SCHIZOPHRENIA

Mental disorders occur in people due to stress, excess of alcohol or drug use, tension due to personal, social, family, financial, legal or other occupational hazards. Schizophrenia, among them is one of the most deceptive and dangerous. Schizophrenia is a disorder which affects your thoughts, emotions, perception, cognition and eventually the behavior. This disorder is equally prevalent between men and women but the onset is usually earlier in men and starts between the ages of 15 and 35 years. It usually has a chronic course like most mental disorders that not only affects the individual but eventually becomes a huge burden to the kith and kin. Although there are many types of schizophrenia, paranoia seems to be the most common problem seen in people. We usually think that after the onset of any mental disorder, patients tend to behave abnormally. Unfortunately this is not how it always takes place. The intelligence of the patient is completely intact in case of paranoid schizophrenia. Paranoia leads a person to being suspicious about everything happening in his surroundings. Some people even start accusing their own relatives of audacious things that make the relatives aware that something might be wrong with him. A person with paranoia lives in constant fear and doubt. He finds it difficult to trust anyone. In paranoia, a person may appear normal and is able to carry out his daily activities for a while. But he keeps on having suspicious thoughts about certain people he may or may not know. He also develops a constant fear that these people are out to harm him in any way. These false beliefs that he has are called “delusions.” People with paranoia have come up with claims of their spouse cheating on them with their own father, brother or with any stranger. Some mother in laws suffering from paranoia complain of their daughter in law trying to poison them by mixing something in their tea and food therefore they refuse to eat. Patients even develop a fear that some group of strangers are following them and are planning to kill them. These people fear of travelling alone or even do not get out of their homes and tend to stay indoors. Some even lock themselves up in their room fearing the worst. As a result of all these suspicions, they may get hostile and become more aggressive towards family members or relatives. In some cases paranoia has led people to commit homicide or even suicide in extreme cases.
The scarier part befalls when these people start hearing non-existent voices talking to them. This is known as auditory hallucinations which the person can actually hear while others around him cannot. They feel like many people are talking about them, mostly in a negative way. They actually start hearing human voices talking to them, some cursing, abusing or commenting about their behavior and thoughts. These voices could be from a known or even unknown person. Initially some people get scared hearing these voices and try to see if there are any people around him talking. But once they cannot find the source of these voices some explain it as a religious happening or feel as if god is talking to them. Others might go to get their ears checked. The disorder may get worse as people tend to feel that they are being controlled by some external force or person. They explain that their actions are being controlled by some superior being, god. Other types of schizophrenia have a more debilitating course where the person loses his day to day functioning with impairment in cognition, inter personal functioning, and volition. The person might show inappropriate mood and display a poor sense of self which eventually leads to an inability to distinguish external reality.
Fortunately due to the advancement in science and especially the pharmaceutical industry, proper medication is available for the treatment of such a disturbing disorder. Unlike early times when such patients were treated like animals and locked up in mental asylums, these days such people are treated in hospitals in an out-patient setting where the patient can just visit the doctor for a prescription of medication and need not be locked up or isolated from society. After taking the medication regularly the patient can carry out his day to day activities as any normal individual would. In most cases, however, patients have to take medication for their entire life. Due to the lack of awareness of such mental disorders, the general population of Nepal still believes in going to traditional faith healers and religious leaders for treatment. Due to the huge stigma that any mental disorder carries with it, people are still found to be reluctant seeking help from a psychiatrist. Even the educated people in our society believe that mental disorders occur due to black magic, due to a sin committed in a past life or due to astrology showing a fault in out stars. People fail to understand that like any other physical illness which may be caused by some bacteria or viral infection; mental disorders too have been shown to be caused by disturbance in the neurochemical and neurobiological state of the brain. Society fails to understand the need for medical assistance for any sort of mental disorders like depression, anxiety and stress. Therefore people are ready to pay huge sum of money as offerings and slay numerous animals as sacrifices at a traditional faith healer with the hopes of getting their relative treated. Whereas the truth is that they could just buy a five rupees tablet and get their patient treated properly by a psychiatrist at the hospital. This trend will continue unless we raise proper awareness of such mental disorders in schools, neighborhood, family and various sections of the society. Abolishing such primitive modes of treatment may be the only way to encourage people to seek proper medical help and treatment. Unlike early times when such patients were treated like animals and locked up in mental asylums, these days.... Dr. Deep Prakash Malla MD (Psychiatry) Consultant Psychiatrist at Norvic International Hospital , Thapathali , Kathmandu

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