Dr Manu Arora
Mental illnesses can take many forms just like the physical illnesses do. Mental illnesses are still feared and misunderstood by many people, but the fear will disappear as people learn more about them.
Schizophrenia is a mental illness that usually strkes in late adolescence or early adulthood, but can strike at any time in life. Mental health professionals have known it for almost 2000 years.
The prevalance of schizophrenia is 1% world over i.e every one of the 100th person is suffering from schizophrenia, irrespective of caste, creed color, so, going by this figure, our country India is having 100 lakh sufferers!
The presentation of the illness is such that at the first instance the relatives of the patient feel that it is due to some “oopri kasar/hawa’’ and the first step is they take the patient to some faith healers (Baba Ji) to get the spell of sprit off the patient. It is not that the family members are to be blamed for this, the reason is the lack of knowledge and the deep rooted false beliefs that is present in the society. Whenever anything appear fearful or strange and difficult to understand or explain, people easily label it to be due to some black magic (jadu tona). The role of doctor comes very late, not until the illness become worse, i.e patient turning suspicious and uncooperative.
The commonest symptoms seen in patients suffering from schizophrenia is “hallucinations’’ During an attack of illness, one may hear voices or see people/images/dead men/relatives or even God, when they are actually not present there. Patient actually hears that they are passing comments on them, abusing the patient, saying bad names to them etc. These voices may range from absolute clarity to just an irritating noise. The images seen by schizophrenics are clear, as real and colorful as if real. The schizophrenics believe that the images are real, part of his life or are affecting their life. They act and behave according to the images they see. For either case i.e hearing voice or seeing images, on asking the patient may give some vague explanation or sometimes they are unable to give any reply.
Another important feature of Schizophrenia is Delusion, which is a fixed, false and unshakable belief and the patient cannot be convinced even with the most rational explanation. For example, the patient may start feeling that there are some people/police or people from outer world who are after him and are going to kill him. So he may find it difficult to stay alone or walk alone on the streets. Patient may try to hide, run here and there to save his life and get extremely fearful. He can try to commit suicide to get rid of this unsolvable problem. This is such a condition no other people can understand thinking it to be too odd ! nor the patient can share with everybody. Patient may start suspecting his own family members that they have joined hands to kill him and they are trying to poison him, in his food. So paients may stops taking food or water from other people or start preparing their own food. Schizopherenic patient may say that other people can now read his thoughts and whatever he thinks everybody comes to know about it. He may say that his thoughts are being broadcaste in air, on radio or television.
Some other associated symptoms in the patients are lack of emotions on the face while talking, may weep or smile /laugh very loudly when alone or may remain talking to oneself or may go on making gestures with hands, or may point in air as if talking to somebody, may remain standing or sitting in one posture or in a strange and difficult to maintain posture for a very long time, the manner of talking is strange sometimes as one may not come to know what they are talking about as the talks are just a mixture of words and does not carry any meaning or the patient may go totally silent for hours or days together and may not even eat anything.
It is important to identify and manage schizophrenia as early as possible. From the above given symptoms, we can now well understand the kind of effect a schizophrenic patient can have on his family. If not taken care at proper time, it can disturb family emotionally, financially, socially and physically, even more than the patient because the patient while he is ill cannot decide that what ever he is doing is wrong, that he should not behave in this way. After one becomes normal then only can one realize.
Today’s medical science has brought effective antipsychotic medications that treat/control the illness to a great extent and help the patient to attain a functioning life and provide relief to family members.
(The author is consultant Psychiatrist Govt Medical College Jammu)
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