Living with schizophrenia

World mental health day is observed 10th of October every year, with the overall objective of raising awareness of mental health issues around the world and mobilising efforts in support of mental health. The day provides an opportunity for all stakeholders working on mental health issues to talk about their work and what needs to be done to make mental health care a reality for people worldwide. It was first celebrated in 1992 at the initiative of the World Federation for Mental Health — a global mental health organisation, with members and contacts in more than 150 countries. It is the most important day in the mental health calendar and this year’s celebration focuses on “Living with schizophrenia.” It seeks to give consideration to those who live with the disorder, their families, friends, doctors and even the society as a whole. The term ‘schizophrenia’ was coined by a Swiss psychiatrist, Eugen Bleuler in 1911, and it comes from the Greek roots ‘Schizo’ (split) and ‘Phrene’ (mind), to describe the fragmented thinking of people who live with the disorder. Schizophrenia affects around 26 million people globally. But despite being a treatable disorder, more than 50 per ecnt of people with schizophrenia cannot access adequate treatment; while 90 per cent of people with untreated schizophrenia live in the developing world. Schizophrenia affects how a person thinks, feels and acts; but not everyone with schizophrenia has the same symptoms apart from the core ones, as the disorder also includes a number of combinations of different things. This illness makes it hard for people to judge reality correctly and may include sleep disturbances, marked unusual behaviours often characterised by hearing voices of unseen individuals, leading the sufferer to talk and laugh to self, feelings that are inconsistent to others, speech that is often disjointed and difficult to follow, marked with unusual ideas; thinking that show that unrelated happenings in the environment have special meaning and reference in the television or radio; persistent feelings of unreality, feeling that one’s thoughts is being known by others without speaking them out or that some external force controls thoughts without the individual permission; bizarre thoughts about issues without logical processing. In response to the commands from the voices of unseen individuals, they may walk away from the house into the streets, especially when there is no support. This illness is very distressing and causes severe interruption to people’s lives, with major adverse impact on family and friends. Schizophrenia can affect men and women from all cultures, backgrounds and all walks of life. About one in 100 people may have one episode, and two-thirds of these will go on to have further episodes. Schizophrenia could start in the late teens, but it can also affect older people for the first time. The causes of schizophrenia are unknown, but episodes are thought to be linked to changes in some brain chemicals and stressful life experiences. There is more media misinformation about schizophrenia than any other type of mental health problem. Sensational stories in the media tend to present people with schizophrenia as dangerous, even though most people diagnosed with the disorder do not commit violent crimes. The good news is that schizophrenia is a treatable disorder although long-term medication may be necessary for some people. From accounts of individuals who had schizophrenia and worked through it, the mandate is not just to survive but to thrive. The personal experience of people living with the disorder is characterised by acquisition of wide range of emotional traumas and personal damage. Usually, they have times of homelessness, abusive attacks as well as physical, sexual and emotional assaults, prolonged confinement to institutions, alienated and antisocial. There are additional tremendous and utterly unbearable burdens. These burdens are capable of dehumanising, creating vulnerability, expunging abilities to develop or nurture dreams, which eliminate personal capacity and intelligence. The schizophrenic patient undergoes a dehumanising transformation from being a patient to being ‘an illness.’ However, anyone who can find their way through the personal mess and the emotionally charged losses that accompany a life lived with schizophrenia is a real hero. The lesson here is that person living with schizophrenia can move beyond surviving to thriving. Recovery often involves a transformation of the self, wherein the patient accepts the limitations and also discovers a new world of possibilities. There is the paradox of the recovery process as an attitude and a way of approaching the challenges. It is not a perfectly linear process but marked with seasons as a slow, deliberate process that occurs by poking through one little grain of sand at a time. A very important conceptual part that emerges from this approach is that of focusing on the promotion of mental health that makes us to consider the person and not just the illness.