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Schizophrenia: Identification of patients and their treatment
All over the world we callously call a certain group of people crazy; mad and plain insane. Off hand we feel that these people are beyond all help. Here, we will try to help you, the reader, to identify and take curative steps for those whom we most easily call mad.
The following symptoms may be present in this group:

a. Hearing voices plotting against the concerned individual.
b. Seeing people whom we cannot see and talking to these imaginary people.
c. Hearing and seeing imaginary demons or gods asking these people to kill themselves or harm others.
d. Cannot complete a normal sentence; the words are all misplaced.
e. Believing that they know someone great; or are aliens or are being targetted by governments; their beliefs may take various forms inexplicable to the common person. For example, the ill person may believe that it is wrong for her to make calls while walking down public roads. May be the ill person also believes that the public transport she will take may be controlled by enemies wanting to kill her.
f. The person may believe s/he may be God or a demon, or a great person.
g. Withdrawal from not only society but people at large.
h. Sitting still for long in the same posture without moving or speaking. Even the limbs have to be moved by another person. When the limbs are moved they remain in the same posture.
i. Loss of coherent thinking; actions are inappropriate for a given situation.
j. Loss of interest in self-care including such basic actions like taking regular showers and shaving. (This symptom alone is not indicated for diagnosing schizophrenia.)

The treatment protocol for this disease is two fold. The first is known as prodromal treatment. Those at risk are to be monitored and counselled periodically. The risky populace includes those adolescents whose immediate blood-families have the disease already; those who have been through great trauma like severe abuse (including rape etc.); those who already have previous mental-ill health histories.

In some rare cases psychiatrists may want to begin medication in rigorously selected persons even before the full-blown disease appears. There are a class of medications called atypical anti-psychotics like the generic aripiprazole, which have virtually no side-effects which outweighs the advantage of the medication vis à vis the loss of the quality of life of the patient.

The second point of treatment should be the moment family members notice any one or all or some of the above symptoms for more than one week, or see their close ones behaving strangely for say two or three times.

If a patient sees a psychiatrist (an MD in psychiatry is the ideal choice since only an MD in psychiatry or neuro-psychiatry will be able to provide optimal treatment for such patients), right at the beginning of illness; the disease will not lose life-years but as the disease progresses; more aggressive (and a cocktail of) drugs are required. But except for severe cases, there is no need for institutionalization; drugs available can work wonders.

In India, hallucinations and delusions happen once and after treatment vanish forever. This is not the case in the First World; where schizophrenia is chronic and thus, requires lifelong medication. For unknown reasons, the prognosis of total recovery of schizophrenics is very positive. No superstition will help the patient; neither any religious ritual. Talk-therapies too are useless for these patients; at least for the first few weeks after starting treatment. One has to understand that this a disease of the brain and not of the mind. The brain undergoes changes which creates the delusions etc. The medicines will correct this and bring back the patient to normal life. As educated people we can at least not reject such wo/men as mad; for who knows when you or I may be afflicted?

One more myth about schizophrenics: schizophrenia is as good or bad as say, diabetes or cholesterol. It is barbaric for men/women to reject their spouses for this disease, or any other mental disease. With a little love, patience and medications, one’s partner will be cured. Also please remember, one day the person you reject today may be the only one willing to stand by you when you are afflicted with diseases which cannot be cured. Schizophrenia in India is just a form of mind-flu.

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