Schizophrenia & Other Psychotic Disorders
Schizophrenia and psychosis are very losely used terms these days but medically speaking they are serious mental illnesses that require intense management.
Schizophrenia is a major mental disorder in which people interpret the reality abnormally. It impacts a persons behvaior, day to day functioning, interpersonal relationships, family life, social life and their occupational functioning.
Stigma and discrimination of people with schizophrenia is common both in healthcare facilities and in the community setting. Stigma leads to social exclusion impacting their relationship with others including their own friends and family. This contributes to discrimination, which in turn can limit access to general health care, education, housing, and employment. They are more vulnerable to neglect, abandonment, homelessness, abuse and exclusion.
Medications are the primary mode of management in people with schizophrenia. Supportive therapies on an individual level as well as psychoeducation and family interventions and psychosocial rehabilitation (eg. life skills training) are helpful. In India, according to the RPwD Act (2016), persons with Schizophrenia are entitled to benefits under this Act.
Common symptoms:
Delusions : when you hold a fixed, false, unshakable belief that persists despite others giving evidence to the contrary. It may manifest in the form of you doubting your partner, being suspicious that people are out there to harm or kill you, feeling that you are being followed or suspicious that people are looking at you and talking about you. Some people feel that someone has done black magic on them even though they dont otherwise believe in such thing as black magic.
Hallucinations : simply put, hallucinations are perceptions without any stimulus. Hallucination can be experienced in any of the sensory modalities- auditory, visual, olfactory, tactile or gustatory. A person having hallucinations will hear voices or sound even though no one else can, see things/persons when there is no one, experience tastes even though there is nothing in their mouth, or feel a sensation or touch despite there being no stimulus.
Disorganised speech : unlike how we normally speak in a certain speed and remain to the point and say things relevant to the conversation, persons with schizophrenia have various speech and thought disorders which lead to them to not be able to hold a normal conversation. They are incoherent, irrelevant or illogical.
Disorganised behavior : manifests in the form of self talking, smiling or giggling, engaging in repetitive or purposeless movements, or displaying dd facial expressions and gestures.
Negative symptoms : remaining aloof and quiet, social withdrawal so much so that sometimes they even refuse food and water for days together, not brushing their teeth or combing their hair or cutting nails and other day to day selfcare activities.
Cognitive symptoms : difficulty in decision making, focussing on thingsm holding attention, troubles with memory and poor insight into their illness.
What causes schizophrenia/ psychosis:
An imbalance in the level of neurotransmitters like dopamine and serotonin cause various symptoms of schizophrenia. The imbalace could be due to :
- Stress
- Viral infections
- Head Trauma
- Hormonal imbalances
- Alcohol and other addictions (cannabis, MD, cocaine etc)
- Medical illnesses
- Neurological disorders
- Tumors
- Family history / genetic
Associated conditions with untreated Schizophrenia and psychosis:
Psychosis frequently goes untreated due to various reasons most common of which are a poor understanding of the illness and stigma attached to mental illnesses and Psychiatrists. Cultural and religious beliefs also play a major role in delayed treatment.
Untreated psychosis and Schizophrenia are associated with :
- Poor family relationships
- Social isolation
- Homelessness
- Joblessness
- Addictions
- Abuse
- Poverty
- Anxiety
- Depression
- Suicide