Schizophrenia

Schizophrenia is a chronic mental illness in which many sufferers experience symptoms of psychosis, such as hallucinations and delusional thinking - where elements of their imagination merge into and become their reality. This is especially the case during acute phases.

Other symptoms can include a reduction in thinking, leading to an individual becoming flat, emotionless, apathetic, socially withdrawn and perhaps neglecting to look after themselves. If managed successfully, Schizophrenics experience few symptoms, or indeed, none at all.

Misconceptions about Schizophrenia are plentiful. Although the word is from the Greek, meaning 'split-mind', Schizophrenia does not mean you have a dual-personality like a modern day Dr Jekyll and Mr Hyde. The condition was named long before it was thoroughly understood.

Another negative misconception is that people with Schizophrenia are violent. This is in part due to the sensational press coverage each time there is a tragic case of violence perpetrated by someone suffering from Schizophrenia. One blessing is these occur rarely, you hear of someone being killed by a Schizophrenic maybe once every few years. When you consider the annual number of murders committed in the UK each year averages between 700 and 800, it really puts things into perspective.

Symptoms Classified as Negative

  • lack of emotions, expressionless
  • inability to enjoy things that you used to enjoy
  • increasingly uncommunicative - difficulty, or reluctance in speaking to people
  • apathy - no motivation to follow through on any plans
  • self-neglect

Symptoms Classified as Positive

  • hallucinations - most commonly voices, either critical or controlling and compelling
  • delusions, vehement beliefs in the unlikely and often bizarre; including
    • mild paranoia, perhaps thinking a partner is being unfaithful
    • paranoid delusions, believing someone is trying to harm or even kill you, perhaps that you have been implanted with a tracking device
    • conspiracy theories, convinced you're a pawn being manipulated by the Intelligence Services, for example
    • delusions of grandeur, belief that you possess magical or psychic powers, egomania
    • attaching too much significance to things, believing songs on the radio are just for you and newspaper headlines contain secret messages
    • over analysing, seeing codes in car registrations, telephone numbers, etc
  • disordered thoughts, confusion, lack of concentration - and possibly the following;
    • thought insertion - believing your thoughts are not your own, but have been placed there by another individual or individuals
    • thought withdrawal, belief that your thoughts are being removed by others
    • thought broadcasting, a belief that your thoughts are being transmitted and can be interpreted by others
    • thought blocking, the idea that your mind literally stops and all thoughts are blocked

Diagnosis

If you suspect you are experiencing the onset of Schizophrenia you should visit your GP. Do not feel ashamed or embarrassed or fear being labeled 'mad'. The earlier the condition is treated, the more positive the outcome will be.

Your GP will ask you questions, ruling out other contributory factors such as recreational drug use which may cause temporary psychotic symptoms. If your GP suspects you may have Schizophrenia you will be referred to your local Community Mental Health Team (CMHT).

CMHTs are comprised of many health professionals. A psychiatrist from the team will carry out a detailed assessment of your symptoms and other indicators, using a diagnostic checklist to determine whether you have Schizophrenia.

Psychological Therapies

Cognitive Behavioral Therapy (CBT) is used to identify thinking patterns which cause unwanted feelings and resultant behaviours. It can help you recognise delusional thoughts and aid you in challenging them, as well as preventing you from acting on compulsive feelings.

Treatment with Anti Psychotics

Antipsychotics are usually employed when treating the symptoms of an acute schizophrenic episode. They can reduce feelings of anxiety or aggression within hours, but may take several days or weeks to alleviate hallucinatory or delusional symptoms. Antipsychotics can be taken orally and can also be administered as an injection. This type of treatment is often used in long-term management of the condition and is called a depot injection.

Compulsory Detention (Sectioned under the Mental Health Act)

If symptoms are extremely severe, compulsory detention under the Mental Health Act may be required - if there is deemed to be a danger you may harm either yourself, or others. Sectioning is not a punishment, it is used to ensure you stay in hospital and receive the intensive treatment you require to alleviate your symptoms.

Family Therapy Support

Schizophrenia, obviously unpleasant for sufferers can also be stressful and traumatic for family members. Family therapy helps both the individual and family members cope with the condition, by offering information, support and practical advice. If family therapy would be of benefit to you, contact your assigned care-coordinator.

Care Programme Approach - (CPA)

Schizophrenia is a serious mental illness and people with the condition may have complex needs that require intensive support. A CPA includes; an assessment of your health and social needs; a care plan to outline how these needs will be met and by whom; the allocation of a key-worker, usually a CPN (Community Psychiatric Nurse) or Social Worker; and regular reviews so that appropriate alterations can be made, due perhaps to a change in circumstances. CPAs are patient, or person-centred - you will be consulted throughout the process.

Lived Experience

“My first experiences with mental health problems were moderate and uninvolving to others. However, it was clearly a problem that I felt misunderstood, yet this can simply be put down to issues around growing up in today's society. The point of real apprehension came when I was at university. For the first time I felt I had overcome some of my deep-rooted social problems by making friends I could be fully honest with. Then gradually I started experiencing severe head pains, which I put down to some terminal illness. As well as this, I became far less confident around others, particularly new faces.

This was very unusual for me, because no matter how assertive and quiet I had been in previous times, I had never felt this uncomfortable around other people for no particular reason. As happens with a breakdown, the problems became worse, and I saw a number of GPs none of whom thought my problems were related to anything other than complications to do with stress. These explanations, however well intended, were not to help me in the next few years.

I felt my problems had been dismissed and the effect of this on me was that I seemed to be living in an entrenched world where nothing I said or did, or the help I tried to access came into being. By the time I was eventually referred to a specialist - psychiatrist - my difficulties had become far more dominant in my life than might have been the case, and moreover, I felt a full loss of decision making towards various things. For example, where 'recovery' would take me, if I had any future goals and desires, and looking at my problems in a resourceful way.

As time moved on, progress in these areas proved to be very slow. Naturally, there were various obstacles preventing the balance I wanted in my life. Firstly, the stigma of having mental health problems was clearly evident, and at the time - 1996/7 - the attitudes were exhibited by fairly wild assumptions and ignorant views, which were often given to me as the right path - for example, stopping medication. Nevertheless, I had become socially withdrawn and deeply unwell, and the medication I was on would initially cause severe drowsiness.

When I was ending my university course prematurely, I passed my final French essay very marginally and my academic skills had been deteriorating for some time after consistently achieving high grades in Economics and Publishing. As is clear looking back my concentration was most likely worsened by my medication; however it has never returned to the level it had been before my breakdown, and it probably never will.

The worst features of diagnosis were both my lack of confidence and the isolation. The two went side by side. When you are being 'treated', unless you assert yourself the emphasis is always going to be on your 'carers' or 'service providers'. The lack of access in medical literature aimed at service users and carers to information on aspects of mental health training, such as verbal communication and how specialist workers are trained, means you are straight away put at a disadvantage, as the myriad of jargon and ambivalent language used makes the challenging of basic rights untenable in many cases.

Although people with chronic mental health problems may be perceived as having little insight into their difficulties, everyone has a right to access Care Plan information, but the all too true picture is how specialists use jargon and phraseology that can lead to unnecessary pessimism. The individual must always be made to recognise their limitations. This is a medical model view, and is very valuable as a yardstick, but it does have its boundaries and later on I felt able to look beyond and challenge this particular practice.

Since 2001, I have undertaken a supported employment scheme with Stepping Stones which led to four IT Qualifications. After that I founded an unincorporated voluntary organisation with a friend through the support of The Dorset Mental Health Forum and Rethink which published Club 57 Magazine and The Whole Psyche until 2006. I also worked for three hours a week at the Military Museum of Devon and Dorset as a research volunteer between 2002 and 2005.

Between 2004 and 2008 I have occasionally been a paid support worker for Rethink and I now work as a Peer Specialist for the Dorset Mental Health Forum. However these achievements do not take away from the fact that I have a condition which can be disabling. I adjust my work around my problems and not vice versa.”