Big Thinkers On Mental Health Its A Small Small World: Ptsd As Self
PTSD is the 4th most common disorder in America, affecting not just veterans but abuse, disaster, and accident survivors. Dr. Rachel Yehuda, one of the country’s leading experts, explains how the traumatic event can divide one’s memories, describes symptoms and threat responses, and offers hope for treatment.
Age Of Onset Of Antisocial And Aggressive Behavior
Among persons with schizophrenia who engage in AGB prior to treatment, there are 2 distinct types, those who presented conduct disorder since childhood and those who begin engaging in AGB as illness onsets.,, Between 20% and 40% of males and females with schizophrenia present CD prior to age 15., Individuals who present CD in childhood/adolescence and schizophrenia in adulthood are responsible for most crimes committed by persons with schizophrenia. The severity of childhood conduct problems is positively, and linearly, associated with the number of convictions for violent and nonviolent crimes, and AGB, even after taking account of substance misuse. Among persons with schizophrenia, those with prior CD show similar symptom profiles, less reduction of positive symptoms with antipsychotic medications, and distinct alterations of brain structures and functioning. These findings together with the distinct pattern of behavior from childhood onwards suggests a distinct abnormality of neural development among individuals with schizophrenia and prior CD. Thus, one pathway to AGB among adults with schizophrenia includes antisocial behavior that onsets in childhood and remains stable over the life span.
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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What If My Relative Becomes Over
If your relative finds it hard to do things, you may want to help them. For example, you might help them to:
- fill in benefits forms,
- go to appointments, and
- take medication.
You may find yourself taking on more than you were expecting to. It is important for you and your relative that they do not become overdependent on you. Your relative could lose confidence in doing things for themselves. And you may feel stressed and tired.
How to help
Set boundariesDecide how much you can do for your relative and agree boundaries. It is better if you can agree this early on, but you can review the situation at any time. Explain the reasons why you need to set boundaries. Try to do this sensitively.
Work towards independenceTake steps to slowly build your relatives confidence and independence by agreeing goals. To start with, your relatives goals may be to:
- make a meal from scratch,
- walk the dog, or
- fill in a form.
Get a carers assessmentYou might have to do more than you want to do because your relative is particularly unwell. Contact your local authoritys social care team to ask for a carers assessment if you are finding it hard to cope. They may be able to arrange additional help or a break for you and your relative.
You can find out more about Carers assessments by clicking here.
Are The Patients Dangerous
There is a myth surrounding Schizophrenia that the patients are a danger to society and can be extremely violent. However, evidence shows that those cases are less than 3% of the total population suffering from Schizophrenia. The case is that people living with Schizophrenia are at risk of suicide and accidental deaths. Most of the patients of Schizophrenia are not violent and do not display any dangerous behavior. Some become violent if they are going through an episode of psychosis or delusions. Studies have found that in cases when they get violent it is more because of the delusions and not because of hallucinations. Tragically, they are more dangerous to themselves as they often end their own lives over the continuous torture their own brain puts them through. When the rate of suicide and self-inflicted injuries are high, asking the right questions like How to deal with Schizophrenia? and reaching out to a psychiatric facility can potentially save a life.
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How To Help Someone With Schizophrenia Who Refuses Treatment
Many people dont know what mental health treatment looks like outside of seeing people in movies or TV shows, she says. Theyve seen people out of control getting shot or picked off the street and restricted in some way. Or they might see people crying and left alone.
Respond In A Helpful Way To Their Irrational Thoughts
It can be challenging when your partner with schizophrenia holds on to their psychotic beliefs, even with evidence that they are not valid. Do not argue or try to convince your partner that they are wrong be prepared to be calm and respectful.
Instead of arguing when your partner is sharing irrational thoughts, you might respond with, I see the situation differently than you do.
Related Reading:20 Steps to Becoming a Supportive Partner
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Factors Contributing To The Development Of Cd Followed By Schizophrenia
The prevalence of CD is 4 times higher among men and 15 times higher among women who develop schizophrenia than in the general population. Both genetic and environmental factors associated with schizophrenia promote CD. From toddlerhood onwards, all children have to learn not to behave aggressively. Given that by age 2, children who are developing schizophrenia show motor abnormalities such as delays in walking and talking and specific neurological soft signs, and in the subsequent years further motor deficiencies, neurological signs, receptive language deficits and lower than average IQ, it may be that for some of them the challenge of learning not-to-be-aggressive is too great.
Children developing schizophrenia may also show abnormalities in the recognition of emotions in the faces of others as do adults with schizophrenia even at the prodrome, their healthy siblings, and children with CD. Inaccurate reading of the facial expressions of others have profound consequences for the childs understanding of his/her environment and also for his/her behavior as adults communicate much information to children via facial expressions, including information regarding inappropriate behavior. Among adults with schizophrenia, poor recognition of emotions in faces, especially fear and anger, has been associated with past violent behavior.,
Help Your Partner Set Small Goals
When your partner is in the early stages of treatment or experiencing a relapse of schizophrenia symptoms, big goals can be overwhelming, such as returning to work full-time or finishing a degree program.
Help your partner set small, manageable goals to help them progress. For instance, you may create a goal to go for three walks per week together to encourage your partner to engage in more activity.
Or, you may give them a goal of helping with one chore per day, such as washing the dishes after dinner, to get them more involved in daily activities. Over time, as symptoms improve, you can add additional, and perhaps larger, goals.
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Addressing Hallucinations And Delusions
If a person is experiencing hallucinations, caregivers should work to calm them, support them, and reduce the intensity of the hallucination as much as possible. Hallucinations can come in many forms, both auditory and visual, and they may be calm or violent. But if you feel its a safety concern, get them medical treatment as soon as possible.
With delusions, both experts agree the best path is never to argue with a person who is experiencing delusionary thinking.
Try to keep calm, says Alexander. You dont have to argue or agree.
Rather than address the delusion, she suggests asking questions about the person in real-time: How can I make you feel better? What can we do for you? What do you need from me?
Dont tell a person, Youre tripping or invalidate their beliefs, says Cowan. Try to remain calm and dont do anything to provoke them, which could trigger a more violent response.
Tip : Monitor Medication
Once in treatment, careful monitoring can ensure that your loved one stays on track and gets the most out of medication.
Take side effects seriously. Many people with schizophrenia stop taking their medication because of side effects. Bring any distressing side effects to the attention of the doctor, who may be able to reduce the dose, switch to another antipsychotic, or add medication to counter the side effect.
Encourage your loved one to take medication regularly. Even with side effects under control, some people with schizophrenia refuse medication or have trouble remembering their daily dose. Medication reminder apps, weekly pillboxes, and calendars can help. Some medications are available as long-lasting weekly or monthly injections instead of daily pills.
Be careful to avoid drug interactions. Help your loved one avoid any dangerous drug interactions by giving the doctor a complete list of the drugs and supplements theyre taking. Mixing alcohol or illegal drugs with schizophrenia medication is harmful, so talk to the doctor if your relative has a substance abuse problem.
Track your family members progress. A mood-tracking app, journal, or diary is a good way to track changes in your family members behavior, outlook, and other symptoms in response to medication.
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.
Who Is At Risk Of Having Schizophrenia
Schizophrenia affects people globally. It is a mental disorder that can target anyone irrespective of their race, age, gender. Predominantly it begins the onset in ages between 17-25 and strikes the late teens or early twenties age group. It is also seen that this age group is most aware of the psychological health issues and most people of this age group question How to deal with Schizophrenia most. However, this is the age that people are mostly unstable due to the growth and development of the brain, which is why early signs of Schizophrenia go unnoticed. If we consider the ethnicity, then Scandinavian and Irish people are more at risk than compared to the Hispanic or Amish groups or the general population.
In men, the first episode of Schizophrenia develops at an age younger than the women. Women tend to do better than men and recover at faster rates with lower risks of relapses. Genetically, it tends to run in the genes and if you have a family member that has suffered the disease then you may be at some risk of developing Schizophrenia. This risk increases to 10% if your sibling has Schizophrenia and increases to 50% if your identical twin has it.
Interestingly this illness shows a preference towards the seasons during onsets too. People born in months of January and April have a 5-10% higher risk than those born in other times of the year. Even patients get admitted to the psychiatric facility more inn months of Summer than in winter.
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Caregiver And Schizophrenia: How To Handle The Psychosis
Psychosis or psychotic episodes can be very difficult for caregivers to know how to handle in just the right way. These episodes can be frightening for everyone, especially the person experiencing them, triggering extreme stress and fear which can make their symptoms escalate. Psychosis is defined as a loss of contact with reality, unable to distinguish between what is real and what is imaginary, and includes delusions and hallucinations . Many times when someone is experiencing a psychosis, they may actually be unaware that anything is wrong. Its important for caregivers to know how to recognize the early-warning signs indicating that a psychosis is developing, and to know where or from whom to seek assistance.
With medication, therapy and time, your loved one may show signs of being able to handle more responsibility, once the psychotic episodes subside and no longer pose a constant threat. Talk to them about how they feel when it comes to doing more things, and a good place to begin is with self-care tasks like personal hygiene, getting dressed, and eating scheduled meals. Start assigning simple household chores, and observe whether they want to work alone or with others. For example, they may like to clean the living room, but they may not like someone else dusting in there at the same time.
Help For People With Schizophrenia And Alcohol Use Disorder
Whenever it comes to any case of treating alcohol use disorder in someone with a co-occurring disorder, the already taxing process of rehabilitation becomes that much harder. In the case of a schizophrenic, alcohol has become an unhealthy coping mechanism for handling their disorder. When they work to give up alcohol, the symptoms of schizophrenia are likely to become worse. This makes it risky to try and give up alcohol on ones own.
Alcoholics going through severe withdrawal, with no co-occurring disorders, have been known to hallucinate and become violent. Adding the symptoms of schizophrenia to this scenario, an individual could be more likely to be a danger to themselves and others. However, this can be minimized with professional medical assistance. Having specialists help means detoxing and recovering from alcohol abuse in a safe space, where symptoms of withdrawal can be monitored and treated accordingly.
If you or someone you love suffers from alcoholism and a co-occurring disorder, like schizophrenia, contact a treatment provider today. They can help to answer questions about rehab and explore available treatment options.
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Schizophrenia Linked To Violent Behavior But Experts Push Back
Kelli Whitlock Burton
A new meta-analysis suggests the risk for violence is higher in patients with schizophrenia, but some experts beg to differ, calling out study limitations and urging caution when interpreting the findings.
The study suggests patients with schizophrenia spectrum disorder are 4.5 times more likely than individuals in the general population to perpetrate violence against others.
While the results showed comorbid substance misuse was associated with a significantly increased risk for violence in those with SSD, data on medication nonadherence, prior exposure to violence, childhood trauma, or other known risk factors were not included in the study.
Dr Seena Fazel
“I think one of the main implications of this study is that prevention of violence outcomes really should be a focus for clinical services, because these are important outcomes to prevent and many of the factors that increase risk are modifiable, such as substance misuse and treatment adherence,” study co-investigator Seena Fazel, MD, professor of forensic psychiatry at the University of Oxford, United Kingdom, told Medscape Medical News.
Still, some experts urge caution when interpreting the findings, which they fear could perpetuate stigma against individuals with serious mental illness if not taken in the context of a study that shows association, not causation.
The findings were December 22 in JAMA Psychiatry.
Imaging Violence In Schizophrenia: A Systematic Review And Critical Discussion Of The Mri Literature
- 1Department of Mental Health and Addiction, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- 2SIFER WEST, Haukeland University Hospital, Bergen, Norway
- 3Faculty of Law, University of Bergen, Bergen, Norway
- 4NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
Background: Persons with schizophrenia have a small but significant increase in risk of violence, which remains after controlling for known environmental risk factors. In vivo MRI-studies may point toward the biological underpinnings of psychotic violence, and neuroimaging has increasingly been used in forensic and legal settings despite unclear relevance.
Objectives: To present the first systematic review, following standardized guidelines, of MRI studies of violence with schizophrenia. To critically discuss the promises and pitfalls of using this literature to understand violence in schizophrenia in clinical, forensic, and legal settings.
Methods: Following the PRISMA guidelines and literature searches until January 2018, we found 21 original studies that fulfilled the inclusion criteria: Studies of persons with schizophrenia, a history of violence or aggressive behavior, the use of one or more MRI-modalities .
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I Grew Up With A Schizophrenic Mother: Here’s The Truth About Living With Mental Illness
My mother first started showing symptoms of schizophrenia when she packed up some of my things, along with my brother’s, and we left Boston. I was 8 years old then. My mother was experiencing paranoia and felt as though someone was trying to hurt us. We traveled to New York to stay with a family member, but that didn’t last long.
The feelings of anger, shame, and guilt mixed with love was a toxic concoction I was made to drink daily.
After about a week, my mom was feeling suspicious of my aunts and we were off again, this time to Florida. We had nowhere to go and I remember walking the streets of Jacksonville for what seemed like an endless amount of time. That year I celebrated Christmas in a shelter.
As a child of a mother with a mental illness, the feelings of anger, shame, and guilt mixed with love was a toxic concoction I was made to drink daily. I hated the way she made me feel. As a teenager, I questioned my love for her because of all the bullshit I felt she put our family through. From the constant housing evictions due to her episodes when she destroyed property, to being called out by my name and the yelling. I could never forget the yelling and constant cursing to no one in particular.
I learned to depend on the spiritual essence that resided within me and all around me. If my mother could not be a listening ear, then the trees or the stars listened.