Coming Up: Schizoid Symptoms
In Part II, I will discuss the schizophrenic side of schizoaffective disorder, something that I have not felt comfortable to talk about much before, publicly or privately. I will cover auditory and visual hallucinations, dissociation and paranoia.
Finally in part III I will tell you what to do about mental illness why its important to seek treatment, what therapy is all about, and how you can make a livable new world for yourself. I will conclude with an explanation of why I write so publicly about my illness and give a list of websites and books for further reading.
This article originally appeared on kuro5hin.org and is reprinted here by permission of the author.
Last medically reviewed on May 17, 2016
Can Everyone Live Alone With A Mental Illness
This is not to suggest that everyone with a mental illness can live alone. Yes, I believe that most of the people who wish to live on their own can do so, with support. It is a sad fact, however, that not everyone is going to fit into this situation. Some people will need supervised care every day. There is no shame in this. Some of us just need a bit more help than others to live our best lives.
However, most people, with some help, can live on their own if they wish to do so.
What Are The Symptoms Of Schizophrenia And How Is It Diagnosed
How is schizophrenia diagnosed?
Only a psychiatrist can diagnose you with schizophrenia after a full psychiatric assessment. You may have to see the psychiatrist a few times before they diagnose you. This is because they need to see how often you are experiencing symptoms.
There are currently no blood tests or scans that can prove if you have schizophrenia. So, psychiatrists use manuals to diagnose schizophrenia and other mental illnesses.
The 2 main manuals used by medical professionals are the:
- International Classification of Diseases which is produced by the World Health Organisation , or
- Diagnostic and Statistical Manual which is produced by the American Psychiatric Association .
NHS doctors use the ICD-10.
The manuals explain which symptoms should be present, and for how long for you to receive a diagnosis. For example, according to the NHS you need to be hearing voices for at least 1 month before you can be diagnosed. Mental health professionals may say you have psychosis before they diagnose you with schizophrenia.
What is the future of diagnosis in schizophrenia?There are many research studies being conducted across the world on how to better diagnose schizophrenia. For example, a recent study found through looking at images of the brain, there may be different sub-types of schizophrenia.
What are the symptoms of schizophrenia?
The symptoms of schizophrenia are commonly described as positive symptoms or negative symptoms. This doesnt mean that they are good or bad.
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Certain Medications Make It Worse
Antipsychotic medications are one important aspect of treatment for schizophrenia. They help control more severe symptoms, such as delusions and hallucinations, and can help reduce bizarre or erratic behavior.
However, many people have negative perceptions of antipsychotic medications, believing that they cause people to become vacant or lethargic.
Although the vast majority of medications have side effects, these vary from person to person. It is crucial to work directly with a doctor to develop and update a treatment plan in each case.
Often, this will include considering whether or not the advantages of pharmaceutical treatment outweigh the risks.
When To Seek Other Housing Options
In some situations, living with family may be problematic. Examples include:
- The main caregiver is single, ill, or elderly.
- The person with schizophrenia is so ill that there is little chance of leading a normal family life.
- The situation causes stress in the marriage or leaves children in the home feeling afraid and resentful.
- Most family events revolve around the person with schizophrenia.
- Support services are unavailable.
Residential options can help your whole family, and it doesnt have to be a permanent thing either. A lot of guilt can come with sending a family member to a facility to treat schizophrenia.
Try to remember that these facilities exist because of the challenges you and your household are facing. Using these services doesnt mean youre casting away your family member or that youve given up.
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How To Live Independently With Schizophrenia
Regular visits to mental health professionals, taking prescribed medications on time, every time, and joining a support group are the three most important things a schizophrenic should do to help control their disorder. Psychiatrists are able to prescribe new meds that may combat symptoms more effectively. Psychologists and counselors can evaluate how well patients are adapting to their environment and make recommendations for non-medicinal treatment. Joining a group therapy session or support group provides a community for schizophrenics to lean on and learn from. Interacting with a community of schizophrenics will provide a network of people that understand symptoms and are able to provide suggestions if and when the disorder spirals out of control. Family members of schizophrenics should also stay involved in the lives of their mentally ill loved ones. Family members are familiar with the patient and are able to tell when something is wrong.
What Myths Are There About Schizophrenia
There are some myths or mistaken beliefs about schizophrenia which come from the media. For example,
- Schizophrenia means someone has a split personality
This is not the case. The mistake may come from the fact that the name ‘schizophrenia’ comes from two Greek words meaning ‘split’ and ‘mind’.
- Schizophrenia causes people to be violent
Research shows that only a small number of people with the illness may become violent. The same way as a small minority of the general public may become violent.
People with schizophrenia are far more likely to be harmed by other people than other people are to be harmed by them. But as these incidents can be shocking, the media often report them in a way which emphasises the mental health diagnosis. This can create fear and stigma in the general public.
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Challenging Or Denying Hallucinations And Delusions
Many people think its best to gently counter hallucinations or delusions by saying something like, Thats not real, or I would see it, too.
Yet these symptoms are very real to them, and denying their reality often just ends up driving them away.
They may decide they cant trust or confide in you since you dont believe them. A lack of trust can make it more difficult to support them and encourage them to get help for symptoms.
Offering support doesnt mean pretending to believe in the hallucinations or delusions. You can simply say:
- It must feel so upsetting to hear those voices.
- That sounds so confusing and stressful.
How Is The Diagnosis Made
Some of the symptoms that occur in schizophrenia also occur in other mental health conditions such as depression, mania, and dissociative identity disorder, or after taking some street drugs. Therefore, the diagnosis may not be clear at first. As a rule, the symptoms need to be present for several weeks before a doctor will make a firm diagnosis of schizophrenia.
Not all symptoms are present in all cases. Different forms of schizophrenia occur depending upon the main symptoms that develop. For example, people with paranoid schizophrenia mainly have positive symptoms which include delusions that people are trying to harm them. In contrast, some people mainly have negative symptoms and this is classed as simple schizophrenia. In many cases there is a mix of positive and negative symptoms.
Sometimes symptoms develop quickly over a few weeks or so. Family and friends may recognise that the person has a mental health problem. Sometimes symptoms develop slowly over months and the person may gradually become withdrawn, lose friends, jobs, etc, before the condition is recognised.
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Know The Signs Of Suicide
Most people with schizophrenia are harmless to others. Theyâre more likely to hurt themselves than anybody else. Sometimes that includes trying to take their own life. You should take any suicidal talk seriously, and pay attention to poems, notes, or any other things your loved one creates that are about death.
Also, be suspicious if they suddenly go from depressed to cheerful. This change could mean they are thinking about suicide. For help on the spot, call your doctor and the National Suicide Prevention Lifeline at 800-273-8255.
What Risks And Complications Can Schizophrenia Cause
Physical health
Research suggests that people with serious mental illness , such as schizophrenia, have a shorter life expectancy. People with mental illness may die 15 to 20 years earlier than the general population. This may because people who live with SMI are at higher risk of having a range of health issues. Such as being overweight, having heart disease, smoking and diabetes.
Because of these issues, NICE recommends that when you start taking antipsychotic medication, your doctor should do a full range of physical health checks. This should include weight, blood pressure and other blood tests. These checks should be repeated regularly.
Mental health professionals are responsible for doing these checks for the first year of treatment. Responsibility may then pass to your GP. Your doctor or mental health team should offer you a programme which combines healthy eating and physical health checks. You should be supported by a healthcare professional to help stop smoking.
Suicide
The risk of suicide is increased for people with schizophrenia. Research indicates that around 513% of people who live with with schizophrenia die by suicide.
Research has found that the increased risk is not usually because of positive symptoms. The risk of suicide is associated more to affective symptoms, such as low mood.
Key risk factors for suicide include:
- previous suicide attempts,
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Know That Youre Not The Only One Who Can Offer Support
Family and friends arent the only sources of support for someone with schizophrenia.
Others can offer different types of support for your loved one. This can be anyone from an organization to an individual, such as:
- support groups
suggests that CSC programs may help reduce symptoms of schizophrenia and significantly improve occupational and social functioning.
Tip : Build Your Support Network
To better support and care for someone with schizophrenia, you need to find help, encouragement, and understanding from others. The more support you have, the better it will be for both you and your loved one.
Recognize your own limits. Be realistic about the level of support and care you can provide. You cant do it all, and you wont be much help to a loved one if youre exhausted, so seek help where you can.
Join a support group. Meeting others who know first-hand what youre going through can help reduce feelings of isolation and fear. Support groups provide an invaluable venue for the relatives of people with schizophrenia to share experiences, advice, and information.
Turn to trusted friends and family members. Ask loved ones if you can call on them for support. Most people will be flattered by your request.
Seek out new friends. If you dont feel that you have anyone to turn to, its never too late to build new friendships and improve your support network.
Take advantage of support services. Ask your loved ones doctor or therapist about respite services and other support available in your area, or contact local hospitals and mental health clinics.
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Vocational And Social Services
While treatment and support can help successfully manage symptoms of schizophrenia, patients still may be left with deficits in function. For instance, they may struggle with holding down a job or finding housing and managing money. To really live an independent and normal life with schizophrenia requires a range of services and assistance. Vocational training can help someone get and keep a job, while housing services can help find a recovering patient an affordable place to live. Other services may include transportation, academic support, or social groups.
Living With Schizoaffective Disorder
Being schizoaffective is like having manic depression and schizophrenia at the same time. It has a quality all its own though which is harder to pin down.
Manic depression is characterized by a cycle of ones mood between the opposite extremes of depression and a euphoric state called mania. Schizophrenia is characterized by such disturbances in thought as visual and auditory hallucinations, delusions and paranoia. Schizoaffectives get to experience the best of both worlds, with disturbances in both thought and mood.
People who are manic tend to make a lot of bad decisions. It is common to spend money irresponsibly, make bold sexual advances or to have affairs, quit ones job or get fired, or drive cars recklessly.
The excitement that manic people feel can be deceptively attractive to others who are then often conned into the belief that one is doing just fine in fact they are often quite happy to see one doing so well. Their enthusiasm then reinforces ones disturbed behaviour.
During my first manic episode I changed my major at Caltech from Physics to Literature.
The day I declared my new major I came across the Nobel Prize-winning Physicist Richard Feynman walking across campus and told him that Id learned everything I wanted to know about physics and had just switched to literature. He thought this was a great idea. This after Id spent my entire life working towards becoming a scientist.
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What Does It Take To Live On Your Own
It does take work to live on your own, however. For some people this work comes easily but for a person with a mental illness, it might not. You need:
- The ability to pay for things like rent and bills
- The ability to reach out for more help when you need it
However, just because youre living alone it doesnt mean that you have to handle everything alone.
People Who Have It Are Institutionalized
It is a pervasive myth that those with schizophrenia stay in the hospital or a mental health institution indefinitely.
The reality is very different. With appropriate treatment, many people with schizophrenia can control the symptoms and lead happy lives.
The American Psychiatric Association note that most people with schizophrenia live alone, with family members, or in a group home.
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Causes Of Death In Individuals With Schizophrenia
Schizophrenia affects approximately 1% of the US population. This serious psychiatric illness is characterized by psychotic symptoms , cognitive symptoms , and negative symptoms .
Although there is no cure for schizophrenia, treatment can decrease symptoms. Currently, these treatments include medications and psychosocial interventions. Many individuals with schizophrenia can work, live independently or with limited assistance, and enjoy life. Unfortunately, some individuals have symptoms that do not respond to treatment and interfere with their ability to lead independent lives and comply with treatment.
Persons with schizophrenia have a greatly diminished life span. In general, people with this disorder die more than 25 years earlier than the general population. In other words, these individuals can only expect to live about 70% of the normal life span. Why do they die early?
In a paper recently published in JAMA Psychiatry, Mark Olfson and colleagues set out to answer this question. They examined reasons for premature mortality in a group of over 1 million people with schizophrenia covered by Medicaid, the largest insurance provider for persons suffering from schizophrenia in the U.S. They identified causes of death for over 65,500 of the 74,000 people who died during the study period and found that individuals with schizophrenia had an increased rate of death across all ages and all demographic groups when compared to the general population.
Dont Take It Personally
Schizophrenia can be a difficult illnessfor everyone. During episodes of psychosis, your loved one may experience frightening sensations that you cant understand. They may act in ways that you dont understand. Other symptoms of schizophrenia can make it hard for people to express emotions or feelings, communicate clearly, or seem interested in others. Its important to know that these are symptoms of an illness. They are no ones fault, but they can still be hard to cope with. Consider reaching out to a family and friends support group for your own support. The BC Schizophrenia Society has a directory of groups around BC at www.bcss.org/monthly-meetings-calendar/.
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The Importance Of Residential Treatment For Schizophrenia
Symptoms of schizophrenia can be very troubling and disruptive. They can also be severe and cause significant impairment in a persons life. In some cases an episode of symptoms may even be severe enough to require temporary hospitalization. For anyone diagnosed with this mental health condition, residential treatment is strongly recommended.
Residential care gives patients the opportunity to focus on and engage with treatment without worrying about home, family, work, and other responsibilities. Inpatient care is also more intensive and helps patients jump-start recovery, guiding them through strategies and exercises that will help them manage their illness once back at home. Treatment in a residential facility gives patients all the tools they need to be successful once they leave, while also providing a safe environment in which to go through therapy.
Avoiding Drugs And Alcohol
While alcohol and drugs may provide short-term relief from your symptoms, they’re likely to make your symptoms worse in the long run.
Alcohol can cause depression and psychosis, while illegal drugs may make your schizophrenia worse. Drugs and alcohol can also react badly with antipsychotic medicines.
If you’re currently using drugs or alcohol and finding it hard to stop, ask your care co-ordinator or GP for help.
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