there is no particular gene connected to the occurrence of the condition, people with a family history of schizophrenia are more likely to develop the condition than those who do not have a history. In simple terms, it means that there is a hereditary element to the condition’s occurrence although having a family history does not guarantee that one will suffer from the condition. Genetics is thus just one of the factors at play when it comes to this disease. Studies on the brains of patients with this disease have also shown a difference in the brain cell structures, their distribution around the brain and their numbers as well. It implies that the symptoms associated with schizophrenia may be as a result of the alterations in brain structure and the central nervous system of the patient in question. Moreover, while there are not any conclusive studies on this front, it is clear that the brain of a schizophrenic is quite different from that of a normal individual.
Considering the fact that the patients are treated with medication that is meant to alter and create a balance in the patients’ neurotransmitter chemicals, it can be stated that the disease is caused by an imbalance between the neurotransmitter chemicals known as dopamine and serotonin. However, the reason behind this imbalance is yet to be underlined by scientists in this field of study.
Another possibility with regards to the cause of schizophrenia has been named as complications during childbirth or during the pregnancy itself. Cases of malnutrition, exposure to toxins and other unwanted microorganisms such as viruses have been stated to cause schizophrenia as well. Such situations affect the child’s brain development that increasing the possibility that they will be schizophrenics once they grow up. Other than the causes, there also are factors that are known to trigger schizophrenia and may in some cases mistaken as causes when all they do is highlight the condition or magnify the symptoms. They include stress and drug use especially in teenagers.
Despite not being able to pin point the cause of schizophrenia, there factors that have been known to increase the risk of an individual in developing the disease. They include family history, exposure to toxins and other unwanted microorganisms such as viruses as well as malnutrition while in the womb, an excessively high immune activation, being born to an old father and using psychoactive or psychotropic drugs during young adulthood. All these may not be the causes of schizophrenia but they increase one’s chances of getting the disease. At this point, it is important to note that the condition mostly affects young adults in their mid or late twenties although there also have been cases of teenagers being diagnosed with the condition. However, it is currently considered impossible to develop schizophrenia past 45 years of age.
As a chronic disease, schizophrenia is largely untreatable and the patient requires lifetime therapy to manage the condition. It implies that the treatment options that are available for the condition are mostly supportive therapies that would help them in dealing with the symptoms so that they can live their lives in as much normalcy as possible. The complex thing about treatment options for this condition is that although medication is the cornerstone of the patient’s wellbeing, the fact that there are expectations of some serious but rare side effects brings about a lot of resistance and unwillingness of the patients to taking the medication. There are two main treatment components which are not necessarily options considering that they must work hand in hand. They are medications and psychosocial interventions. Support systems are also considered invaluable while the patent is coping with the disease and coming to terms with its impact in their lives.
Considering that schizophrenia has been associated with imbalances in the brain’s neurotransmitter chemicals, the medications prescribed for this condition are often those that can control the brain’s symptoms by playing around with these chemicals. The attitude of the patient towards the medication greatly affects the doctors’ choices during prescription. Patients who are cooperative would be given pills while those who are largely resistant are often given injections. Others could be given medication to calm them down first in the event of aggression. Generally, the available medication for this condition are the antipsychotics, which could either be typical or typical where the typical ones have more severe side effects than the atypical ones. Most patients today are treated with the atypical antipsychotics to enable them live out their lives as normally as possible. However, the typical ones are relatively cheaper than the atypical ones, and considering that the treatment is long-term, it may be presumed wiser to settle for them despite their side effects.
When it comes to treating schizophrenia, it must be noted that the time taken from the start of the medication to the improvement of the symptoms varies with the individual and the most important thing is to continue with the medication as prescribed. The psychiatrist in charge is often going to change the dosages and the prescriptions until they find the most effective combination given that he goal is to control the symptoms at a minimal level so that the patient can be normal again. In this case, it is important to work with the medical team and hope for the best in terms of results.
Severe schizophrenia is often characterized by denial and aggressive anti-social tendencies that make it difficult to interact with the patient (Torrey, 2013). However, once they are on antipsychotic medication, they become more social in that their symptoms of psychosis recede and once again they are able to be social and interact with the people around them. It is the point when they can be introduced to other interventions, both psychological and social, but without abandoning the medication. While the dosage and frequency may be reduced, the patient still has to keep their neurotransmitters balanced to avoid a relapse into the serious symptoms. There are various types of intervention that can help a schizophrenic, and these include individual therapy, social skills training programs, family therapy, and vocational rehabilitation, as well as supported employment.
Individual therapy involves helping the patient to acquire stress management skills, so that they are able to cope with life’s difficulties and identify the warning signs of their breakdown and thus, effectively manage their condition. Given that these individuals live in the real world, it is impossible to protect them from the stress factors and harsh realities that they are likely to face. Thus, it remains practical that they are given the necessary skills to protect themselves if they are to live in this normal world without suffering to much from their condition. Such skills will eliminate the idea that they are victims by empowering then to take care of themselves at all times.
A social skills training program is aimed at helping them recover from the anti social symptom of their psychosis. The training program is often tailored to improve the communication skills of the individual and get them to interact with other people with much more ease. It is an important intervention because the patient needs to live a full life and their social wellbeing depends on their ability to communicate, form and maintain relationships and simply be able to express their thoughts and feelings in a way that can be understood and appreciated.
Family therapy is all about equipping the patient’s family with all the relevant information that would enable them co-exist harmoniously with the patient. It is often done in order to avoid the tension and stress that would often come from having a member of the family diagnosed with this condition. In the past, there were often cases when the patient would be left to live on the streets due to frequent conflicts with family members who were unable to understand them due to their condition. Other families also left their loved ones without medical attention only making them get worse with time. Thus, the family therapy is aimed at teaching the family the importance of their support for the patient and how they can live together peacefully.
Vocational rehabilitation is aimed at training the patient with useful skills that can help them to earn a living. In most cases, schizophrenics end up jobless and homeless due to their hampered cognitive functions. However, the right medical care they are able to control this symptom and thus, think clearly. When they become adults, it is quite important for them to have the necessary skills to make some money and support themselves. Vocational rehabilitation enables these individuals to work and be independent thus eliminating the feeling of inadequacy and vulnerability.
On the other hand, supported employment occurs when a given institution provides the patients with the access to employment and supports them in such a way that they are able to keep the job. Finding a job is not the only challenge for these patients, keeping it is actually more difficult considering the symptoms of psychosis which may include confusion, loss of long-term memory and aggressive behavior among others. When provided with supported employment, they are not only monitored but also constantly motivated to stay on the right track and work hard. Thus, they are enabled to become fully functional members of the society with the ability to depend on themselves.
Another important aspect in the treatment of a schizophrenic is the support that they are supposed to receive. Other than their families and medical institutions that work with them through the vocational rehabilitation ad supported employment, it is important to note that they live in the real world and that they have to be able to feel at ease when outside their homes and hospitals as well. For this to happen, these individuals need a support system or a support group, in which they are able to talk about their experiences and feelings as schizophrenics. It will be a good way for them to encourage and motivate one another as they deal with their challenges with each others’ support.
Dealing with the Patients
The most important aspect of treating schizophrenia is rehabilitation into the real world. Most patients suffering from this condition are considerable alienated from the rest of the world during the first stages of treatment as they get to deal with the severe symptoms of their psychosis. Nevertheless, once they are able to get on with their lives with little support from the medication, they need to be able to interact with other people in normal environments without feeling inadequate or relapsing into their symptoms. In order to ensure that the environment is safe for these individuals and helpful in their journey towards normalcy, it is important for the people with whom they interact to understand how to deal with them. However, it must be noted that they are not invalids and that they need to feel as normal as possible without being singled out and looked at sympathetically all the time.
Parents and Guardians
At home, the parents are presumably the pillars of strength for the person suffering from schizophrenia. Thus, it is their role to encourage, motivate, and challenge the individual adhere to the doctors’ directives when it comes to medication and social indulgence. For parents, the most important thing is to provide moral and emotional support so that the patient can feel valued and loved. Also, they need to know that they are trusted and thus, the parent must leave them to do the things that they are comfortable dong around the home. The should avoid smothering them with attention as this would only make them feel vulnerable especially when their other siblings are granted the freedom to do the same things without help or supervision. Thus, when dealing with a schizophrenic child, the parent must not only be understanding and supportive but also willing to trust in the child’s abilities and let them do as much as they can independently.
As parents, they are required to have strong relationships with their children so that they feel comfortable enough to talk about their experiences and challenges and come up with ways to overcome them together. Communication is thus an important part of how the parents interact with these individuals. While the parents need to be in good terms with their children to foster effective communication, they should not pay too much attention to them as this too will make them lose confidence in their individual abilities as well.
As friends of a schizophrenic individual, it is also important not to smother them with attention. The patient may need help from time to time and thus, it is important to understand how to offer help without undermining their capabilities. While the friends do not have to be emotional shields, they have to avoid unnecessarily stirring up strong emotions that may lead to stress. Thus, while they can indulge in aimless banter every once in a while it is always crucial to avoid putting too much pressure on the patient. They may be able to manage stress but it is not wise to test their abilities all the time. Reminding them of their medication schedule is also a relatively good idea in that they may get carried away and forget about it creating imbalances that may trigger a relapse in symptoms.
In most cases, teachers are considered crucial in the development of an individual. They are able to make or break the person’s confidence and must as such be careful. A schizophrenic individual needs a lot of support without necessarily soft peddling them. They need as much motivation and encouragement as they need to be challenged and pushed to do their best. However, this must be accomplished carefully seeing as they do not need extreme pressures. Teachers are best placed acting as guides when it comes to setting and accomplishing goals. They need to be able to set realistic expectations that are neither too low nor too high. They are tasked with the responsibility of ensuring that the patients develop the necessary skills that will set them up for normal community living. Thus, the teachers are expected to handle schizophrenic students with as much attention and care as they handle the other students except that they should consider forming personal relationships with them to enable them open up and talk about their feelings, expectations, and needs.
Over the past few years, the impact of the community when it comes to schizophrenics has been under scrutiny given the renewed interests in the contribution of the environment to the treatment of the condition. The community within which one lives must be able to give them enough opportunities to realize their potential as individuals. For a schizophrenic patient, potential may imply living a normal life with the help of medication and support systems as well as stress management skills. It may also include being able to compete equally for employment opportunities and being evaluated for their capabilities and not instead favored for their weaknesses. Thus, it can be stated that the role of the community with respect to this condition remains largely undefined except that the people must be understanding and at some point tolerant when dealing with these patients considering their vulnerability to stress.
Schizophrenia is a serious and chronic condition that does not just go away but rather requires full time management for a full life. The patient is able to live a normal life if they adhere to their medication and partake in all the interventions as laid down by their doctors. In some instances, the patients are able to make a full recovery from their symptoms and thus live out the rest of their lives to the best of their abilities with limited restrictions. However, in other cases, the patient keeps struggling with the possibility of a relapse based on the environmental factors to which they are consistently exposed. Basically, it means that while schizophrenia is in some way a mental disorder associated with alterations in the brain structure, there are a lot of environmental factors at play here. When considering the symptoms of this condition including delusion, hallucinations, disorganized thoughts and speech, as well as hampered social engagement stand out as the most significant ones to be noted. Patients with this condition are also usually aggressive and in denial of their condition implying that getting help for them is not always an easy task. With respect to how they can be dealt with, it is important to note that they need as much normalcy as they can get and thus they should be allowed to be independent whenever they can. Independence, in this case, implies being able to take care of themselves and to help with tasks as much as they can. They may not be able to function fully without medication and psychosocial intervention but with these treatment options these individuals are limitless in their potential.
The largest impediment to adequate care for people with schizophrenia is the lack of information. The community is a place where such individuals are expected to spend their lives and achieve their dreams similarly to the rest of the people. Thus, it follows that one would expect the community to be in a position to support them fully and help them in their journey towards recovery and rehabilitation. They are not inadequate or disabled rather they just have challenges dealing with situations that the normal individual considers easy to deal with. As such, it is important for the community to at least be neutral as opposed to judging and condemning individuals who have this condition.
Another recommendation would be for the parents of schizophrenic patients to give them enough room to grow. While it may be assumed that giving them a lot of attention will help to deal with their emotional detachment and expression issues, it may further push them into depression as they consider the attention a manifestation of mistrust. Thus, the parents must consider giving these individuals the room to take care of themselves and to help out with chores whenever they are able to. Therefore, they will feel useful and capable of normalcy. They should enable them to live in an ordinary society without requiring help except for the support systems and medication.
- Keefe, D., & Harvey, P.D. (2010). Understanding schizophrenia: A guide to the new research on causes and treatment. London: Penguin.
- Raine, A. (2006). Crime and schizophrenia: Causes and cures. New York: Nova Science.
- Torrey, F. (2013). Surviving schizophrenia: A family manual (6th ed.). New York: Harper Perennial.
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