Accepting schizophrenia
Schizophrenia is a widely misunderstood mental disorder. Polly Enfield discusses the symptoms of the condition and explains how there is hope for sufferers.

If ever the word were guaranteed to strike fear into our hearts, it’s the big ‘S’ word- schizophrenia.
No matter how non- judgmental society today might think it has become, the truth is that the fear and stigma associated with this most dramatically- reported of mental disorders, has dug deep into our common beliefs.

Some of us actually enjoy terrifying ourselves with a good horror movie, from the safe haven of our armchair, so we are often all- too- quick to latch on to the ‘dangers from schizophrenics’  when it’s reported this way in our newspapers.

What is schizophrenia?

It’s a mental disorder that effects how we think, feel and behave. If we had it, we might feel confused and be convinced that family, friends or complete strangers have become our enemies. We might be absolutely sure that something is real and true, no matter what people around us might say to a contrary- and we might have visions or hear voices that no- one else can see or hear, because we are actually creating them in our own heads. Scary stuff!

Most of the time we sit back in the safe haven of our belief that schizophrenia is something that happens to ‘other’ people. But is it?

Anyone’s life is unpredictable

Most of the time we think that everyday life just goes on pretty much the same from day to day, and that our experiences and our reactions are pretty much predictable on a daily bases. It’s the , “I’m alright, Jack!” syndrome that most of us can relate to at times.

But life can, of course, pull the carpet out from under our feet one minute; or accentuate our joy the next. We might win the Lotto, for example (which will probably have us experiencing a mixture of the two!) or find that we are quite suddenly facing life all alone and experiencing real vulnerability for the first time; and are finding it difficult to cope- and before we know we are, we’re heading for needing some professional help.
Luckily, there is currently an enormous government- led initiative to improve our access to psychological therapies and why? Because one in four of us will experience quite severe mental distress at some time during our lives, to an extent, which will require some degree of professional help.

Instinct versus understanding

Care in the community for the mentally unwell has come in for a lot of stick since the closure back in the 1960s of so many of the out-of-date mental health institutions, where ill-informed society used to conveniently lock away many of its diverse embarrassments. But try comparing your own viewpoint with ‘road rage’ to appreciate what seems to have happened here.

So, should we do something about this? I believe we should; because it’s a fact that one in a hundred people will personally  experience  some degree of schizophrenic disorder at some time in their adult lives; usually  somewhere  between the ages of fifteen and thirty-five. If we become better- informed, we might learn how to change these instinctive and unhelpful responses.

Broken leg and broken heads

Everyone’s health varies from time to time and may sometimes cause problems for us. There will be a variety of symptoms, of course, depending on what’s wrong. A broken leg not only causes pain and swelling; it will also evoke a fairly predictable response in other people. They usually understand a broken leg- might have experienced it themselves and will probably mutter soothing sympathies, which will make the people concerned feel a lot better.

But have you noticed how quickly the sympathies can wear thin when you are describing feeling a bit emotionally out of sorts? It’s very difficult for people to empathise with you, because they probably haven’t got a full picture.

So just imagine for a moment how impossibly hard it would be even to try to sympathise, when the sufferer cannot even begin to explain their problem- or maybe they won’t even realise that they have a problem at all. We are now beginning to venture into the world of schizophrenia.

And I say ‘world’ advisedly, because it can seem at times to be almost a parallel universe of experience, and it can be a very scary place indeed.
Schizophrenia, and a similar sort of condition called ‘manic depression’, both have groups of definite symptoms that psychiatrists can identify, and they both involve episodes of ‘psychosis’. This is a term which means that the person has actually lost touch with what we would all normally understand as reality.

Common experiences

We’ve all had dreams or nightmares where we find ourselves in a frightening bizarre and topsy- turvy world, but at least we normally have the ability to wake- up and shake off the uncomfortable feelings. Just imagine how it would be if you couldn’t do that- but nonetheless you still have to work out how to get up and get washed and dressed; write a shopping list or go to work? Add to that a nagging little voice in the back of your mind telling you that you’re not buttering your toast properly; or perhaps the newsreader on Tv seems to be speaking to you alone, in a very personal way? Weird thought these examples may sound, they are very common; and, theoretically, these ‘psychotic’ experiences can also happen to any of us, even if we have no previous history of serious mental distress.

Pause for thought

Just before we progress further down this road, there’s a little side- alley that I think is worth investigating beforehand. Consider these three questions- “Is a brave person one who has no fear? Or one who has fear and chooses to cope with it? Or one who has fear and has little choice but to cope with it?” Your answer  will vary, depending on your own experience of life so far- and also bear in mind that fear can either perfectly reasonable (as in the case of our caveman and his sabre-toothed tiger) or quite irrational, as in the case of the tiny spider in the bath. But to cope with any fear, we all need bravery.

In the case of the broken leg, your DNA might mean that you were born with a weakness in your bones- but also love base- jumping and you live near to some great places to practise! In the case of psychotic illness like schizophrenia, it might be that your great- aunt Ada was known to be a bit excitable at times and that you have now developed a taste for experimenting with street drugs- or maybe that you have experienced events  in your life that are too painful to face.

It is now much better understood that unrealistic levels of stress, family tensions and particularly childhood abuse are highly implicated in bringing on psychotic events in adulthood; and it’s even believed now that subtle brain- damage at birth can have an effect on your eventual mental wellbeing.

The way forward

Reassuringly, although the ‘s’ word has so often been mentioned in the same breath as the word ‘violence’, it is actually the exception rather than the rule that sufferers behave in this way as they are more likely to turn inwards on themselves to try to cope. Again, contrary to popular belief, hospital admission is often not needed and many people who suffer schizophrenia can and do live lives as stable as others do.

So, to bring you briefly back to the little alley where we paused a while earlier, should we not be applauding the bravery of these people who, in spite of facing great challenges still resolve to live a live?
The right diagnosis and the right choice of treatment have never been better for sufferers of severe mental illness such as schizophrenia, as well as for the more moderate and very common anxieties and depressions.

There are many pages of professional information available on the Internet. As well as the rethink site already mentioned, advice can be found from The College of Psychiatry of Ireland at www.irishpsychiatry.ie or from the Royal College of Psychiatrists at www.rcpsych.ac.uk/mentalhealthinfoforall The time is ripe for us to cast fear aside, and to take time to learn, and to do all that we can to understand and support those who suffer mental distress.

Why do we over-react?

Human beings instinctively distrust what they can’t completely see and therefore understand. This was life-saving when caveman saw part of a sabre-toothed tiger peering out from the undergrowth, hell-bent on catching breakfast- and it can be equally important for modern humans when they see a vehicle nosing out of a side-road.

We stand on the horn, yell and wag our fingers at the offending car. We can’t really see who’s inside; or consider that perhaps they’ve made a simple error of judgment and might be feeling rather stupid for having cut out. So, we over-react- just as we do when ‘care in the community’ is given some bad press, making us believe that there is now a silent band of schizophrenics squatting under every bush, just waiting to pounce.

Nature versus nurture

Are we born with more or less chance of suffering schizophrenia, or does something happen that brings it on? This ‘Nature versus Nurture’ debate has raged on over every aspect of our lives, as all the scientists try to work out what’s going on. More often than not, the answer is that it’s possibly a blend of the two. There can be a genetic predisposition handed down in the DNA through the generations (the ‘nature’ side of the coin) or something about our lifestyle, environment and experiences, which is the ‘nurture’ side of the coin.

Schizophrenia is NOT a split personality

A split personality, in which two or more personalities exists within the same person, is a rare psychiatric illness called dissociative disorder. People with schizophrenia have only ONE personality. The word ‘schizophrenia’ comes from the Greek word meaning split and this is perhaps where the confusion started. However, schizophrenia is a split from reality rather than a split in personality.

Info

Shine is the national organisation dedicated to upholding the rights and addressing the needs of all those affected by enduring mental illness including, but no exclusively , schizophrenia, schizoaffective disorder and bi-polar disorder, through the promotion and provision of high quality services and working to ensure the continual enhancement of the quality of life of the people it serves. Shine supports people with mental ill health and their families and friends in a number of different ways.

The information helpline 1890 621 631 is open every day from 9am to 4pm and can provide general information, a listening ear and specific information about shine services. Shine also has an online library called www.recover.ie