The woman hasn’t eaten food in weeks because she believes there are bugs inside her body and she would never feed them. She sees them all over her body too. The people around her don’t see them but she doesn’t perceive things the same way as they do.
This is a symptom of schizophrenia: being disconnected with reality. People diagnosed with it believe what they can see, hear and smell is all real, explained Dr Humera Saeed during a seminar held at The Recovery House in Karachi on June 22, World Schizophrenia Day.
They may act suspicious or hyperactive and choose to isolate themselves because they are frustrated with their condition. “No one seems to understand what they are going through,” Dr Saeed added.
Schizophrenia is more common than people realize. About 1.5% of Pakistan is diagnosed with it, according to research from 2016 conducted by Shakila Akhtar.
Both men and women can have schizophrenia. It is not gender specific, said Dr Saeed, adding that your ethnicity doesn’t matter either.
What causes schizophrenia?
People with family history are at a higher risk of being diagnosed with it, according to Dr Saeed. There are times when it may be in your genes but is inactive, so the type of environment you grew up in or are living in becomes a contributing factor.
“If you’ve faced childhood trauma, [mental, physical and emotional] abuse or have been in a stressful and vulnerable situation these genes might become active,” she said. Another risk factor is certain viruses or infections that you acquired as an infant but never recovered from. Moreover, an increase in brain chemical dopamine levels and a drop in serotonin may contribute to it too.
What are the symptoms?
Mental conditions cannot be generally diagnosed by any medical or blood test. There are, however, certain symptoms that can help specialist doctors identify it.
The symptoms for schizophrenia have been divided into two broad groups: positive and negative.
The word ‘positive’ here means the presence of certain symptoms and ‘negative’ refers to the absence or lack of mental functioning, including rational thinking, said Dr Saeed.
Positive symptoms are often exaggerated concepts and actions that show that the person cannot tell the difference between what is real and what is not. They experience different kinds of hallucinations and delusions.
Hallucination is imagining something is present when in reality it is not there. These are some kinds of hallucinations that people with schizophrenia may experience:
A person may hear voices inside their head. The voice can come in many forms. It could be one sound or voice or many.
People with schizophrenia may see people and objects that don’t exist in real life.
Loss of appetite
Many people may lose their appetite because of their exaggerated sense of taste and smell.
People develop certain sensitivity towards touch and constantly feel that something is crawling or moving around or in their body.
Delusions, on the other hand, are false beliefs and thoughts. There are people with schizophrenia who believe that aliens are trying to abduct them or the government is out to get them.
Some people may believe that they are a celebrity, famous actor or even historic religious personality such as Jesus Christ. This is known as delusions of grandeur.
Persecutory delusions are experienced by those who believe they are being hunted, targeted or stalked. They constantly feel like they are being tricked into something.
Those with referential delusions think that certain forms of communication, such as song lyrics or a gesture from a TV host, are a special message just for them.
Negative symptoms refer to the absence of healthy mental functioning which includes thinking, behaviour, and perception. These symptoms may be found in people with depression too because of which the chances of a schizophrenia misdiagnosis are quite high.
Some of the symptoms are:
Don’t feel like socializing
Some people may lose the will to leave their house and socialize with other people. As a result, they isolate themselves.
Absence of emotions
People with schizophrenia are not able to express themselves, emotionally and verbally.
Lack of motivation
The energy levels of the person go down and they are not able to show interest in anything that concerns them or others.
Lack of hygiene
People may not feel the need to change their clothes or take a shower.
What can you do to help?
If your loved one has schizophrenia then you must support them in every way possible, said Dr Saeed. You should embrace those with schizophrenia rather than shun them or be embarrassed by them, she explained.
Psychologist Midra Ikram, who works for The Recovery House, said that people should refrain from stigmatizing patients. “If someone has cancer we don’t start calling them Cancer[ous],” she said. “In much the same way, we shouldn’t identify patients with their illnesses by calling them Schizophrenic or Bipolar.”
Medicine and therapy are the two main ways to treat and manage the condition.
Patients require different medicines and doses. Some will need a high dosage, while others will be given smaller doses.
Medicines often take four to six weeks to start working. They, of course, have side effects but they can be managed and controlled.
Therapy may help families and patients to lead a healthier life and assimilate into a daily routine. It starts off with setting small goals for the patients, such as changing their clothes, showering or even brushing their teeth and then moving on to bigger goals like getting a job or starting their own work.
Where to find help?
Any psychiatrist can help you with a diagnosis and treatment. Private psychiatrists practice in major cities in Pakistan. Government hospitals have psychiatry wards with specialists who also run out-patients clinics. As with all medical practitioners you have a right to ask for their qualifications.
The following institutions cover mental health treatment:
Aga Khan University Hospital
Pakistan Association for Mental Health
It runs a free clinic.
Contact: 021 358 33 238
Karwan-e-Hayat is a not-for-profit welfare organization which deals in mental conditions and treatment. Their payment policy depends on the income of the patient and their family. For first time visits it is best to visit their Khayaban-e-Jami OPD, where an interview of 30-45 minutes takes place. Once the consultant confirms the diagnosis, the patient is admitted to their rehabilitation programme.
Phone: (+92-21) 111 534 111, (+92-21) 3285 6773-75
Address: Khayaban-e-Jami OPD
101, Al Noor Arcade,
Near Qamar-ul-Islam Mosque,
The Recovery House
The Recovery House, a project of Caravan of Life Pakistan Trust, also works as a non-profit organization. You will have to get an appointment first; then they will interview you for 45 minutes and evaluate the patient’s state for free.
The next step is an assessment with a psychologist who will diagnose the patient. The sessions costs Rs2,000, but the fee is waived if a person can’t pay for it. The patient is either admitted or provided with a daycare facility.
Admission charges for a day are Rs5,000, while the daycare costs Rs1,000 per day.
The fee is charged depending on the financial situation of the patient. It may be waived for those who can’t afford it.
Phone: (021) 34546364
Address: 156 Tipu Sultan Rd, Bangalore Town Block A Kathiawar Society, Karachi