Transcript by: Dr. Susan Samuels
Schizophrenia is a psychiatric disorder that can involve chronic or recurrent psychosis.
Psychosis can involve hallucinations, delusions, disorganized behavior, disorganized thought, and emotional flattening, or a motivation to actually get things done. Schizophrenia is a fairly rare disorder, that affects less than 1% of the population. More men than women will be affected by schizophrenia – but it’s fairly negligible the difference. Most cases of schizophrenia develop in late teens and early 20’s, but it can develop as late as in your early 30’s. For most people with schizophrenia, symptoms can come on quite slowly. And in fact, what somebody might notice is a slow and gradual decline functioning. One of the most common things for people around those suffering from schizophrenia notice in the beginning is that they’re withdrawing socially. Part of this might have something to do with the fact that some people with schizophrenia are feeling more depressed, as they are starting to experience these symptoms. Sometimes it has to do with the fact that they’re having hallucinations, seeing things and hearing things that other people are not seeing and hearing. And that kind of separates them from the people around them, and as a result, they’ll withdraw. If you’re around somebody that is starting to develop schizophrenia, you might notice things like some sort of odd and irrational statements they’re making. Maybe their personal hygiene is not at the same level that you’re used to seeing. And they’re not as interactive with you, they’re really pulling back when you try to engage. Something else that people talk about a lot with schizophrenia is what we call flattened affect – where they just don’t have quite as much the range of emotions when they’re talking to you, and in response to things that you’re saying.
Photo credit: Jake Attree
Some of the challenges for people with schizophrenia might involve this lack of motivation to actually get things done, and also a disconnect with people around them. And this might be because they’re internally preoccupied, meaning they might be focused on the voices and the things that they are seeing that other people can’t see. And when other people can’t see them and they’re experiencing them it by default sort of leads to a disconnect. These two things are part of the symptoms of the condition and not necessarily a choice that people are making. And I think that’s really important to remember when you’re working with your loved ones.
Some of the types of support that people with schizophrenia may need from their caregivers involves helping them remember things, like getting to appointment, taking their medications and even some basic activities of daily living like taking a shower, eating their meals. There are several strategies that can be helpful for caregivers of people with schizophrenia to help them stay on track. One of these strategies might be consistency. Taking into account that it’s really helpful to know what’s gonna happen every day. When I’m gonna take my medication, when I’m gonna eat my meals, when I’m gonna see my doctor; That’s really helpful. One of the other strategies that might be helpful is asking your doctor about a long acting, injectable medication that only needs to be taken once a month. This would be an alternative to having to take a medication every single day. Because sometimes when people have schizophrenia have a worsening of their symptoms and oftentimes have sort of an altered sense of reality, they may have a decreased level of insight as their illness at those times. And it’s exactly at that time that it’s important that the family is educated about the illness and has their own level of insight about the illness, so they can continue to guide their loved one. The National Alliance on Mental Illness, or NAMI, is a tremendous organization that provides a lot of supports for people with mental illness and also for their loved ones. And you can find all sorts of information about what’s available to you in your area by going to the website (The National Alliance on Mental Illness).
Photo credit: Weill Cornell Medicine
Susan Samuels, MD, is an assistant professor of clinical psychiatry and clinical pediatrics at Weill Cornell Medicine and an assistant attending psychiatrist at New York Presbyterian Hospital. Dr. Samuels is experienced in working with acutely and chronically medically ill children and their families as they cope with the challenges during hospital stays as well as on an outpatient basis.