How to identify early signs and symptoms of Schizophrenia in people

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations i.e. hearing sounds, seeing things that others cannot and feeling things, delusions (a false firm unshakeable belief in something despite evidence to the contrary) e.g. the police and CBI are watching me, chasing me and mean me harm and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.

Early symptoms would be becoming quiet, withdrawn to self, not showing interest in day-to-day work, starting to mutter to self or gesticulate, feeling that world around him or her is changing and suspicion of some conspiracy against him.

Other symptoms may include not taking care of self like bath, brushing etc., not keeping surroundings clean, some symptoms of anger irritability and even risk of self-harm maybe part of early illness

What is psychosis in schizophrenia?

The illness especially hallucinations and delusions are due to high levels of dopamine in the frontal region and limbic region.

Psychosis refers to the loss of touch with reality which is a common symptom of schizophrenia and includes the hallucinations, delusions.

How is schizophrenia different than bipolar disorder?

Schizophrenia is a group of disorders with the above mentioned symptoms which are continuous and only sometimes episodic.

In bipolar disorder there are episodes of depression consisting of sadness, low mood, low pleasure, lack of energy, crying spells and thoughts about self-harm and death. There may also be episodes of high energy, high mood, high pleasure seeking with big thoughts, big plans, talking excessively. Feeling that you are powerful person, possess powers and excessive confidence leading to big plans, acts and excessive spending, decreased need for sleep and aggression and loss of touch with reality.

Some overlap maybe seen in symptoms of bipolar disorder and schizophrenia.

What is the lifestyle of people suffering from schizophrenia?

The lifestyle of those who are regular on treatment which maybe about 50 per cent of population with schizophrenia will be as stable as you and me, but some continue to have symptoms and hence are unable to retain jobs and maintain relationships. The presence of not taking self-care, and some symptoms like forgetfulness may prevent from leading an independent life making them dependent on family or caregivers.

Why is schizophrenia more common in men than women in India?

The prevalence of the number of patients suffering from schizophrenia is higher in men compared to women because men have an earlier onset of the disease, they have more severe symptoms, and progressive illness compared to women. They are prone to substance use and poor outcome compared to women. The symptoms not being so intense in women makes them less likely to reach healthcare services and if they are reasonably functional at home they are often taken care off at home.

What are the challenges that caregivers face?

Severe financial strain.

Emotional and physical stress

More prone to depression anxiety exhaustion and burnout

Sleep deprivation

Unable to manage their time

Afraid to seek help as they feel it's their responsibility to take care of patient with illness

The author is Consultant Psychiatrist, Masina Hospital, Mumbai. Views are personal.

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