Recurrent Breast Cancer

Friday, December 8, 2017

Many famous people have had schizophrenia, including Vincent Van Gogh; Mary Todd Lincoln; John Nash- a brilliant mathematician; Brian Wilson, the Beach Boys; Nathanial Ayers;  and “The soloist,” a black American who was a double bassist at Julliard. Those with schizophrenia can be gifted.
 Schizophrenia symptoms include auditory hallucinations, disorganized speech, delusions, hallucinations, and catatonic behavior. Those affected are diagnosed between sixteen and thirty years of age. Symptoms include delusions, hallucinations, thought disorders, and lack of motivation. There is no specific gene that triggers the disorder. Schizophrenics are aware of their thought disorders. They have control over thoughts and behavior.
      The affected person may believe they are being persecuted. They may think they have extraordinary powers and gifts.
Symptoms include hallucinations and hearing voices (auditory hallucinations).  This may include visual images (seeing things that are not there).    When speaking, the person might jump from one subject to another for no logical reason. Speech may be muddled and difficult to understand.
         Lack of motivation is typical. The affected person loses their drive. They may give up on daily activities, such as personal hygiene, washing and cooking.   They may not respond to happy or sad events, or may react inappropriately.
        Social withdrawal is typical. When a patient with schizophrenia withdraws, it is often because they believe someone may harm them. They might not be aware of the illness. Hallucinations and delusions are real to the patient. Schizophrenics have difficulty with concentration, planning, organizing, and communication.   Treatment goals include having few or stable symptoms. Hospitalization is not recommended unless there is another medical issue that demands inpatient treatment.  Some have no family history of the disorder. It may be due to a new mutation.
A psychiatrist experienced in treating schizophrenia guides treatment.  The team may include a psychologist, social worker, psychiatric nurse and a case manager. The team approach may be available in clinics with expertise in schizophrenia treatment. Medications are the cornerstone of treatment. Antipsychotic medications are the most commonly prescribed drugs.  They control symptoms by affecting the brain neurotransmitter, dopamine.
Treatment goals include antipsychotic medications to manage signs and symptoms at the lowest dose. Medications could include antidepressants. It may take several weeks for the patient to notice improvement. 
Willingness to cooperate with treatment determines drug choice. The patient should consult with their treatment provider regarding side effects. 
Newer, second-generation medications are preferred. They have a lower risk of side effects. These include Chlorpromazine, Clozapine, Haloperidol, Fluphenazine, and Perphenezine. 
Older antipsychotic medicines could cause frequent and potential side effects, including possibility of a movement disorder (tardive dyskinesia) that may or may not be reversible. Once psychosis recedes, in addition to continuing medication, psychological and social interventions are crucial.
Psychotherapy helps normalize thought patterns.  Learning to cope with stress and identify early warning signs of relapse help with symptom management..
Socials skill training improve communication and facilitates daily activities. This provides support and education to families dealing with schizophrenia. Vocational rehabilitation can help those with schizophrenia prepare for further education and employment.
Many communities have programs to help those affected to find housing, self-help groups, and crisis intervention. With appropriate treatment, most people with schizophrenia can manage their illness. During crisis periods or times of severe symptoms, hospitalization may be necessary. If drug treatment is not effective, electroconvulsive therapy (ECT) is considered.
Coping with a mental disorder as complex as schizophrenia is challenging,  both for the person with the condition and for friends and family. Here are some ways to cope.
Learn about schizophrenia and join a support group. Education motivates the person to stick to a treatment plan. Support groups can help them reach out to others facing similar challenges.  Stay focused on goals. Managing schizophrenia is an ongoing process.
Stay motivated.  Help your loved one take responsibility for managing the illness and working toward goals.
Learn relaxation and stress management. The person with schizophrenia and loved ones may benefit from stress reduction techniques, such as meditation, yoga, or Tai Chi.
Go with your loved one to their appointments. Getting the information first hand will help you know what you're facing.
My amiable brother started hearing voices in his head at the University of Kansas in1970. I try to keep in touch with him by phone.
Manifestations of the disease process include psychotic disorders, such as delusions, hallucinations, and dysfunctional ways of thinking, called thought disorders (such as believing that” I can fly).”  Depression is common. It runs in families, even if the genes may not manifest. Auditory hallucinations could interfere with activities of daily living.
Clonazapine is a drug that may be prescribed. Social skills training is another treatment.  Treatment goals include avoiding hospitalization.  Once you get in the hospital patients tend to stay a while.  
Source: NIH