Home   Index   Search   Contact Us

Schizophrenia

(Northpark Psychotherapy Unit :  033 341 5565 : Townhill hospital)

What is Schizophrenia?
Schizophrenia is a chronic, severe, and disabling brain disease. Approximately 1 percent of the population develops schizophrenia during their lifetime. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Their speech and behavior can be so disorganized that they may be incomprehensible or frightening to others.

Signs and Symptoms

Early signs of schizophrenia may not be noticed by family and friends. People who suffer from schizophrenia sometimes display one or more of the following symptoms in the early stages of the illness:

As the disorder progresses, the symptoms become more intense and bizarre. The person develops peculiar behaviour, begins talking nonsense and has unusual perceptions. These more severe symptoms are usually the reason for seeking treatment.

Delusions are unusual beliefs that are not based in reality. For example, people suffering from schizophrenia might believe that someone can hear their thoughts or control their feelings, actions or impulses.

Hallucinations are distortions of the senses. Auditory hallucinations cause people to hear sounds that are not there. Visual hallucinations cause people to see things that do not exist. Tactile hallucinations are sensations without cause, like burning or itching. Olfactory hallucinations, smelling non-existent odours, can also occur.

Preoccupations are thoughts that take on more importance in the sufferer’s mind than they normally would. The same though returns often and can become unrealistic. This may include a preoccupation with health, or “doing the right thing”.

Disordered thinking interferes with planning, motivation and communication. For example, a person may use words that make no sense, or jump from one thought to another unrelated thought.

Social withdrawal causes the schizophrenic to seek isolation. This may include an intolerance of being in crowds, small gatherings or even with just one other person.

Lack of motivation and emotion as well as apathy are symptoms, which are troubling for family members to see in their loved ones. Few people experience all these symptoms at once. Some may occur during the remission phase and may worsen in the most active phase of the disorder.

Treatments

Like many other mental illnesses, schizophrenia is usually treated with a combination of therapies, tailored to the individual’s symptoms and needs.
Antipsychotic medications under the supervision of a psychiatrist is the treatment of choice for schizophrenia, because the illness is related to biochemical imbalances. These medications can reduce hallucinations, delusions and disordered thinking, but few of them adequately treat the social withdrawal and apathy that occurs in schizophrenia.

As with all medications, antipsychotic medications have side effects. Some, such as dry mouth, dizziness, drowsiness and constipation, go away with time. Other side effects include restlessness, tremor and muscle spasms, cramping or stiffness. An irreversible side effect is tardive dyskinesia, which causes abnormal movements in the mouth, face and later in the arms and legs.

Many of these side effects can be helped or avoided when reported to the psychiatrist. It is important not to abruptly stop taking the medications, increase the medications or take additional medications without consulting a doctor. Such changes can cause relapse or other serious problems.
Medication is usually prescribed through the remission phase of the illness to prevent relapse. Though relapse may occur even when medication is taken as prescribed, taking the medication provides the best protection from future relapse.

Psychotherapy and other supportive therapies address the emotional and practical responses to these illnesses and are typically recommended in addition to medication.
The hallucinations, delusions and isolation caused by schizophrenia can impair a person’s relationships with other people, daily living, spiritual growth and job skills. Individual psychotherapy helps patients to understand their emotions and deal with life’s problems in a more confident, healthy way. Group psychotherapy allows patients to learn social skills and gain emotional support for the difficult times as well as offer support to others.
Occupational therapy helps patients return to daily living skills and routines, which may have been impaired by mental illness. Activity therapy focuses on problems through recreational and group activities.

Living with Schizophrenia

The outlook for people with schizophrenia has improved over the past two decades. While no absolute cure has been identified, modern treatments have allowed many schizophrenic patients to lead independent, fulfilling lives. It is important, however, that people who might have the disorder be diagnosed quickly so that treatment can begin as soon as possible.

How family and friends can help

The first way family and friends can help is to take an active role in having the patient seek treatment. The schizophrenic person usually believes that delusions and hallucinations are real and that psychiatric treatment is not needed.

When treatment begins, recognize that many of the antipsychotic medications will likely cause the patient to require more sleep than usual. Also, understand and be prepared to recognize possible medication side effects as well as symptoms that would require contacting the doctor.

Speak clearly and simply. Because the illness can cause problems with thinking, it is helpful to limit conversation to the most simple statements and questions. Recognize delusions and hallucinations as symptoms. The perceptions are real to the patient; do not argue that the delusion is true or false. Pointing out that he or she does not have to listen to the voice or wait for the voice to speak again can be helpful.

Find a way to empathize. For example, the loud music played by the neighbours at night might be interpreted in a delusion as a tactic to control the patient’s thoughts. Rather than insisting that this is untrue, acknowledge how upsetting loud music can be while trying to sleep.

Provide structure. Help the person recovering from the illness to plan the days to include plenty of sleep, healthy food, fresh air, time for exercise, cleanliness and social interaction.

Family and friends should plan ahead and be prepared for possible crises. Medications, phone numbers and other important information and materials should be kept readily available.

Dealing with a relative or friend with schizophrenia can be tremendously stressful. Family and friends can find emotional support, understanding and hope from outreach, education and advocacy groups. Whether you are the victim, a family member or friend, everyone who is affected by this mental illness should seek help.

Tips for living with Schizophrenia

Schizophrenia recovery does not assume the patient will be symptom-free all the time. People living with schizophrenia patients must be aware of this. Delusional thoughts may surface occasionally, even with antipsychotic medications. Psychotherapy can teach schizophrenics to identify delusional thoughts, and by attending some psychotherapy educational sessions, family members can learn how to manage delusional thinking.

Up to 75 percent of all people living with schizophrenia will have some degree of social withdrawal. Verbal communication may be difficult: family members may have to be sensitive to facial expressions. Mood swings and difficulty focusing are also common occurrences even when schizophrenia recovery is a success.

Schizophrenia recovery may suffer relapses, even with regular medication. Family and friends who understand an individual schizophrenic's psychotic behaviour may be able to detect symptoms of a relapse in its early stages, allowing treatment to begin as soon as possible. Warning signs may be apparently harmless. For instance, many people clip newspaper coupons. A harmless enough activity, but if a schizophrenic's delusion caused him to believe that coupons were secret messages, suddenly starting to clip and collect coupons may be a sign of a relapse.
 

Back to Townhill hospital

 








The materials on this website may be copied for non-commercial use as long as our copyright notice and website address are included.
Copyright KwaZulu-Natal Department of Health, 2001

 | Disclaimer