“Schizophrenia” is one word with a thousand different meanings. Schizophrenia is a severe mental illness which alters ones perceptions, beliefs and behavior. Like all other mental illnesses, popping a pill will just not cut it. Schizophrenia(s) is especially diverse, with a large number of differing symptom clusters. A multi pronged approach aimed at both symptom clusters and quality of life would be ideal in managing schizophrenia.
The multi pronged approach would mean,
1)Treating the symptoms. 2)Returning productivity and social functioning 3)Returning the sufferer to joyful living.
Schizophrenia is ideally treated by the doctors, the patient himself, his family and the society in which he lives in.
Treating the symptoms –
A cornucopia of pharmacological agents have been developed to target the varying symptoms of schizophrenia. An excess of dopamine is postulated to cause psychotic symptoms, antipsychotic medications target dopamine receptors and block them, thus leading to a reduction in psychotic symptoms.
There are 5 dopamine receptors, located in different parts of the brain and responsible for a number of functions.
Your doctor will be able to choose an appropriate drug keeping in mind the receptor the drugs work on and their side effect profile.
Once hallucinations and the agitation reduce, psychotheraputic( such as CBT-P) measures may help in improving insight and reducing reactions to delusions and hallucinations. Medications and behavioral treatments may also be prescribed for improving activity levels.
In addition to antipsychotics, nootropics and supplements (such as omega 3 fatty acids) that improve neuroplasticity (the ability of the brain to modify itself), can help the brain cope with schizophrenia.
Returning productivity and social functioning
Schizophrenia also causes deficits in social and occupational functioning. In long standing cases, all social interaction and productive activity may be lost. A syndrome called deficit schizophrenia, characterized by a loss of interest, restricted emotional expression and poor socialization can sometimes occur.
In addition to medications, social skills may need to be re learnt, especially the basics of being able to converse effectively and the ability to maintain eye contact. Regular activity schedules may need to be made and enforced.
ToM (theory of mind) deficits make it difficult for those with schizophrenia to understand feelings and emotions. Targeted intervention can also help improving these defects.
Appropriate occupational opportunities should be explored once the illness has been stabilized, so that people afflicted by schizophrenia can support themselves and their dependents.
Returning the sufferer to joyful living.
Once therapeutic and occupational needs are met, focus needs to be laid back on “life”. People with schizophrenia are no less heroes than cancer survivors and disabled triathletes. The goal would be to return the sufferer to their premorbid level of functioning. The family and the society needs to loose all the stigma that is associated with mental illnesses. A stigma free society will help to an un-imaginable extent. When then stigma does go, help seeking behavior will improve to a great extent.
The extent to which one can benefit from treatment varies greatly and depends on a number of factors that include age, gender and marital status. The sooner one seeks help, better the prognosis of schizophrenia.
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