Schizophrenia over Time: Experiences Living With the Illness
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Introduction
Several medical studies have shown that there are no definitive or known causes of schizophrenia, but there are assertions that there is a significant contribution regarding one’s genetic makeup, altered brain chemistry through the increased levels of dopamine and the environmental contributions regarding such aspects (Hernandez, Barrio, & Yamada, 2013). Just like other mental disorders, schizophrenia manifests through different phases, and its severity increases as one’s condition move from one case to the other. The first phase is the prodromal phase that is mostly characterized by the exhibition of withdrawal cases in individuals. The second phase is the active phase that entails and individual showing the severe symptoms such as delusions, hallucination and other non-conforming behaviours. The last phase is the residual phase that mainly manifests through the exhibition of the cognitive symptoms by the individual.
Saks’ Experience with Schizophrenia based on the Symptoms Experienced
Just like most of the patients with schizophrenia, Saks started experiencing symptoms of the condition while she was in the first year as a law student at Harvard when she was doing a memo assignment. During this period, Saks experienced instances of delusions that manifested through having the thought of being complicit of the killing of thousands of people with her mind. Again, she managed to lure her colleagues from the library to the rooftops and singing an unintelligible song with no meaning attached to such words used to lyrics (Saks, 2012). The delusions also manifested through hallucinations when she experienced reported instances where someone was standing behind her with a knife and trying to kill her (Saks, 2012). Such hallucinations were associated with loose association disorganized speech during the entire conversation. On other occasions after completion of her studies, Saks narrated instances when she stayed in a shambolic studio apartment, felt gaunt, could remain silent for long and would be hallucinating through words such as “tell them to get away” and other instances (Saks, 2012). However, one apparent red flag that arose is when she started teaching at her current place of work. During the day, she narrates how she experienced loose associations, was overcame by fear, uttered unintelligible words like fire on ice, hallucinated about people poised with daggers, and experienced delusional aspects when she declared “I am God, I used to be”.
Positive and Negative Symptoms from Saks’ Experience
There were several positive symptoms that Saks experienced during her struggle with schizophrenia. One of those symptoms are delusions, where Saks reported instances where she declared herself God or saw herself capable of killing thousands of people with her mind. Saks also experienced hallucinations when she narrated of constantly seeing people with either daggers or knife closing in on her (Saks, 2012). Again, instances of disorganized speech also manifested through have loose associations and experiencing unintelligible and incoherent speech. The instances of disorganized behavior also manifested through her inability to keep herself clean nor feeding. On the other hand, the negative symptoms manifested through the poverty of speech, especially when her friend came to her rescue, and all she could say is thanking him for coming. The other negative symptom evident in her case is lack of interest and lack of motivation. Saks often experienced reduced interest or a lack of motivation even to carry out essential house chores or even turning lights on (Saks, 2012). Such aspects were characterized by instances of flat effects in her speech.
Clinician Rated Dimensions of Psychosis Symptom Severity and WHODAS
Clinician Rated Dimensions of Psychosis Symptom Severity measure is an instrumental tool that could be employed effectively owing to the presence of the eight items and the scale of zero to five that gauges the severity of the eight symptoms. These symptoms include delusions, hallucinations, psychotic disorders, disorganized speech, mania, depression, negative symptoms, and psychomotor disorders (APA, 2014). The tool could help in determining the severity of the symptoms and effectively help to capture the variation in severity, help in the formulation of a treatment plan, help in prognostic decision making, and help in reaching conclusions about the pathophysiological mechanism in place (APA, 2014). On the other hand, WHODAS could be used to ascertain the severity of various attributes highlighted in the six domains. These include self-care, socialization, life activities, cognition, mobility, and participation. Based on the case of Saks, this tool would be vital in measuring the severity of both the positive and negative symptoms as well as the cognitive symptoms of schizophrenia.
Treatment Plans for Saks
In formulating the treatment plan for Saks, there is need to understand that the treatment plan agreed would be lifelong as in the case of various individuals with schizophrenia. The treatment plan would entail both the psychotherapy sessions and the administration of the antipsychotic drugs (Walsh, Hochbrueckner, Corcoran & Spence, 2016). These drugs would be administered to lower the severity of the symptoms associated with the disease and ensure that there is positive chemical balance in the brain of the patient to suppress the instances of the rise of dopamine. In most instances, clozapine is usually prescribed together with the psychotherapeutic sessions to alleviate the severity of the symptoms that the patients always experience (APA, 2014). However, save for the antipsychotic drugs and the psychotherapeutic sessions, there are long term challenges that could force the professional to change aspects of medication. Therefore, to sustain this lifelong treatment plan, holistic approaches such as family, social, vocational, and medical aspects must be tailored in the treatment plan. Families play an important role in helping the patient adhere to the treatment stipulations just as social aspects that help the improve relationship with people and reduce instances of disorganized behavior (Walsh, Hochbrueckner, Corcoran & Spence, 2016). Vocational activities would help the individual to effectively integrate into the society and fight stigma related to the condition.
Factors that may Influence and Individual’s Experience with Schizophrenia
Though no study ties schizophrenia to the racial attribute of an individual, racial identity plays an important role in shaping up the experiences of the individuals living with the condition. For instance, among the Hispanics and African-Americans, schizophrenia is attributed to the devil in most families, making treatment of the condition blatantly neglected (Hernandez, Barrio, & Yamada, 2013). On the other hand, in relation to gender, women are more likely to seek medical intervention in such cases compared to men owing to the fact that they always come out at the early stages compared to men (Hernandez, Barrio, & Yamada, 2013). Such developments would immensely reduce any negative experience with the condition, and the treatment plans formulated always take into account their gender, hence reduced manhandling. Again, concerning sexual orientation, the members of the LGBT are bound to suffer adverse effects of schizophrenia owing to the stigmatization, social prejudice, and blatant discrimination they often encounter in healthcare facilities (Walsh, Hochbrueckner, Corcoran & Spence, 2016). There is a high likelihood that the individuals with the perceived non-conforming sexual orientation would bear the brunt of severe symptoms of the conditions compared to the ‘straight people’ in society.
Additionally, the patients coming from low-income families are at high risk of developing severe symptoms of the conditions compared to those people from the middle or high-income families. The fact that the treatment is a lifelong process translates to increased costs in medication and reduced family income, an aspect that could be allowed to get worse if the families cannot afford the medication and the psychotherapeutic sessions (Walsh, Hochbrueckner, Corcoran & Spence, 2016). Finally, religion could play a vital role in reducing or worsening the negative experiences of patients with schizophrenia. For instance, religions such as Christianity attribute such conditions to one being posed with demons and the only way to reduce such instances is through exorcisms (Hernandez, Barrio, & Yamada, 2013). Such beliefs are often grounded on dogma and could only worsen the severity of the symptoms, plunging the patient to further chaos. However, among individuals who prioritize scientific therapies over religious assertions, such conditions are easily managed, and the severity of the condition effectively brought under control.
References
American Psychiatric Association. (2014). APA.(2013a). Clinician-Rated Dimensions of Psychosis Symptom Severity.
Hernandez, M., Barrio, C., & Yamada, A.-M. (2013). Hope and burden among Latino families of adults with schizophrenia. Family Process, 52(4), 697–708. doi:10.1111/famp.12042
Saks, E. (2012). A tale of mental illness — from the inside. TED talk. https://www.ted.com/talks/elyn_saks_a_tale_of_mental_illness_from_the_inside#t-862239
Walsh, J., Hochbrueckner, R., Corcoran, J., & Spence, R. (2016). The lived experience of schizophrenia: A systematic review and meta-synthesis. Social Work in Mental Health, 14(6), 607–624. doi:10.1080/15332985.2015.1100153