It is estimated that approximately 1.5% of the population of the UK are living with schizophrenia or a schizophrenic disorder. Most will be diagnosed before the age of 30. Living with schizophrenia can be difficult. Firstly, the impact it has on the patient and how they can manage their diagnosis and symptoms over their lifetime, and secondly, the impact on the family and friends of the patient and how they can help.
Generally, someone suffering from schizophrenia has difficulty distinguishing between what is real and what is not real. Schizophrenia is a long-term psychotic illness with symptoms including hallucinations, delusions, feelings of being controlled, muddled thoughts and changes in behaviour. In order to be diagnosed with schizophrenia, the patient must have been experiencing symptoms for more than one month. The exact cause of schizophrenia is unknown; it may be due to a combination of genetic and environmental factors.
There are a variety of symptoms which may come and go, and which can be divided into three categories: positive, negative and cognitive symptoms. Positive symptoms include hallucinations and/or hearing voices, delusions, thought and movement disorders. Negative symptoms are often to do with changes in normal behaviours or emotions, or a lack of interest or pleasure in everyday activities of life. Cognitive symptoms are usually only found with testing and include difficulty focusing and understanding or using information. Many people believe that people with schizophrenia have a tendency to be violent and that their behaviour can change suddenly and dramatically, but this is not necessarily the case, especially if the condition is managed properly.
The sooner someone seeks help for schizophrenia, the less likely they are to experience more serious symptoms and a further significant decline in both their physical and their mental health. For many patients, living with this condition involves long term medication in the form of antipsychotics which help to reduce delusions and hallucinations. According to the Royal College of Psychiatrists, this type of medication can help four out of five people. Unfortunately, there are side effects with antipsychotic drugs including tiredness, restlessness, weight gain and diabetes depending on which drug is taken. Once medication is taken, it must normally be continued for the rest of the patient’s life.
As an alternative, but usually used in conjunction with medication, psychological treatments can be effective in managing symptoms. In particular, Cognitive Behavioural Therapy (CBT) can help the patient find ways of thinking or behaving that help them to cope with the illness.
Many patients can be at increased risk of premature death, but this usually due to poor lifestyle habits. Schizophrenia often goes hand in hand with drug and/or alcohol abuse, and sufferers may have a tendency to gain weight and smoke. It is therefore important that these conditions are also tackled as part of the treatment for schizophrenia.
Support services for those living with schizophrenia range from GPs and community mental health services to mental health clinics and consultant psychiatrists. It is important that they all work together with the patient and their family to provide a stable support network. This provides the best chance for treatment success. Communication between patient and doctor is vital to ensure the patient is receiving the right dose of the right medication and to ensure that the positive effects of the drug are not at the detriment of other aspects of quality of life produced by its side effects.
Family therapy enables the patient and their immediate support network to cope will the illness, including how to recognise the signs of a worsening condition and ways to give support within the family. The outcome for patients can be affected by the responses of their family members. High emotional expression families can lead to a relapse of the illness.
Above all, a diagnosis of schizophrenia does not mean forgoing a fulfilling personal or working life. if managed properly, it should not affect someone’s ability for example to hold down a job, or to have fulfilling relationships. There are many people who live with schizophrenia and still manage to live full and happy lives.
Dr Winbow and Prof Hale are both very experienced in treating patients with schizophrenia. To make an appointment, please contact us at Private Psychiatry on 01732 836320.