Positive Health Online

While any mental illness needs to be treated and taken seriously, schizophrenia commands extra attention as it is ridden with several myths and an utter lack of awareness among the public.

People living with schizophrenia are completely curable, some with just six months of medication and treatment.

Dr Samir Parikh, India Director, Fortis Hospitals, observed that often treatment gets delayed as the patient of schizophrenia and his or her family do not realize that there is a medical problem.  He added that sadly, nearly 50% of cases go undiagnosed. As a result, schizophrenia patients are brought in for treatment at a very late stage, when their caregivers finally realize that there is something seriously wrong. This is easily avoidable if a patient is taken to a psychiatrist early enough. A patient of schizophrenia suffers from hallucinations and delusions, is unable to cope or think straight, takes their hallucinations to be real. Hence treatment gets delayed. If a patient is taken to a psychiatrist early enough, they can be cured within six months.

According to Dr Samir , more than 60% of patients have near complete recovery, 20% of them have more than partial recovery and less than 20% of them may require very long-term treatment. More than counselling, medicines are the main pillar of treatment; the earlier they are started, the better, Dr Samir added.

Caregivers and peers of such patients are often fraught with despair and acute anxiety as they presume the disease is incurable. This is a myth which comes in the way of recovery and really needs to be busted fast. Family members need to be patient and understanding and take them to a doctor when they realize that something is wrong. Dr Parikh added that the medication is not expensive and need not be lifelong.

Dr Parikh observed that the kinds of treatment available for patients of schizophrenia are medicines and counselling. He added that there is very little role of counselling except for rehabilitation. He further added that in very acute cases, some doctors give electric shocks to the patient.

Often families of schizophrenics are in denial and disregard their symptoms. It took Ms Aggarwal, a resident of Delhi, several months to reach a doctor wherein she was diagnosed with schizophrenia. Her family was in denial and could not accept that her social withdrawal and bouts of depression needed medical intervention. She has responded to treatment and is well on her way to recovery.

Dr Parikh added that another myth is that such patients are extremely violent and cause harm to both themselves and the people around them. This, he added, cannot be further from the truth.

Schizophrenia is a serious brain condition that interferes with a person’s ability to think, act, express emotions, see reality and relate to other people. Schizophrenics may hear voices or see things that aren’t there or believe that someone is controlling their minds.

Dr Sidharth Chellani, consultant psychiatrist, observed that genetics played a significant role in the occurrence of schizophrenia in that nearly 30 to 40 % of schizophrenics have got the disease owing to hereditary factors. Relatives of schizophrenics have a higher chance of developing the disease. Chemical reactions and neurotransmitters in the brain, stressful or emotional life events combined with a predisposition to schizophrenia, play a role in causing the illness. It may even be brought about by viral infections or malnutrition before birth or problems during birth.

Dr Chellani added that some of the symptoms of schizophrenia include delusions, misunderstandings, confusions and opinions. These occur differently in different people. Schizophrenics may believe that people are trying to harm them; they are very suspicious about other people’s intentions. Hearing voices is the most common form of hallucination seen in schizophrenics. There is complete thought disorder; patients may speak in a confusing manner or suddenly stop talking. Schizophrenics display child-like behaviour, sudden anger or agitation. They may have difficulty in performing daily activities and maintaining hygiene. Patients may also suffer from depression, loss of interest in routine activities and lack of socialization. They have difficulty processing information and feel worthless and helpless and are ridden with guilt and self-blame. They display aggression and social withdrawal.

Among children and the youth, Dr Sidharth Chellani emphasized, schizophrenics show poor scholastic performance, social withdrawal, muttering to or gesticulating to oneself. The young also suffer from delusions and hallucinations and have poor self-care and hygiene.

Depression and anxiety are responsible for the high rate of suicides attempted by schizophrenics

Ms Preeti (name changed), a schizophrenic who lives in Delhi, can be heard talking loudly to imaginary people while taking a bath and when she is alone in a room. In her late 40s, she suffers from hallucinations and thinks women are chasing her and are out to get her. Almost on a daily basis, she screams and shouts and abuses her old, frail mother and other family members. But she is in denial and insists that there is nothing wrong with her and refuses treatment. Her mother, who spoke to this writer, said that she was at the end of her tether as her daughter vehemently refuses treatment.

But this is not so with Prashant (name changed). A handsome, strapping man, in his late 20s, he suffers from severe hallucinations and sees  ‘colours’ and imagines them to be hostile and harmful. When he consulted a psychiatrist he was diagnosed with schizophrenia and is under medication. He is well on the road to recovery and has even engaged in a full-time job.

Dr Sidharth Chellani, said that some of his patients, who suffered from schizophrenia had recovered and were into their own enterprises, holding high-profile jobs at MNCs [multinational companies] and doing normal jobs. So, it really is a myth that people living with schizophrenia cannot lead normal lives and take up employment. He added that the illness was not restricted to any socio-economic background; both men and women are affected equally, especially those between the age-group of 15-35.

He explained that if school-going students were diagnosed with schizophrenia they could be cured within a few months with good treatment and did not need a special needs department. The child would be advised rest for the initial few weeks and rehabilitated back to their previous pattern of education.

There is a high success rate in treatment. If the family is supportive and there is compliance to treatment, mostly patients are able to achieve a significant level of recovery, Dr Chellani observed. If people approach treatment early, then there can be complete recovery but if it gets late, owing to lack of awareness or family support, then the onset of treatment gets prolonged.

Ms Annu Kalra, spiritual guide and counsellor, based in Delhi, asserted that the overall attitude to mental health patients in the country was very convoluted. People conveniently assume that such patients don’t need any help and that they should self-heal. There is a definite stigma attached to it…people have an accusatory tone towards such patients: “Oh why is he or she behaving like this?”

“If a client comes to me in a low mood, I help him regain inner harmony and balance. I also recommend meditation. But if a clinical diagnosis is required, I refer them to a psychiatrist. Patients of schizophrenia also need compassion and hand-holding,” she added.

Our society, quite tragically, is very judgmental towards patients of mental illness, including those living with schizophrenia. There are not enough trained doctors and psychiatrists available to treat the growing number of patients. According to World Health Organisation data, there is a 200% deficit in the number of psychiatrists and mental health professionals in India. As Dr Parikh observed, the seats in medical colleges need to be increased and this may take a while.