World Mental Health Day – Living with Schizophrenia

In fact, mental illness can span from depression, anxiety, unwarranted or exaggerated fear, to full-fledged psychosis, schizophrenia, major depression, manic depression and mood disorder. 'The Scream' painted by Edvard Munch is said by some to symbolize the human species overwhelmed by an attack of existential angst. AFP PHOTO / SIDSEL DE JONG

Schizophrenia remains one of the most neglected and misunderstood illnesses in the world. It imposes a heavy toll on the individuals who experience it, their family members and caregivers.

Each year, World Mental Health Day is celebrated on Oct 10. This day is significant in drawing attention to issues concerning not only mental illness, but also mental wellbeing. This year’s theme is “Living with Schizophrenia”.

To commemorate the day, The Malaysian Mental Health Association and the Health Ministry are organising week-long events to increase public awareness on mental health problems, including schizophrenia, and to destigmatise all forms of mental illness.

What is schizophrenia?

Schizophrenia remains one of the most neglected and misunderstood illnesses in the world. It imposes a heavy toll on the individuals who experience it, their family members and caregivers.

The high level of stigma, discrimination and superstitious beliefs associated with schizophrenia is an added burden to those with this illness.

Schizophrenia is a serious mental illness that affects how a person thinks, feels and acts. Many people with schizophrenia find it difficult at times to tell the difference between real and imagined experiences, to think logically, to express feelings, or to behave appropriately.

Schizophrenia often develops in adolescence or early adulthood, and affects approximately 26 million people worldwide.

People with schizophrenia experience a range of symptoms, usually hallucinations and delusions, that make it difficult for them to judge reality.

While there is no absolute cure for schizophrenia at the moment, effective treatments are available in both public and private healthcare delivery services in our country.

Early signs of schizophrenia include:

  •  Sleep disturbance
  •  Appetite disturbance
  •  Marked unusual behaviour
  •  Feelings that are blunted (flat) or seem incongruous (inconsistent) to others
  •  Speech that is difficult to follow
  •  Marked preoccupation with unusual ideas
  •  Ideas of reference – thinking unrelated things have a special meaning, i.e. people on TV talking to the person
  •  Persistent feelings of unreality
  •  Changes in the way things appear, sound or smell

One of the main reasons schizophrenia has been considered such a devastating illness is the fact that it usually first appears during the late teens or early 20s, at a time of life when the young person is finishing education or entering the workforce, establishing social networks, and beginning to assume independence.

Any serious illness can severely disrupt this normal development, and it is this disruption, rather than the symptoms of the illness alone, which impacts the young person so severely that “living with schizophrenia” makes life miserable for those challenged with this illness.

However, there are others too who “live” with schizophrenia. These are the family members and caregivers. The impact of schizophrenia on the mental health of family members and caregivers cannot be underestimated. The burden of schizophrenia also falls on them.

The social stigma attached to schizophrenia, the discrimination experienced by sufferers, and the difficulties in rehabilitation and social reintegration, are also shared by the family.

Stigma and discrimination

Management of persons with schizophrenia has been very shameful in the past and is still so in many parts of the world, and there have been dark periods in the history of humanity during which the mentally ill have been mistreated and ridiculed.

Even today, in many parts of the world, a great proportion of patients still do not receive any treatment at all, and in effect, this dehumanises them from an individual to an illness, or worse, a curse.

Today, progress in the treatment of schizophrenia no longer means that patients’ dreams and aspirations to lead a normal life need to be permanently put on hold.

Having schizophrenia is no longer a lifelong curse. Recovery, to a large extent, is not only possible, but is a natural right of those diagnosed with the illness.

Take for instance, Visalatchi, who is 22 years old. She was diagnosed with schizophrenia when she was 19.

She underwent a challenging period of grappling with her illness, which brought immense suffering to her family as well. She then sought treatment at a government hospital in the Klang Valley.

She is now functioning well, and is on medication and periodic follow-up with her psychiatrist.

Visalatchi successfully runs her own bridal make-up business. She aspires to be an advocate for mental illness and has even written about it in a book, In My Shoes, which was launched in Klang, Selangor, last Friday.

What can be done?

Blaming one another for the illness of a loved does not help. Neither should the facts of the severity of schizophrenia lead to pessimism.

Modern methods of treatment, coupled with a change of attitude in society about mental illness, have resulted in very impressive changes that have allowed “living with schizophrenia” to be a positive and productive experience for many people.

Helping a person with schizophrenia

  •  Do not feel ashamed because someone in your family has it. It is a medical condition, just like  diabetes or hypertension.
  •  Do not feel guilty or seek someone to blame. Schizophrenia is nobody’s fault.
  •  Educate yourself about your relatives’ condition. Learn more about his or her symptoms and early  clues such as poor sleep and social withdrawal, which indicate an impending relapse.
  •  Establish a daily routine for the person to follow.
  •  Encourage the person stay on the medication prescribed.
  •  Assure the person that he or she is not facing the illness alone, but has your support.
  •  Avoid harsh or direct criticism.
  •  Compliment achieved goals without being too effusive in your praise.
  •  Caring for the person can be emotionally and physically exhausting. Take time for yourself.

Newer antipsychotic medications with minimal side effects have made significant recovery possible.

Many more can live in the community, leading normal everyday lives.

The dynamic collaboration and synergism between consumers, caregivers, professional associations and society as a whole can make “Living with Schizophrenia” worth living.

> Datuk Dr Andrew Mohanraj is the deputy president of the Malaysian Mental Health Association. He is also a member of the Mental Health Promotion Advisory Council, Health Ministry.

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