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Schizophrenia: a patient's perspective

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CHAPTER 1

Schizophrenia

Is there a way to know some signs of mental illness? Usually, people with mental illness will not openly admit that they have an illness until they are accepted in the society. When an ill person feels safe and secure, only then he or she will discussed the condition honestly. It takes a lot of courage and motivation to reveal to others one's condition. When an ill person suffers from a mental illness, he or she may confide in a friend or even a stranger to for advice or just to be heard. It is not easy for someone to suffer from severe illness and disturbance. The following information are some warning signs of mental illness. Usually when one is ill there are "marked personality changes". They are "also unable to cope with problems and daily activities". Also they may have "strange idea or delusions". Some have "irrational fears". Others feel "sadness" for a prolonged period time. Some show "marked changes in eating or sleeping patterns". Many can have both "extreme highs and lows". And certain people "abuse alcohol or drugs". Furthermore, a number of people may have "excessive anger, hostility, or anxiety". Moreover, some can have very "violent behavior", (Haycock, D. A. p. 68). By noticing these behavior changes in an individual one will be able identify and function with the ill person. Being able to identify someone who suffers from mental illness, allow one to recommend him or her support and help from a practitioner. The patient can then receive help more quickly and the chance to heal is better.

Health professionals use a clinical manual to diagnose someone with a mental to illness. This manual is called the DSM.

DSM:

Multi-axial assessment (p. 27)

DSM assessment is conducted using 5 axes that categorize issues that client is facing.

AXIS 1—Clinical problems e.g. dementia, depression, anxiety, schizophrenia, eating disorders, substance abuse.

AXIS 11—Personality disturbances and mental retardation e.g. paranoid personality, schizotypal personality, borderline personality, antisocial personality, histrionic/dependent, obsessive-compulsive personality.

AXIS 111—General medical conditions e.g. neurological, endocrine, neonatal or antenatal complications, respiratory/digestive/circulatory.

AXIS IV—Psychosocial and environmental factors e.g. primary support group, social environmental, education/occupation, economic/housing, access to heal care, legal conditions.

AXIS V—Global assessment of functioning e.g. rate from 1 to 100, charts progress or deterioration.

Schizophrenia

Schizophrenia is like a complex puzzle with many moving parts that still cannot be solved. Some may say it is a mystery, a mystery that has been since many centuries. We still do not know the exact answers, but we have hypotheses. Schizophrenia is described as a serious mental disorder. Those with schizophrenia are not being able to distinguish between reality and the imagined. People with Schizophrenia are suffer from delusions, hallucinations, disorganized speech, the inability able to think properly, and social withdrawals. This serious illness can occur at any time of life. Most of the time however, it occurs during late adolescence or early adulthood. One with this brain illness may not be able to work or function the same way as before the illness. Scientists believe that Schizophrenia may have genetic factors. More precisely, if someone has this illness within your family, you may get it as well. People with schizophrenia may experience symptom differently. One with this disorder may feel labelled or stigmatized, and others may take advantage of the patients in various forms. Usually, people who have Schizophrenia experience symptoms that last for at least 6 months. Some with medication may be stabilized while others may take more time. In the following paragraph I will be describe my personal experience in this journey with schizophrenia.

A person suffering from schizophrenia commits "social withdrawal or isolation". One shows "little interest in speaking or being with others". One can have "preference for spending time alone". An ill person may have some "sleep disturbance". He or she might also show "little motivation, energy or ambition. One may have "little interest in previously enjoyable pastimes, hobbies, sports, or other activities". One can be "easily distracted". One may have "reduced concentration, difficulty paying attention or remembering things". There is a chance that the person's goes grooming, self-care, or personal hygiene habits deteriorate". Some sick people show "problems performing or functioning in school, at work, or at home". Many have "difficulty understanding what others say or what they are reading". Many show "lack of emotional display", "little facial expression", have flat monotone speech, and even the "inability to have organized speech". Many people will have "conversations that include statements irrelevant to the topic, use inappropriate choice of words, and have unconnected flows of speech". (Haycock, D. A. p. 69). When one notices the signs of Schizophrenia, one should immediately recommend the individual to seek for help and meet with a health professional, psychologist or psychiatrist.

Someone with Schizophrenia may show a lot of emotional changes such as "depression, exaggerated feelings, fear, guilt, rapidly changing emotions, inappropriate affect and lack of emotions", (Haycock, D. A. p. 97). In this context, having these symptoms will make the patient very disorganized and have unexpected behaviors. When one is fearful, he or she would constantly be worried about being hurt or being attacked. One does not feel secure with anyone, not even with friend. A person may look for security by isolating him or herself. Often one will feel blue and will have a different idea about life and the surrounding and constantly feel empty or even depressed. Feeling guilty is natural for those with schizophrenic as they frequently blames themselves. They will also feel guilt for not being able to focus. Often there are drastic changes in emotions that lead to severe pain and even tears. They will feel a negative energy that leads to crying while describing a certain situation or scenario. This will affect the self for a certain period of time.

According to the Schizophrenia Society of Canada, 'Schizophrenia is a serious mental illness that affects 300, 000 Canadians. Finding the causes for Schizophrenia proves to be difficult as the cause and course of illness is unique for each person'. It affects both men and women equally, with men, schizophrenia affects to around 20 year olds, whereas with women, it affects those in their late 20's to early 30's. It could take up to 10 years to properly diagnose someone with Schizophrenia. This serious illness is divided into different subgroups such as Paranoid Schizophrenia, Catatonic Schizophrenia, Disorganized Schizophrenia and Undifferentiated Schizophrenia.

The defining feature of the paranoid subtype (also known as paranoid schizophrenia) "is the presence of auditory hallucinations or prominent delusional thoughts about persecution or conspiracy" (Bengston p.1). Basically, the patient fears that others want to hurt them. The patient suspects that strangers or closed ones will talk behind their backs and create speculation. The patient will not be able to see their friends the way they used to. There will be a change in behaviour with more anger and anxiety. I am diagnosis with paranoid schizophrenia. When walking on the street, I will always turn my neck to look back if there is someone behind me that tries to harm me. It is an irrational feeling of being spied on; it seems that the world is against me, and that I am part of a network. The network wants to use me for some uncanny reason. Not knowing where to turn to, I was fearful for many reasons. For a long period of time I felt that I had supernatural powers. I was able to see certain things; when closing my eyes the pupils of my both eyes were like a theater screen. More precisely, I would see different types of forms, pictures, sometimes faces; it is like watching movies by closing my eyes. At the beginning it was cool and enjoyable, but with time it became a nightmare. It seemed that I was in a different dimension. I felt like I was surrounded by an external force, like gravity is pulling me from different directions. I had the power to see objects with the speed of light. It was very fast and very clear. I felt that the rapid eyes movement REM, were showing things as fast as possible and I had to remember what I was seeing.

Those with paranoid schizophrenia often deal with anxiety. One can have excessive stress or feel worried about certain things or situations. This leads to sleeping problems and can cause other illness. Not being able to sleep at night can change the mood of a person. Sometimes one may sleep for a few hours and the next day one has to go to work after not sleeping enough. This affects the patient mentally and physically and causes them to not be productive at work. Not sleeping enough will lead to suffering and will create stress in one's life. Feeling stressed out can damage the mind. Showing a lack of interest in a task or loss of motivation is normal when someone has strong anxiety or is severely stressed out.

For a while I had cognitive distortion with emotional reasoning. For me it made me believe that I could see certain things. I had some visual powers. That made me feel a few things, for example, I would feel that people are trying to hurt me for no reason but I will not realize I would be hurt until I get a "flashback" of seeing this scene in a different angle. I also believed people wanted to control my mind and take charge of my body. This made me become suspicious in situation when people are be against me for no reason. It seems that I was in a war where I had to fight to protect myself. My mind would work non-stop for 24 hours a day and I was often tired. I could not do regular tasks. Furthermore, when I am in my thoughts, I had less concentration on regular tasks and my mental sharpness went down. This led to my feeling very weak and sick. Hence, I would not be motivated to do activities or to spend quality time with my peers and family.

There was a time where I did not want to shower or wash myself. For me it was like a computer application in me that was deleted. I kept my nails long and dirty. People would be confused when they saw me, when they know that I was usually very active and very friendly. Having good hygiene used to be necessary and important for me. However, when I was out of reality, it was extremely hard to balance my life with good judgment and decision-making. Looking at me, people were confused and that made me confused. People did not know about my beliefs and projections of them were of people who had different opinions of me. Most of the time, people would react and act according to their beliefs not mine. Slowly, when my health deteriorated, I was losing contact with the reality and started ignoring my friends, colleagues at work, and family. It was an extremely hard moment for me and for my peers, coworkers and my family.

Sometimes I would hear noise and people talking about me. I felt like it was a message that they wanted to send to me. Hearing voice was disturbing and horrifying, especially when I was alone. We say walls have ears but in this case they also have mouths. By now you should be able to figure out my perspectives on my illness. There are various events that happened within a day that most patients forget. The mind seems to block the majority of the disturbances and worries for a certain time. There would be a period that I could spend hours with some irrational thoughts invading my life. Shortly after, I would forget 90% of my thoughts, actions, and reactions. Only 10% will be in my mind and is expressed to psychiatrists or psychologists. Ten percent may seem small but it is 10% that the practitioners have of me.

What happened with the rest of 90% of information? Certain percentage will be deleted from the memory, other information will be short term memory, and some in the long term memory. Information in this case will be like book in a bookstore, where a person will only get the information they go to the store and grab a book. Therefore, one may share the information with someone or may keep it for themselves. Towards my life experience I have learned that it is important to be honest but it is not good to be too honest. In this case, patients or myself will have various thoughts in our minds and most of the time one may not share the secret information that has invaded our mind. However, the information may come back when one feels terrible or faces a difficult situation.

Having paranoid thoughts can be disturbing and diminish our intelligence. Having paranoid thoughts is associated with strong emotions such as negative feelings. Our behaviors may change due to different circumstance. One may react by having bizarre movement or become violent. When one is violent, it may occur due to excessive negative feeling or when projecting things. Certain people may see things which others do not. Being violent is not acceptable but how do you control your own action? The patient will not notice any triggers or stressors as the patient is occupied by so much information in his or her mind. Do not try to control the patient by manipulating him or her by showing an interest in a book from the bookstore. If you want to help them find out how the patient is suffering and educate yourself with the disorder.

Being too emotional can break relationships. One may make fun of certain situations but the patient may take it personally and have negative feelings. Being paranoid schizophrenic is a challenge, living daily with severe negative feelings can bring one to suffering intensely. A simple situation can become a chaos. Sometimes, emotionally one can feel that he or she is being tortured. The intense negative feelings can be dramatic and intolerable. The mind is totally blocked with sorrow, sadness, and pain.

Someone with paranoid schizophrenia will slowly withdraw from reality. One will chose to have very limited friends and will isolate themselves from his or her friends. The patient believes that his or her friends want to harm him. By now the patient has probably had multiple psychotic episodes. It is natural for patients to believe that people are there to harm them and continue thinking this particular situation until they are seen by a health specialist.

Some believe that people with schizophrenia are violent. However, most schizophrenics are not violent and are not dangerous. Although there are a certain percentage of people who become violent due to some external factors, most of the cases are not violent. Most of the time, people can become violent because they are already affected by the outside world, and have irrational beliefs and suffer from them. Therefore, when paranoid, people feel pain and worries. Some may say that a paranoid schizophrenic are making up stories. However, this story may occur in one's mind or may happen during a particular period of time but cannot be prove. When listening to the story one may judge that it does not makes sense. Through hallucinations or delusions, the patient would experience difficulties in his or her life. If some sort of drama occurs, the patient would say it has happened and would strongly believe that the story happened for real.

When undergoing treatments, it is very difficult to maintain a stable relationship with the family, spouse, or with the outside world. One feels tired and weak from the medications. Medications have side effects that could affect the relationship with the spouse. For example, with having a lack of sexual desire, the partner may wish to have sexual intercourse but one may feel exhausted and may withdraw from having a sexual relationship. He or she may show lack of intimacy and passion. If the partner does not show any sign of desire then the patient may not show any sign of arousal. Slowly, this could create conflicts with a couple. If the spouse does not show any support or understanding with the patient then the relationship may not work. The wife or husband has a primary role of supporting and showing love, affection, and honesty with someone who has schizophrenia.

In disorganized-type Schizophrenia, the predominant feature is disorganization of thought processes. As a rule, hallucinations and delusions are less pronounced, although there may be some evidence of these symptoms (Bengston p.1). When talking about this symptom subtype, the patient has a different type of thought than a normal human being. Basically, the cognitive part of thought in the mental process is different. When discussing about one's experiences on this matter, one could spend hours with the same thought constantly thinking over and over of the same situation or scenario, and this followed by emotional withdrawal. For example, one will subconsciously attach an emotion with the thought and as a result one would have an irrational feeling. In a severe case, one might not be able to do regular activities, such as taking a bath, dressing, brushing his or her teeth or even preparing meals, and one will lose touch from doing certain things before like one was ill.
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Excerpted from Schizophrenia: a patient's perspective by Abu Sayed Zahiduzzaman. Copyright © 2013 Abu Sayed Zahiduzzaman. Excerpted by permission of AuthorHouse.
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