| |
Dr.
Bill Gaultiere
Executive
Director of New Hope
www.NewHopeNow.com
"Did
you ever think you heard something and turn to discover nothing
there?" asks John Gillen on mentalwellness.com. "We
all have. But have you ever heard voices that seemed to be inside
your own head? Voices telling you that you smell bad or that you
should leap in front of a bus?"
John
suffers from Bi-polar disorder and Schizophrenia. He started hearing
frightening voices like this in his head when he was 14 years
old and into his 20’s. At times the voices were so unbearable
that he tried to literally run away from them by taking trains
or buses to far away cities. But always the voices came too. Until
John ran for help and got on the right mix of medications.
In
fact, recently John said, "My life has changed dramatically
because of these medications. I no longer wait for the voices
to tell me what to do. I set my own goals. I’ve moved into
my own apartment and attend a day program. And I’m hoping
to go back to school this summer to become a chef."
Unfortunately,
the mentally ill, like John, are routinely misunderstood, mistreated,
discriminated against, and made fun of. This shouldn’t be.
What they need is medical treatment and ongoing support from family,
friends, and community services. The mentally ill want nothing
more than to live a "normal" life, to be accepted and
to make a contribution. To achieve some semblance of normalcy
they and their caregivers need to educate themselves about mental
illness and develop a support system. Towards these ends, here’s
a summary of basic information and helpful resources.
Facts
on Schizophrenia
- 1.5% of
population or 3 million adults in the U.S. have Schizophrenia
or another severe mental illness.
- Years of
research have shown schizophrenia to be a biologically based
brain disease in which dopamine and serotonin levels are elevated.
- The government
pays 64% of the $30 to 65 billion per year that is spent treating
schizophrenics.
- Age 16
to 30 is the typical age of onset for schizophrenia.
- 80% of
schizophrenics relapse if they stop taking medication (30% relapse
while on medication).
- 70-90%
of adults with severe mental illness are unemployed.
- 33%-50%
of the homeless are schizophrenic.
- Schizophrenics
are 100% more likely to get in a motor vehicle accident.
- Schizophrenics
have more infections, heart disease, type II (adult onset) diabetes,
and female breast cancer. (Perhaps because they’re less
able to explain their symptoms to doctors, their symptoms are
wrongly attributed to their mental illness by doctors, and they
have an increased pain threshold.)
- 20% of
schizophrenics attempt suicide and 10% commit suicide (the #1
cause of premature death for schizophrenics).
- After 10
years of treatment, 25% of schizophrenics recover completely,
25% improve considerably, 25% improve modestly, 15% do not improve,
and 10% have died.
Symptoms
of Schizophrenia
Schizophrenia
is a dysfunction of the thinking processes leading to psychotic
symptoms, confusion, and withdrawal from the outside world. A
diagnosis is made after at least six months of psychotic symptoms
(hallucinations and/or delusions) and severe impairment in functioning
at school or work and in relationships. Often the symptoms are
divided into "positive" (disturbances added by the illness)
and "negative" (psychological capacities lost).
- Positive
Symptoms:
- Hallucinations:
hearing, seeing, or smelling things that aren’t there.
- Delusions:
paranoia (that others are controlling, monitoring, or threatening
them or are reading their minds); grossly exaggerated self-opinions,
belief that they can control others’ thoughts.
- Confusion
about what is real or imaginary; déjà vu; preoccupation
with religion; superstitious.
- Odd thoughts
or speech, thoughts racing or slowed, talk on things irrelevant
to context.
2.
Negative Symptoms:
- Flat emotions;
little facial expression, monotone speech; lack spontaneity;
poor rapport.
- Lack of
initiative or motivation, passively go along in social situations
with disinterest or mechanically.
- Social
withdrawal; no close friends.
Other
Schizophrenia Disorders
- Schizoaffective
Disorder: Major Depression (or Mania) and Positive Symptoms
of Schizophrenia.
- Schizoid
Personality Disorder: a pervasive pattern of detachment from
social relationships and a restricted range of expression of
emotions in interpersonal settings.
- Schizophreniform
Disorder: Schizophrenia symptoms for only one month.
- Schizotypal
Personality Disorder: a pervasive pattern of social and interpersonal
deficits marked by acute discomfort with, and reduced capacity
for, close relationships as well as by cognitive or perceptual
distortions and eccentricities of behavior.
Other Psychotic
Disorders
- Brief Psychotic
Disorder: Some Schizophrenia symptoms for less than one month.
- Delusional
Disorder: Nonbizarre delusions (i.e., involving situations that
occur in real life, such as being followed, poisoned, infected,
loved at a distance, or deceived by spouse or lover, or having
a disease) of at least 1 month's duration.
- Major Depression
(or Mania) with Psychotic Features
- Psychotic
Disorder Due to a General Medical Condition, a delirium, or
a dementia
- Shared
Psychotic Disorder: person develops a delusion in the context
of a close relationship with someone who has an established
delusion.
- Substance-Induced
Psychotic Disorder
- Substance-Induced
Delirium
Treatment
Considerations
Schizophrenia
is not considered curable, but it is treatable. The goals of treatment
are to eliminate or reduce psychotic symptoms and to increase
the level of functioning. With medication compliance, education
about the illness, and an ongoing support system there is help
and hope. Here are some important points to consider:
- The sooner
schizophrenic patients are treated after the emergence of psychotic
symptoms the faster and more completely they recover.
- Getting
and staying on medication helps to minimize the Schizophrenic’s
symptoms and improve functioning. It usually takes time between
doctor and patient to find the right medication(s). Most common
medications currently used are Zyprexa, Risperdal, Clozaril,
Seroquel, Dogmatil, and Haldol.
- Avoiding
or reducing relapses is essential because psychotic episodes
can be damaging to the patient’s brain and psyche.
- Educating
patients about their disease and helping them accept their disability
and develop self-care and coping skills are important.
- Family
therapy or supportive (not uncovering) psychotherapy can also
be helpful.
- Developing
peer support amongst others with mental illness or disabilities
is valuable.
Helpful
Resources for Schizophrenics and their Families
- American
Association of People with Disabilities (1-800-840-8844 or http://www.aapd-dc.org).
- Friendship
Network: help networking with others who have mental illness
(516-741-0222 or http://www.echonyc.com/~friends).
- Internet
Mental Health: information, diagnosis on all psychological disorders,
peer counseling, and more for the mentally ill (http://www.mentalhealth.com).
- Medic Alert:
medallion necklace with toll-free number to Medic Alert who
gives emergency responders information about the patient’s
diagnoses and medications, along with the name and phone numbers
of the patient, their physician, and a family member or friend
who can take them home (1-800-432-5378).
- National
Alliance for the Mentally Ill: offers support groups, 12 week
course, and information for family members (1-800-950-NAMI or
http://www.nami.org/).
- Schizophrenia.com:
information, success stories, discussion, chat, and more (www.schizophrenia.com).
*Information
for this article is based on clinical experience and training
along with facts gathered in February 2000 from Schizohrenia.com,
the National Institute of Mental Health, MentalWellness.com, Internet
Mental Health, the National Alliance for the Mentally Ill, and
The Wall Street Journal (August 25, 1999).
|
|
