Aunt agatha Advocates: What is Schizophrenia?

Written by: Carissa Aletha Liem (21-I1), Harel, Jolina Nair (21-E5)

Designed by: Lay Kai En, Ashley (21-O1)

Introduction: What is schizophrenia?

Schizophrenia is a chronic, severe mental disorder which alters one's thoughts, actions, emotions and perception of reality. Because their condition causes them to lose touch with reality, they often feel terrified and withdrawn. This poses a great challenge in their day-to-day lives and relationships with others. It is a lifelong disease that cannot be cured. However, there are treatments to help schizophrenic patients cope better. 

Contrary to popular belief, schizophrenic patients do not have multiple personalities. Instead, schizophrenia involves a psychosis, a type of mental illness in which a person cannot distinguish hallucinations from reality. This makes the world appear as a confusing mix of thoughts, imagery and sounds. This may result in psychotic episodes where there is a sudden change in personality and behavior when they lose touch of reality. 

The severity of schizophrenia varies from person to person. Some may only experience one psychotic episode while others may experience many episodes throughout their lifetime but still maintain a relatively normal life. The worsening and improvement in cycles are known as relapses and remissions. 

What are the symptoms?

The prodromal period is the period when symptoms first appear before a full psychotic episode. It can span over days, weeks, or even years. It can be difficult to notice as there is often no specific trigger. Instead, symptoms are often subtle changes in behaviour that include random outbursts, social withdrawal, difficulty sleeping and concentrating.

Positive symptoms or psychotic symptoms are thoughts or actions that are not based in reality. They can be split into three categories: delusions, hallucinations and catatonia. Delusions are false, mixed and strange beliefs that a person refuses to forgo despite evidence proving its falsehood. Hallucinations are sensations that are not real. This most commonly comes in the form of hearing voices that comment on a person’s behavior, insults them or gives them commands. Less common forms include seeing false images, smelling strange odours, tasting strange flavours and feeling unusual sensations. Catatonia, on the other hand, causes a person to become temporarily mute and fixed in a single position for a prolonged period of time. 

Disorganised symptoms are positive symptoms that show that a person is unable to think straight or respond normally. This can include illogical comments and the inability to hold a conversation. They tend to shift sporadically from topic to topic with repeated movements and gestures. They can also be indecisive and forgetful, making it difficult for them to comprehend sights, sounds and feelings.

Cognitive symptoms affect one’s learning abilities. They make it difficult for schizophrenic patients to process information and make decisions. They have trouble focusing and have a poor working memory. This may also mean that they are slow to recognise their symptoms. 

Negative symptoms occur when there is an absence of normal behavior in people with schizophrenia. These symptoms include limited emotions, withdrawal from relationships, lack of energy and motivation, and even poor hygiene and grooming habits.

How people with schizophrenia cope

So, how do people cope with and manage schizophrenia? Coping with schizophrenia is a lifelong process, but some self-help strategies could help limit the length and frequencies of schizophrenic episodes. Firstly, regular exercises help provide both emotional and physical benefits as it relieves stress, improves focus and calms the nervous system. Exercise therapy has also led to a decrease in negative symptoms and an overall improvement in cognitive skills and the quality of life of schizophrenic patients.

Next, keeping a balanced diet by eating regular, nutritious meals can also help schizophrenic patients avoid psychosis and other symptoms, usually brought about by changes in blood sugar levels. Boosting the intake of omega-3 fatty acids from fatty fish, fish oil, walnuts, and flaxseeds can help improve focus, banish fatigue, and balance moods. Low in fat and calories, packed with fibre and important vitamins, and without any heart-heavy cholesterol, vegetables are another staple in the diet of schizophrenic patients. Moreover, people with schizophrenia are most likely on medication and would need even more sleep than the standard 8 hours. Thus, avoiding caffeine and reducing sugar in their diet is imperative. 

Understanding and using medication is also a critical part of coping with schizophrenia, though it is important to note that medication is not a cure for schizophrenia and only treats some of the symptoms.Antipsychotic medication reduces psychotic symptoms such as hallucinations, delusions, paranoia and disordered thinking. These medications work on chemicals in the brain like serotonin and dopamine, helping patients tame psychosis. 

Ways to support those with schizophrenia

Often, people are confused and unsure about what schizophrenia is and their role in helping someone with schizophrenia. They might be afraid of accidentally doing something that could exacerbate the symptoms of those with schizophrenia. Thus, to have a wider understanding of the condition, if you are a friend, family member or a carer of someone with schizophrenia, you can consider doing a psychoeducation program, which can provide you with the chance to learn about schizophrenia from a professional. Someone from the healthcare industry would be able to demonstrate ways to deal with crises and better communication techniques. We can even learn to recognise the early warning signs of a psychotic episode, allowing us to have a plan for what to do. 

We can also learn motivational techniques to encourage the person to do things for themselves. Encouraging treatment and self-help is a cornerstone of helping a loved one with schizophrenia. While medication is a critical element of schizophrenia treatment, recovery also depends on other factors as well. The more someone does for themselves, the less hopeless and helpless they’ll feel, and the more likely their doctor will be able to reduce their medication. Our encouragement and support can be crucial to them starting and continuing a program of self-help. We should also focus on the person’s strengths – the things they enjoy or are good at. It is essential to keep reminding them that they have a role as a member of their family and community.

What not to say 

When dealing with someone with Schizophrenia, it will be helpful to empathise with their condition. As such, it is important to watch one’s words when interacting with schizophrenic patients to avoid agitating them and worsening their condition or coming across as insensitive. 

Firstly, we should refrain from engaging in a heated argument with schizophrenic patients as it only serves to provoke them even more. When going through a schizophrenic episode, the patient often loses control of their behavior or actions and can say things that are out of their personality. When we refute or criticise their behavior directly, it may cause the patient to feel cornered and attacked, triggering their fight or flight response. 

When a schizophrenic patient gets threatened, they may become irrational and lash out more easily, increasing the tensions between the two parties. Therefore, it is important to give the patient some space and listen to what they have to say instead of dismissing their claims entirely. When we acknowledge their beliefs and thoughts, it may be easier for them to share their inner thoughts and feelings which may improve their condition in the long run. 

As observers, we should also avoid stigmatising schizophrenic patients and second guessing their stability. Although schizophrenic patients may have ‘multiple personalities’, they still have emotions thus they should still be respected. When one questions their condition or suggests alternative treatments, it may trivialise the severity of their condition or make them less willing to share their thoughts with others. 

Conclusion

Ultimately, schizophrenia is a serious mental illness that should not be ignored or trivialised. That being said, schizophrenia is far from being a ‘death sentence’ as it can be cured by timely medical intervention and an environment of supportive family and friends.  It is only through knowing the illness better that we can lend a helping hand to those who really need help and support them on their journey to recovery. 

Bibliography

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2. Koutsky, J. (2021, April 21). 20 Things You Should Never Say to Someone With Schizophrenia. Parade. https://parade.com/1195578/judykoutsky/things-not-say-someone-schizophrenia/.  

3. M. (2021, April 27). Schizophrenia Treatment and Self-Help. HelpGuide.Org. https://www.helpguide.org/articles/mental-disorders/schizophrenia-treatment-and-self-help.htm

4. M. (2021a, April 20). Helping Someone with Schizophrenia. HelpGuide.Org. https://www.helpguide.org/articles/mental-disorders/helping-someone-with-schizophrenia.htm

5. Helping Your Loved One Get Schizophrenia Treatment. (2014, March 28). WebMD. https://www.webmd.com/schizophrenia/features/helping-your-loved-one-get-schizophrenia-treatment