“It’s only in the mysterious equation of love that logical reasons can be found.”
(Russell Crowe as ‘John Nash’, A Beautiful Mind)
A Beautiful Mind, released in 2001, was the biographical movie of legendary mathematician John Forbes Nash Jr. The movie made people understand that mental problems can be treated with the love and support of family, friends, and society. The movie traced Nash's emergence as a brilliant mathematician even as he struggled with one of the most debilitating mental diseases, schizophrenia.
Schizophrenia is known to affect one in every hundred people. One of the most disabling and economically burdening diseases, schizophrenia mostly affects young adults. Men are twice as likely to develop the condition as compared to women, and people with the condition have double the risk of death due to suicide than the general population.
Apart from mental well-being, the disorder also affects a person’s social and occupational life. Most of the time, they are isolated or worse, get thrown out of their families due to the frustration of the caregivers or poor understanding of the illness. Due to the behavioural changes, people suffering from the disease end up on the streets or become addicts.
Often, persons with schizophrenia are portrayed as dangerous, violent or psychopathic in movies and television shows. Ironically, they are just the opposite. A person suffering from schizophrenia is not more dangerous or ‘criminal’ than anyone else. Instead, they are often victims of violence, abuse or fraud. They are more likely to harm themselves and are aggressive only when provoked or ridiculed.
Usually, the affected person may not have the ability to seek professional help. This is why the society needs to have a better awareness of the disease.
What is schizophrenia?
The term schizophrenia comes from the Greek words 'schizin' (split) and 'phren' (mind), roughly translating to “splitting of mind”. The word intends to show how there is a dichotomy in the way a person with the disease thinks, speaks and perceives the world. The affected often have their own ‘imagined’ world in which they live and believe, detached from reality. It can lead to self-absorption and excessive communication with oneself.
Schizophrenia is not entirely genetic, though the presence of illness in the family plays a role.
Symptoms of schizophrenia include muttering to oneself—patients may hear voices commanding them or discussing things with them—and having false, unshakable beliefs that cannot be changed by evidence. These are termed ‘hallucinations’ and ‘delusions’ respectively. They may also suffer from suspicion (they may feel people are conspiring against them) and muddled or disrupted thoughts expressed through unusual behaviour and incomprehensible speech.
There can also be another set of symptoms like poor emotional response or expression, poor self-care/personal hygiene, withdrawn behaviour, lack of attention or concentration and troubles with memory. Sometimes, inappropriate social attitudes and smiling can occur as the ‘sense of social context’ is lost. Research, however, shows that patients with schizophrenia are rarely violent.
How can we help?
Although schizophrenia is a serious mental disorder, it is highly treatable. Specific medications called antipsychotics are used effectively for the treatment. This should be started early, along with psychological counseling that can help an individual suffering from schizophrenia attain complete recovery.
More than two-thirds of the patients can improve much with proper treatment. Patients need to continue medication and treatment as per the advice of the doctors and need to be in regular touch with them.
Contrary to popular belief, these medicines are not addictive drugs and do not ‘damage the brain’! Antipsychotic medications will take at least four weeks to show their effects and need to be continued until the patient recovers. Research shows that the rate of recurrence of problems is higher if medicines are stopped suddenly and hence it is vital to have a regular discussion with the doctor.
The earlier the treatment begins, the better it is. Besides medication, vocational rehabilitation is vital. For a complete recovery, apart from a reduction of symptoms, patients need to regain their jobs, relationships and daily activities. For the meaningful social participation of those living with schizophrenia, it is important to do away with the stigmas associated with the disease.
What can we do?
Awareness, identification and care are the three main pillars of managing any mental disorder. Community awareness about the early signs of the illness, sensitising the family members and primary health care workers are extremely important in this regard. All stakeholders need to assume collective responsibility.
The media too has an important role to play. Authentic Information-Education-Communication (IEC) material can be referred to for detailed information (official websites of National Institute of Mental Health, US or National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru and other national institutes). Books like 'The Belgrano and Me' by Stephen Sharp and 'Surviving Schizophrenia' by Dr. Fuller Torrey give realistic narratives of persons living with the illness and the challenges faced.
On this World Schizophrenia Day let us strive to abolish the stigma related to this illness. Support and encourage people who suffer from the disease. To end with the quote that we started with, empathetic solutions lie only in the “mysteries of care and love”.
Dr Debanjan Banerjee is a Consultant Neuropsychiatrist, Apollo 24|7 & Apollo Multispecialty Hospitals, Kolkata