If we talk about Pakistan, then unfortunately the stigma regarding mental health illness is still there. Even though from the past few years we have observed a positive shift in taking it as any other illness, still there is a long way to accept it as a norm.
Sadly, the health sector, especially mental health in Pakistan needs improvement and ironically mental health issues are highly neglected. About 10-16 % of the Pakistani people are suffering from various mental illnesses. Women are the majority victim of it. To make the situation more alarming, as reported by WHO, there are only 5 psychiatrist hospitals and only 400 psychiatrists for the entire population of Pakistan. If we estimate it roughly, then for about half a million of the population there is only 1 psychiatrist.
Unfortunately, the patients don’t even get complete treatment, either they quit the treatment or never seek guidance due to the feeling of being judged by the family.
Schizophrenia is one such suppressed and neglected disease. In this article, we are going to talk about schizophrenia, its symptoms, causes, risk factors, diagnosis and treatment.
What is Schizophrenia?
Schizophrenia is one of the suppressed and highly neglected illness in Pakistan. Schizophrenia meaning in Urdu is “Shikaak Deemaghi”. Due to being highly misdiagnosed and for other reasons, this disease has been a topic of continuous debate.
Schizophrenia is a chronic severe mental disorder in which a person is unable to differentiate between reality and fantasy. It results in a combination of various delusions and hallucinations leading to extremely disordered and disoriented behaviour, and thinking impairs daily life whether you are at school, work or even in society and relationships.
Schizophrenia paranoia can leave you extremely frightened and withdrawn. Patients require a proper schizophrenia treatment and the treatment can be lifelong.
People suffering from schizophrenia may hear voices and even feel that other people are controlling and reading their mind. The patient may feel that others are trying to harm him/her. This illness can be extremely terrifying, making a patient feel agitated, terrified, and even sitting without talking and moving for hours.
Causes and Risk Factors of Schizophrenia
People often mix schizophrenia with split personality disorder, however, this is not true. But, the possible cause of schizophrenia is a combination of environmental and genetic factors. Long term stress and anxiety is also the culprit of various mental health disorders. Glutamine and dopamine are the two chemicals in the brain that cause schizophrenia.
The causes of schizophrenia still need to be understood. However, there are still possible risk factors which are:
- Inherited or family history with the schizophrenia
- Use of psychotropic or psychoactive drugs
- Complications during pregnancy or childbirth such as any viral infection or malnutrition
The signs and symptoms of schizophrenia vary for males and females. In men, this condition starts to develop from their late teens to early 20s. In the case of women, it mostly affects women starting from their early 20s to 30s. Now, before a person reaches the last stage of schizophrenia, there are early or first signs in the prodromal period. Since there is no particular trigger, it is challenging to diagnose whether this phase would last a few days, weeks or years. So, you might get to observe very subtle changes in the behaviour of those who have schizophrenia, especially at the start of this illness.
The symptoms include
- Difficulty in concentrating
- Change in the grades
- Mood swings
- Social withdrawal
- Difficulty in sleeping
Types of Schizophrenia Symptoms
Apart from the aforementioned common symptoms of schizophrenia, the symptoms are further divided into three major types.
- Positive Symptoms of Schizophrenia
- Negative Symptoms of Schizophrenia
- Cognitive Schizophrenia
Positive Symptoms of Schizophrenia
Even though the name implies the word “positive” these symptoms are not seen in any healthy individual. In this type, you are basically losing touch with reality.
The positive symptoms of schizophrenia are divided into three types
In this, the person would be more like a paranoid as there would be no logical or true belief. The patients would have imaginary false beliefs and a constant thought that people are trying to protect you, care for them or harm them. There would be no truth for that hence called delusions of the torment.
Hallucination is one of the most common types of schizophrenia. You would feel, see and hear things that no one would. In this, the person would see and feel objects that are not real, hear the things before other people and even feel invisible when touching you when in reality there is nothing.
3. Movement Disorders
In this, you don’t respond to others. In this, a person starts to show a certain movement over and over again.
Negative Symptoms of Schizophrenia
This particular type of symptom of schizophrenia is difficult to recognize because it is often mixed with depression. In this, the person would suffer from behavioural and emotional disruptions.
The symptoms of negative schizophrenia are:
- Lack of happiness in daily life
- Need help with daily tasks
- Not taking care of basic personal hygiene
- Dull talk in a monotonous voice and no movement on the face, it is called “flat affect”
- Inability to start and sustain any planned activity
These symptoms are very subtle and are detected only after various diagnostic tests are performed. These symptoms include
- Troubling focusing attention
- After learning anything, the inability to use it right after learning
- Poor understanding of how to function i.e. inability to grasp the information and how to use it.
Types of Schizophrenia
Signs and symptoms of schizophrenia vary from person to person but here are 4 major types:
- Paranoid Schizophrenia– In this, the person suffering from it shows extreme odd behaviour and may do things that a normal person wouldn’t think of doing so. A person suffering from it has little pleasure in life and has an extremely inappropriate emotional attitude.
- Catatonic Schizophrenia– In this type, the patient suffering from it is more like a paralyzed person. There is nothing that can excite the patient and the one suffering from it is shut down physically, mentally and emotionally. Even if the patient can sit idly and not eat anything, if this condition persists, there is a need for medical urgency.
- Undifferentiated Schizophrenia- In this, the person suffering from schizophrenia would be paranoid and confused.
- Schizoaffective Disorder– In this the person suffering from it has other mental illnesses such as mood disorder as well.
Diagnosis of Schizophrenia
Diagnosis of schizophrenia needs a complete psychiatric evaluation, physical exam, medical exam and laboratory test.
Your doctors will ask you and your family about any signs and symptoms regarding your condition followed by your medical history for any mental health issue. A physical exam is done in order to check if there is any factor contributing to the disease. Brain imaging studies that include CT Scan and MRI are done to look out for any abnormalities in the brain that might be linked with schizophrenia.
The chances of recovery are higher if schizophrenia is diagnosed as early as possible. In order to achieve an effective treatment for schizophrenia patients a combination of psychological counselling and medication is used. The doctor would also help and guide the patient and his/her family about the importance of medication and therapy, for if left untreated, the patient might never recover from schizophrenia.
In The End,
Currently, there is no complete cure for schizophrenia but an early diagnosis can help manage it. But, if we particularly talk about Pakistan, not only schizophrenia but anyone who suffers from mental illness is considered a bad omen. In Fact, still, there are people who think it’s due to evil beings. For this very reason, it’s high time that we should work on ending the stereotypes, attitude, prejudice and discrimination towards people suffering from mental illness.
In a country where health is already a secondary thing, human negligence on mental illness can no longer be denied. Treat mental illness like any other illness and don’t shy away from consulting a doctor.