National Schizophrenia Awareness Day 2020

1 in 100 people will experience an episode of schizophrenia in their lifetime.

Many people have heard of schizophrenia, but they may not understand what schizophrenia means for individuals living with the diagnosis. ‘National Schizophrenia Awareness Day’ takes place on May 24 and was introduced to help people understand what this diagnosis means for people who are living with schizophrenia across the world.

What is schizophrenia?

Schizophrenia is a disorder of the brain affecting how an individual behaves, thinks and sees the world around them. The individual has an altered perception of reality. Doctors often describe schizophrenia as a type of psychosis.

It is characterised by disturbances in thought processes, perceptions, emotional awareness, and social interactions. Schizophrenia may present differently in each individual, but it is typically persistent and can be both severe and disabling. Only around 13% of people living with schizophrenia in the UK work.

What causes schizophrenia?

The exact cause of schizophrenia is unknown. Schizophrenia tends to run in families, but there is no single gene that is thought to be responsible. It’s believed that a combination of genes makes an individual more prone to the condition. But having these genes does not always mean that you will develop schizophrenia. Stressful and emotional situations can trigger a psychotic episode and the development of schizophrenia. The use of drugs such as cannabis, cocaine, LSD or amphetamines, may also trigger symptoms of schizophrenia in people who are susceptible.

The condition is diagnosed after an assessment by a mental health professional. If an individual believes they, or someone around them, has the condition it is important to see a GP as soon as possible. Sometimes it may not be clear whether someone has schizophrenia so an individual could also be assessed for bipolar disorder, schizoaffective disorder, depression, anxiety, PTSD, and substance misuse at the same time.

Symptoms of schizophrenia

The symptoms of schizophrenia can be described as ‘positive’ symptoms or ‘negative’ symptoms.

Positive symptoms are experiences or behaviours that you start having as part of schizophrenia:

  • Hallucinations, such as hearing voices or seeing things others don’t
  • Delusions (including paranoid delusions) – strong beliefs that others don’t share
  • Disorganised thinking and speech

Negative symptoms are experiences or behaviours that you stop having as part of schizophrenia:

  • Feeling disconnected from your feelings
  • A loss of concentration
  • Lack of motivation to do things
  • Avoiding people
  • Difficulty with social relationships
  • Not participating in self-care

To read more about the symptoms of schizophrenia, click here.

A diagnosis of schizophrenia

If you or someone you know has been diagnosed with schizophrenia, you might feel anxious about the future. You may worry about the stigma attached to the condition or feel scared.

It’s important to remember that a diagnosis is a positive step towards getting the right information about the condition and the kinds of treatment and services that are available.

Schizophrenia is often treated with a combination of medication and talking therapies. Individuals with schizophrenia are usually treated by a community mental health team (CMHT) and are allocated a care co-ordinator. The CMHT provide day-to-day support and treatment ensuring that the individual has as much independence as possible. They use a care programme approach (CPA) and have access to specialist mental health teams like the early intervention team and crisis resolution teams. Click here to read more about the CPA and community-based care.

Treatment for schizophrenia

Phycological treatment can help people cope with the symptoms of schizophrenia. Therapies such as CBT, family therapy and art therapy can be used on their own or alongside antipsychotic medication.

Antipsychotic medication is usually recommended as the initial treatment for the symptoms of an acute schizophrenic episode. They work by blocking the effect of the chemical dopamine on the brain. They can cut feelings of anxiety or aggression within a few hours of use, but it can take several days to weeks to reduce other symptoms like hallucinations and delusional thoughts.

There are 2 main types of antipsychotic medications:

  • typical antipsychotics – the first generation of antipsychotics developed in the 1950s
  • atypical antipsychotics – newer generation antipsychotics developed in the 1990s

Both medications can cause a variety of side effects such as shaking, trembling, muscle twitches and spasms, drowsiness, weight gain, blurred vision, lack of sex drive, dry mouth and constipation.

Antipsychotics can be taken orally as a pill or can given as an injection known as a depot.

Most people can take the medication up to 1 to 2 years after their first psychotic episode to prevent more episodes occurring. Some people may only need antipsychotics until the acute schizophrenic episode has passed, but sometimes people can take them for longer if the illness is recurrent.

People who have serious psychotic symptoms as a result of an acute schizophrenic episode may need a more intensive level of care than the CMHT can provide. These episodes are usually dealt with by antipsychotic medication and special care. In some cases, a Crisis resolution team (CRT) can treat people who are experiencing an acute and severe psychiatric crisis. The CRT aims to treat people in the least restrictive environment possible (ideally in or close to their home). This can be in the individuals own home, in a crisis residential home or in a day care centre. The CRTs also plan aftercare once the crisis has passed to prevent a further crisis happening. Without the input of the CRT, the individual would require treatment in hospital.

Serious acute schizophrenic episodes may require an admission to a psychiatric ward at a hospital or clinic. An individual can admit themselves voluntarily to hospital if their psychiatrist agrees that it’s necessary and people can also be compulsorily held at a hospital under the Mental Health Act (2007). An individual will only be detained at a hospital if it’s necessary for the sake of the individuals own health and safety and to protect others. The individual will stay for as long as necessary, they will receive appropriate treatment and aftercare will then be arranged.

If there is a significant risk of future acute schizophrenic episodes occurring, the individual can write an advance statement. An advance statement is written instructions about what you would like your family or friends to do in case you experience another acute schizophrenic episode. It can also include contact details for their care co-ordinator.

 

The Stigma surrounding schizophrenia

There is often a negative stigma attached to a person who has been diagnosed with Schizophrenia.

This is because historically, people with schizophrenia were frequently put into psychiatric hospitals because it was believed that they were dangerous or needed to be kept away from society. This is no longer the way that people with schizophrenia are treated but one of the lasting misconceptions, is that those with schizophrenia are a danger to society.

Media reporting has added to this ideation. When schizophrenia is mentioned in the news, it is often connected to a crime that has happened by someone with the condition or someone who is now being assessed for the condition. It has been reported before that people have committed murder because of the voices they heard. These stories have contributed to the public’s negative view that people with schizophrenia are violent and dangerous.

The majority of those with mental illnesses, including schizophrenia, are non-violent people. Schizophrenia does not cause someone to be violent and people with schizophrenia do not have a “split personality”.

In this video from MIND, people with the diagnosis talk about the reality of living with schizophrenia. They discuss the first symptoms they experienced and the stigma and discrimination they face.

 

At Northern Healthcare, we understand schizophrenia and often act as a crisis residential home for some individuals. Some of our residents have a diagnosis of schizophrenia and we work closely with them and their care teams to ensure the best possible support plans are in place to aid their recovery.

 

(Photo by Anthony Tran on Unsplash)

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