schizophrenic case study
Understanding Schizophrenia: A Persuasive Case Study
The World Health Organization measures schizophrenia as one of the top ten most crippling diseases in the world. It changes the way a person thinks, feels, and acts. It is a chronic, long-lasting, severe mental disorder. Schizophrenia does not discriminate; it affects men and women equally, and the onset usually occurs in late adolescence or early adulthood. It is relatively rare in childhood and old age. Studies conducted during the past decade indicate that schizophrenia is quite heritable. Adopted children whose biological parents had schizophrenia have a greater chance of getting the illness. Schizophrenia affects about 1% of people, relatively equivalent to 2 million people, in the United States. Step inside the mind of the chronically mentally ill, a world where between the realms of reality, there exist vivid hallucinations and delusions taking the form of raw, unrelenting fear and paranoia. This psychological torment is the outcome of an amplified thought process derived from the defective coordination of emotion and thoughts, further worsened by the constant regression of a person’s personality into the grips of an illness marked by social withdrawal and isolation. It is a split from reality – from who you were and how life was meant to be. Schizophrenia is not a dissociation into several personalities, a common misconception due to the literal meaning of the word. Rather, it is a disintegration of the unity of the mind, which is why this illness is so disabling.
The striking form of schizophrenia symptoms may be one of the reasons why it has generated such fear and misunderstanding among the public about the nature of the disorder. The symptoms of schizophrenia are generally divided into “positive” and “negative” symptoms. The “positive” symptoms are so called because they reflect an excess or distortion of normal function. Perhaps the most notable of these is thought disorder, which may appear as a mere minor communication difficulty, but can become more severe and incoherent. At the acute end of the spectrum the person may experience a florid delusional state. Hallucinations may also occur at various levels, and in some cases hallucinations can appear to switch off the outside world for the person, into a “universe” of strange and incomprehensible experiences that may last for weeks or even months. 80% of hallucinations are auditory and are mainly experienced as voices. Other positive symptoms may include bizarre behaviour or disorganised behaviour. The “negative” symptoms reflect a diminution or loss of normal function. The person may become emotionally blunt and flat, and lose the ability to experience pleasure. Poverty of speech can also occur, as can an inability to sustain goal directed activity. This split into positive and negative symptoms has been criticised as being over-simplistic and has even been described as “false” schizophrenia is currently considered as one syndrome but the subdivision is still useful in describing particular sets of symptoms.
In addition to drug treatment, many people with schizophrenia can benefit from psychotherapy. This is a treatment of talking through problems to try to understand and resolve them. Psychotherapy can provide support and education to patients and their families, and help in the application of social and self-care skills. There is now solid evidence that the use of cognitive-behavioral therapy is effective in treating persistent psychotic symptoms and preventing relapse. This is a structured form of therapy that is focused on problem-solving. Therapy can be provided one on one or in a group. It is a complementary approach to the biological treatments of medications and ECT, and has been shown to improve the overall success of treatment.
The first line of treatment for schizophrenia is typically antipsychotic medication. These drugs are designed to alleviate symptoms of psychosis, including delusions, hallucinations, and thought disorder. They are usually taken daily in pill or liquid form. Some antipsychotics are injections that are given once or twice a month. The newer antipsychotics are called second generation antipsychotics, and are preferred because they have fewer side effects than the older drugs, which are called first generation antipsychotics. Some of the common side effects of antipsychotic medications include dry mouth, blurred vision, and constipation. Some people may experience extrapyramidal side effects, which are involuntary muscle movements, tremors, or restlessness. The symptoms can be mild or severe, and can be treated by adjusting the dosage or switching to another antipsychotic. Extrapyramidal side effects can also be treated with medications called anticholinergics. A potentially serious side effect of second generation antipsychotics is weight gain and the development of metabolic syndrome. People taking these medications should have regular monitoring of weight, blood sugar, and lipid levels. If there are significant problems, a different antipsychotic or other medication can be prescribed. Despite these side effects, antipsychotic medications are crucial in the treatment of schizophrenia, and it is important for patients and families to understand the nature and side effects of these drugs. Overall, antipsychotics have been shown to be effective in reducing symptoms in at least 60% of patients. When taken consistently, the majority of patients will have a significant reduction in symptoms and a lower likelihood of relapse. This is known as maintenance or prophylactic treatment.
Because with careful management, including compliance with medication and a supportive environment, people with schizophrenia can function as well as anyone else in society. They are able to have close relationships, work, and live independently. However, the affected individual must recognize that they are ill and the importance of staying in treatment even when feeling better. This is a hard reality for many who suffer from this disorder, as often they do not believe that they are ill and may discontinue medication.
Commitment to reality and what’s real is central to the daily life of those who suffer from schizophrenia. They need continuous moral and emotional support from friends and family. Since the disorder begins at the prime age of sixteen to twenty-five, while individuals are still trying to define their goals and aspirations for the future, emotional, financial, and residential support is crucial.
Schizophrenia is a disorder that has been largely misunderstood throughout history, and although great advancements have been made in the past few decades, many members of society still have misinformed opinions. One way to rectify this is through increased awareness and understanding of the average person, with the hope that at some point the general populace can be able to look at the disease without stigma. This can be achieved through campaigns of public service announcements and increased awareness in schools. With national or global events such as these, those societies that are the most misunderstood can be explored in deeper detail so that people can better understand what it really means to have schizophrenia, as compared to some other stigmatized mental illnesses or diseases, and the impact of the world wars on how people thought about the ill. This would go a long way to increase understanding and to help those who have schizophrenia to have a sense of acceptance in their communities.
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