Schizophrenia is a mental disorder that affects a person’s ability to think, feel, and behave normally. It is characterised by disturbances in thinking, sense of self, perception, and behaviour. “People with schizophrenia may experience episodes of psychosis, during which they may have difficulty distinguishing between reality and their own thoughts and feelings,” says Dr Parth Nagda, a consultant psychiatrist at Kokilaben Dhirubhai Ambani Hospital in Navi Mumbai.
Despite the challenges that come with schizophrenia, Anil Kumar Sharma, 70, of Jaipur, manages to take care of his family, demonstrating the strength and courage of those living with this disorder.
He was diagnosed with schizophrenia when he was just 27. Currently, he experiences auditory hallucinations, but he is able to manage the symptoms because of better insight into his condition and treatment.
His daughter, Mehal Sharma, 25, says that he can handle his personal responsibilities and take charge of the home in the absence of her mother. “He takes care of my brother and me just like any other caring father would. But whenever his symptoms of auditory hallucination relapse, the family takes charge in taking care of him,” says the daughter.
Aman Kumar (name changed on request), 34, a software engineer from Bengaluru, has a different story to tell. He was diagnosed with schizophrenia when he was 29. After receiving proper treatment, he is now able to take care of himself both personally and professionally. However, the initial phase was challenging to him, too.
Kumar was working in Europe when he experienced his first schizophrenic episode in 2017. It began with insomnia, progressed to a panic attack, and culminated in hallucinations (seeing, hearing, and feeling things no one else could) and delusions.
Back then, Kumar and his wife Mina (name changed on request), 30, had no idea what this condition was. They believed that Kumar’s health had been affected by the climate, cultural shift, and work environment, and that over time he would be able to adapt to the changes.
However, Kumar’s symptoms got so bad one night that he feared his life was in danger in a foreign land, prompting him and his wife to immediately leave for India. He believed that everything would be fine once he moved to his own country. But that was not to be, as he could not shake off his fear.
“The challenge was that he was not ready to consult a doctor or take medicines as he believed that he was completely fine,” recalls Kumar’s wife.
Consulting a psychiatrist is important
Dr Spandan Thakkar, a psychiatrist at the Mood and Mind Clinic in Ahmedabad, says that often the first challenge of treatment is convincing the person with schizophrenia to see a doctor. People experiencing delusions and hallucinations believe there is no need for medical intervention because, for them, the voices and conspiracy theories are real.
“Following the protocol is an important element of the treatment,” says Thakkar.
The challenge of building insight
One of the main goals of therapy is building insight so people living with the condition have a better grasp of what they are experiencing. This way, the next time they experience a hallucination or delusion, they are better able to identify it while it is happening.
Insight with regards to schizophrenia is defined as being aware of having the illness, recognising the social effects it may cause, understanding the necessity of treatment, being familiar with the effects of medication, being cognizant of the implications, and recognising the warning signs of the disorder.
Symptoms and how to recognise them
Dr Thakkar says that the acute phase of schizophrenia is characterised by an abrupt onset of symptoms, including delusions, hallucinations, disorganised speech and behaviour, and other significant changes in behaviour. During this phase, the person experiences significant distress, and may require hospitalisation.
The chronic phase of schizophrenia is characterised by less severe symptoms, but these symptoms may still be disabling. Common symptoms include difficulty with concentration, apathy, and social withdrawal. Other symptoms may include incoherent speech and difficulty with relationships.
Duration of treatment
According to Dr Nagda, once treatment is initiated there is typically a 20-40 per cent improvement within the first month and this can double in the following month and so on. In accordance with the clinical practice guidelines, it is recommended that those with schizophrenia adhere to the prescribed medication regimen for a period of one year to optimise efficacy and reduce symptoms.
It is of utmost importance that they continue to take their medication as discontinuation can cause a relapse. In such a case, a period of three years would be required to prevent a second relapse and one or two medicines must be taken throughout the year to avoid a third or fourth relapse.
Role of family members
Dr Nagda says that family members need to identify the symptoms, consult a psychiatrist and follow the treatment protocol.
- Learn as much as possible about the disorder, its symptoms, and how to manage it.
- Give individuals with schizophrenia small tasks that they can perform easily. This will not only keep them busy and occupied but will also give them confidence.
- Listen and provide encouragement, understanding, and acceptance.
- Create a safe and supportive home where they can feel comfortable and secure.
- Seek the advice of a psychiatrist for occupational therapy during the chronic phase.
- Make sure to take them for regular visits to a psychiatrist.
- Take the time to care for yourself and seek help when needed.
Don’t argue, support
Dr Munia Bhattacharya, consultant psychologist at W Pratiksha Hospital, Gurgaon, advises against arguing with a loved one with schizophrenia using phrases such as “that doesn’t exist” or “that’s not the truth.” Instead, she suggests supporting them calmly and without judgment.
“You can talk about your loved ones’ immediate and short-term goals with them, which can help with plan building and give them a sense of greater control over their lives.” Remind yourself that this is a process of healing; it will not happen all at once if there is resistance to attending visits or taking medication, concludes Dr Bhattacharya.
