Schizophrenia and the schizophrenia spectrum are widely misunderstood and still often carry with them a stigma. If your loved one has been diagnosed with a condition falling on the schizophrenia spectrum, understanding the condition, as well as how it is treated can help in supporting them.
The Schizophrenia Spectrum:
In the past, doctors working in the field of mental health classified schizophrenia into five separate subtypes. Those subtypes included catatonic, disorganized, paranoid, residual, and undifferentiated. While these subtypes do somewhat work for classifying the types of schizophrenia people are afflicted with, it is simply not a good enough system. For this reason, doctors today classify schizophrenia on a spectrum. Rather than five subtypes of one disease, it is a group of mental disorders sharing symptoms. The common theme between them is that they change how you think, feel, and act. Any condition on the schizophrenia spectrum is a psychosis, meaning what seems real is not. This can vary greatly in severity from mild delusions to vivid hallucinations. Some of the symptoms most commonly associated with schizophrenia are:
- Hallucinations: Hallucination is the symptom that is most commonly associated with schizophrenia. These can come in the form of visual hallucinations or audio, such as hearing voices in your head.
- Lifelessness: A complete lack of interest in life and daily activities. This is also a symptom commonly associated with depression.
- Odd Behavior: This symptom encompasses a huge variety of behaviors. Anything from walking in circles to obsessively writing down everything that happens.
- Disorganized or Confusing Speech: This symptom involves speaking in a way that does not make sense to others, for example forming sentences with words that just do not go together.
- Delusions: Holding on to easily disprovable beliefs, such as thinking you’re a superhero or being followed by aliens, are considered delusions.
To be diagnosed on the schizophrenia spectrum you need to have at least two of the above symptoms for a period lasting six months or longer. When diagnosing schizophrenia, doctors may still refer to the old classification symptom to give a more specific description. However, a diagnosis that would have been described as “disorganized schizophrenia” in the past would now be described as “schizophrenia with disorganization.”
Treating Conditions on the Schizophrenia Spectrum:
A common misconception about schizophrenia is that it cannot be effectively treated. It is true that historically, mental illnesses were not well understood, and a common solution was simply to institutionalize or imprison patients. Fortunately, today through careful treatment people can often live full, productive lives despite their diagnosis. People living with a condition on the schizophrenia spectrum will usually require lifelong treatment, even when symptoms have subsided entirely. Treatment usually consists of a combination of therapy or counseling and medication.
The centerpiece of any schizophrenia treatment is medications, typically antipsychotics. They are thought to work by affecting how dopamine is transmitted in the brain. The goal of using medications is to manage signs and symptoms with the lowest dosage possible. Due to how uniquely the disease affects each patient, typically a doctor will want to try multiple different prescriptions, doses, and combinations over time to find the ideal combination. In addition to antipsychotic drugs, antidepressants and anti-anxiety medication may be used to manage some symptoms. Usually, it will take somewhere between a couple of weeks and a couple of months for noticeable changes in symptoms to occur.
Supporting People on the Schizophrenia Spectrum:
If you have a loved one, especially someone you live with, on the schizophrenia spectrum it can be difficult to understand your role in helping them recover. It may be scary to think you could accidentally do something to make their condition worse. Fortunately, if you take care to follow a few guidelines you can help make their management of the condition easier.
- Emphasize their strengths: Avoid calling extra attention to their weaknesses or shortcomings and focus on the things they enjoy or are especially good at .
- Remind them they have a role in their family/community/society.Remind them of their value to others and emphasize that they have a purpose.
- Consider a family psychoeducation program: If you can take the time to learn more about schizophrenia and how to communicate and deal with it you may be able to offer better support.
- Learn to recognize warning signs of a psychotic episode: If you learn the early warning signs and have a plan in place psychotic episodes can be far more manageable.
- Learn motivational techniques: Learning techniques for motivation can help you encourage your loved one to do things for themselves.
- Keep track of their healthcare visits: Without being overbearing, keep track of appointments and make sure they aren’t missing any.
- Make sure they have someone they trust:Whether it’s you or someone else, ensuring your loved one has someone that they trust who will always be there for them can make managing symptoms easier.
- Spend one-on-one time with them: Building stronger social skills and forming relationships with one-on-one activities like chess or card games can strengthen mental health.
- Support them during difficult times: During difficult times, such as after a hospital visit, try to be especially present with your loved one.
While it’s important to understand how to help someone you love with schizophrenia on a daily basis, it’s even more important to recognize when there may be an emergency. If the person exhibits any of the following behaviors , seek immediate medical attention:
- Deliberately injures themselves or others
- Talks about killing someone else or themselves
- Seems extremely disoriented
- Is experiencing intense hallucinations
- Acts very confused
One final note is that you should try not to be overbearing when it comes to things like reminding someone to take medication. A better alternative is to work out a plan to overcome forgetfulness and help them establish a routine.
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