Schizophrenia
is a mental illness that is caused by a chemical imbalance in the
brain. The victim lives in a state of altered reality and will exhibit
strange behaviors, bizarre beliefs and often experience visual and
auditory hallucinations. In their psychotic state, their thoughts
and hallucinations seem real to them. Sometimes only the family
members may be aware of the unusual behavior and strange statements
that are clearly false.
My
own father has been a schizophrenia patient since he was a young
man. He began treatment when I was just an infant. A lifetime of
trying to understand this serious mental disorder has taught me
that dealing with a schizophrenic patient can be difficult and requires
a lot of patience and knowledge. I hope that my experiences will
be able to help others out there who may be dealing with a family
member who is suffering from this illness.
Fortunately,
my father has always responded well to medication and has been able
to lead a fairly normal life, with only an occasional psychotic
episode. He is retired now and seems to be in the best mental condition
of his life. The stresses of employment and child rearing are behind
him and he enjoys his life. Many patients are not so fortunate.
The medicines required to control schizophrenia can have unpleasant
side effects, which discourages many patients from staying on their
necessary medication. Their illness can prevent them from being
able to take care of their basic needs and without a good support
system they often end up as one of the homeless population or in
jail, where they rarely receive the treatment they need.
The
support system is usually the family, but support can also come
from professional care givers, church groups, shelter operators,
friends, roommates, or professional case managers. For the purposes
of this article I will refer to all potential support systems as
"family."
It
may be difficult to get a person who is showing signs of schizophrenia
to agree to get treatment. In their altered state, everything seems
fine to them and they don't think they need psychiatric help.
Convincing the patient to get treatment in the early stages of the
illness is much easier than waiting until they are exhibiting extreme
psychotic behavior. Forcing the patient into treatment is considered
a violation of his civil rights in most states, unless the patient
is a danger to himself or others. Even when they do submit to an
evaluation, they may not volunteer their strange thoughts or ideas
to the mental health professional, usually a psychiatrist. The psychiatrist
must personally witness the bizarre behavior or ideas for himself
before he can order a commitment to a mental health institution.
The family members need to speak privately to the person doing the
evaluation, to discuss the patient's bizarre behavior and ideas.
When the family members give this information to the psychiatrist,
he can later question the patient about these delusional thoughts
and strange behaviors and make the appropriate evaluation.
Initial
treatment will usually require hospitalization while the mental
health professional continues to evaluate the patient and bring
him back to reality with the proper medication. In past history,
mental institutions had the reputation of being gloomy, dungeon-like
places where patients were often restrained and not much real treatment
was provided. Mental illness was stigmatized and families would
hide their shame. Now it is known that mental illness is a biological
condition that often has genetic components, and can be treated
with anti psychotic drugs. Many hospitals now have mental health
units which are as clean and bright as the rest of the hospital,
where patients are treated with the dignity and respect they deserve.
Once
the patient returns home, it is vital that the family continue to
offer support. Schizophrenia is not a disease that can be treated
once and then goes away. The family needs to ensure that the patient
takes his medication and goes to follow-up appointments. If the
patient stops taking his medication, psychotic symptoms may reappear.
Early warning signs of an impending relapse are increased emotional
withdrawal or a change in sleep patterns.
If
a patient does become psychotic, there are ways to respond to him
that can help avoid a full-blown episode. If the patient makes statements
that are bizarre, don't tell him that he is imagining things,
and it does no good to play along, either. Tell him "I know
you believe that is so, but I don't see it that way."
Always speak in calm, reasonable tones. Don't shout, criticize,
or threaten. Comply with reasonable requests, and avoid continuous
eye contact or touching the patient. Being respectful and kind may
keep the situation from escalating into dangerous or violent behavior,
but if you do fear for your life or safety, or that of others, the
police may need to assist you in getting the patient to a mental
health facility if the patient refuses to go voluntarily.
With
the supportive attitude of family, the schizophrenic patient can
return to a normal life. Reduce or eliminate stress within the family,
and help him set attainable goals, without pressure and criticism.
Letting him know what he is doing right is the best way to keep
him moving toward his goals.- J. E. Davidson
