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Society and media have used the term “schizophrenia” unfairly for ages to describe violence and disturbance, although the vast majority of patients who live with schizophrenia tend to do self-harm rather than harming others. It is often mis-interpreted with psychoses. This is one reason why many individuals and their families find this diagnosis devastating and perhaps shattering; it feels as if this person was judged to have a life of violence and ‘failures’.

Schizophrenia affects about 1 in 100 people, and tends to occur slightly more in males than in females, and the onset of the symptoms ranges between 16 and 30 years of age. This pamphlet aims at describing schizophrenia and tips for patients and caregivers to cope with this illness and stay in control of their lives.

Let’s start by distinguishing facts from myths about schizophrenia:

MYTH: Schizophrenia is split personality.

FACT: Schizophrenia is an illness that affects the individual’s thoughts, feelings, and behaviors. It is described in further details later in this leaflet.

MYTH: People with schizophrenia are violent and should be kept away.

FACT: This is the exception, not the rule. Patients with schizophrenia are more likely to harm themselves or be victims of violence.

MYTH: Patients with schizophrenia should often be hospitalized.

FACT: Hospitalization is only needed in rare situations, and with proper treatment, many individuals with schizophrenia have a stable life, work, and stable relationships.

1. What does schizophrenia feel like?

The symptoms of schizophrenia are usually described as positive and negative.

  • Positive symptoms: unusual experiences that are intense, distressing, and troublesome. They involve hallucinations (auditory, visual, sensation, or smelling experiences that are not really there), delusions (strong beliefs that others find weird or misunderstood), disorganized speech and thought process (disconnected or blocked thoughts), movement disorders (repetitive purposeless movements, or complete loss of motor activity)
  • The most common type of hallucinations is auditory. To the patient, these voices are utterly real, and may be conveying different messages to him/her, most commonly criticizing or even abusive.

Once the patient slips deeper into the symptoms of schizophrenia, s/he finds it more difficult to distinguish hallucinations from reality, and connecting with people around becomes more challenging.

  • Delusions can take different forms, for instance, persecutory “others are trying to poison or spying him”, or more bizarre, such as “people on TV are sending him special messages” or “aliens are broadcasting my thoughts to the space’’.
  • Negative symptoms: loss of energy, loss of interest or joy, lack of concentration, decreased socialization, reduced expression of emotions either by facial expression or vocal tones, decreased self-care (hygiene, shaving, tidying)
  • To the patient, the whole world is wrong, and everyone around has a problem of not seeing or believing his/her experience.

2. What puts a person at risk of developing schizophrenia?

  • Genetics; the risk of developing schizophrenia is 10 times higher if you have a parent who has schizophrenia
  • Changes in brain chemistry; imbalances in the naturally occurring neurotransmitters, namely Dopamine and Glutamate are associated with schizophrenia
  • Changes in the brain structure; research on people with schizophrenia suggests that some areas in the brain change in shape and activity
  • Traumatic childhood
  • Drugs, alcohol, and stress may trigger the signs of schizophrenia

3. What are the treatment modalities at LWHCC for schizophrenia?

The earlier the treatment of schizophrenia is initiated, the better the results are, and the lesser need for hospitalization.

  • Medications, mainly antipsychotics, aiming at reducing the hallucinations and delusions, helping the patient think clearly, and helping the patient take good care of one-self.

Other medications may be prescribed depending on the presenting situation, such as antidepressants and mood stabilizers.

Please do not hesitate to contact the mental health team at LWHCC for detailed description of those medications.

  • Psycho-education about the nature of the illness and treatment has shown to be very effective with individuals with schizophrenia. Psychoeducation also helps individuals with learning coping skills and more adaptive interpretations of the events.

Which treatment modality is better for me?

At LWHCC, we will provide you with free triage service with a professional mental health nurse who will carry on a brief mental health assessment, either over the phone or during a face-to-face interview, and guide you to the appropriate service based on your mental health status and individual needs.

4. What can you do to help yourself?

Although schizophrenia is a lifelong condition, treatment along with self-help techniques have shown great improvement in the quality of life of individuals with schizophrenia.

  • Follow your treatment as agreed with your mental health team.
  • Learn about schizophrenia. Education is empowering and encouraging to follow your treatment plan
  • Eat well and stay active. Maintain a healthy lifestyle to avoid medication related side effects, including diabetes and weight gain
  • Avoid smoking, drugs, and alcohol
  • Stay focused on your goals; recovery is a long process
  • Learn relaxation techniques
  • Learn about your warning signs; maybe lack of appetite or changes in sleeping patterns, or when others start telling you that you are neglecting yourself
  • Remind yourself that the voices cannot harm you. They do not have a power over you and cannot get you to do things you do not want to do
  • Keep yourself busy with things you enjoy. If you can, go back to work or study
  • Share details of your illness with a trusted/ close person and set a plan in case you become unwell

5. What can you do to help a close one who has schizophrenia?

Living with someone with schizophrenia is challenging. You may not recognize your close one and may not understand what is going wrong with them. It can have a toll on the couple’s/family’s finances, social relationships, and personal relationship. Keep in mind that your close one is suffering. He/ She does not intend to be rebellious or cause harm. Schizophrenia is a chronic illness that lasts for a long time and treatment requires a lot of commitment, and this is best achieved with the support of family or close social network.

  • Learn about schizophrenia. You may want to discuss your concerns with the patient’s mental health team. Please do not hesitate to contact us any time you have a question.
  • Listen. You do not really need to provide answers. Simply, by providing your attention and reassurance helps your close one further than you can imagine with accepting their condition and treatment
  • Learn about the warning signs when your close one is becoming unwell
  • Be active in your close one’s treatment.
  • Do not neglect yourself. Make sure you have emotional and mental capability to support your close one, or else you will burn out
  • Make a plan with the patient if s/he becomes unwell
  • Learn about the warning signs
  • Do not challenge the delusions by stating that they are wrong or imaginary, and do not go along with the delusion. Simply state that you see things differently and that everyone has the right to see things in their own way.

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