Schizophrenics too can live a life of love

It's not easy to take care of someone whose reality is very different from yours. Here's how to ensure a loved one with schizophrenia can lead a normal life Each time the door bell rings, 72-year-old Chaya Vaswani (name changed) starts trembling in her Andheri flat. She hears voices and has delusions that there are strangers waiting outside to take her away from her home and family. If you brush her off saying, "Oh, there's nobody there" or "It's just a figment of your imagination" she gets even more upset. Her fear manifests in aggression. Such is the crippling effect of schizophrenia that Vaswani, a former librarian and a voracious reader who loved sharing her knowledge of books with her two daughters and students, has turned into a social recluse for the past 10 years. "When I see her, I feel we have lost the woman she was earlier. She used to be an independent human being," says Vaswani's daughter Neha P. When someone in the family suffers from schizophrenia, it is tough for the others to shuttle between the makebelieve world of the patient and the real world. Worse still, having their loved ones being ridiculed and termed 'mad, mental, gone case, or insane' is very hard. Neha has been honest about her mother's disorder with friends andrelatives. In most cases, family members lose out on precious time in accepting the illness. Both patients and their caregivers are often shrouded in shame and silence because our society still considers it taboo. "It's time people understood that schizophrenia is like another other illness. The earlier you accept and start treatment, the better the chances of the patient's recovery," says Dr Shyam Lulla, consulting psychiatrist of PD Hinduja Hospital, Mahim. According to the World Health Organisation, one in every 100 persons suffers from schizophrenia. Schizophrenia is a mental disorder characterised by abnormalities in the perception or expression of reality. In other words, a person loses the ability to think, feel or behave in a normal way. Patients suffer from hallucinations and delusions - they hear voices and see strangers around them. It starts in the most productive period of life 15-45 years. With Vaswani, it started with frequent mood swings, irrational behaviour, suspicions about the intentions of acquaintances, accompanied by hearing of voices and delusions. She suffers from bipolar disorder (paranoid schizophrenia), in which patients experience delusions and hallucinations. The illness has other catgeoires. Catatonic schizophrenia patients are oblivious to their surroundings and are extremely active or inactive for hours. Some patients have difficulty doing simple tasks and may ramble while speaking. Under the residual type, patients may exhibit eccentric actions or speech and those with the undifferentiated type have symptoms that may not fit into any of the earlier classifications, or may fit a few categories instead of just one. "Never challenge the patient's beliefs or delusions. They are very 'real' to the person who experiences them, and there's little point in arguing. Instead, set up a support structure and provide them with proper medical treatment for recovery," says Dr Yusuf Matcheswalla, head of psychiatry department, Masina Hospital, Byculla. Symptoms of schizophrenia There is no physical or lab test that can diagnose schizophrenia - a psychiatrist usually comes to a diagnosis based on the clinical symptoms. Some of the symptoms associated with paranoid schizophrenia are well documented while some are warning signs shared by patient's families and care givers. Here are signs to watch out for if you suspect a loved one may have the illness. - Severe headaches, inability to sleep at night and loss of appetite - Difficulty concentrating and maintaining personal hygiene - Unpleasant memories and becoming fearful, suspicious and argumentative - Lack of desire to socialise or interact with others, even friends and relatives. The patient thinks people want to harm her/him - Voices and delusions, staring into empty space for hours, muttering - Aggressive and violent behaviour, suicidal thoughts It took several years before Jane Fernandes (35) forgave her parents and herself for not being able to help her schizophrenic brother, who walked out of their house 15 years ago. "Each time I see a half-naked schizophrenic wandering the streets my heart skips a beat. Not a day goes by without me thinking of him," says Jane, who is now married and has two kids of her own. Recalling her brother's suffering, she says, "For years, I blamed myself and my parents for his mood swings. We just didn't know what to do when he hurled abuses for hours and became violent." Taking care of a schizophrenic person can be very challenging if the person is physically aggressive. "Today, we have some excellent medication in the market for treating schizophrenia. When a patient gets violent, the family should immediately seek medical help and keep the patient in a protected environment so that the patient does not harm her/himself or others," says Dr Lulla. Tips for caregivers While taking care of people with mental disorders, caregivers and family members should not ignore their own health and personal lives. "They must learn to dissociate themselves from the patient and take time off. Most importantly, families should accept the illness and not feel guilty about the patient's behaviour," says Amrit Bakshi, president of the Schizophrenia Awareness Association. According to him, even today most families try to hide the illness for the fear of being ostracised. "Actually, informing neighbours and relatives helps because they are prepared when the patient starts behaving erratically. In fact, they empathise with the caregivers and also offer unconditional support," says Bakshi. After taking care of his wife for 15 years, Pune-based civil contactor Kiran Joshi says that one should never make people with mental illness feel they are useless. Joshi believes that proper medication and work therapy works best. "Earlier, when my wife would get angry, she would end up spanking our two teenage daughters. But with support from the family and neighbours, we have managed to motivate her into maintaining our society's garden and working at a local animal shelter. Her energy is channelised well now," he says. Family members must be realistic in what they expect of the person with schizophrenia and of themselves. Maintain a sense of humor, as it will help you remain calm. Make an effort to educate yourself. Learning about schizophrenia and its treatment will allow you to make informed decisions about how to manage the illness and handle setback. Do not dispute the patients' delusions. They are 'real' to them, so avoid arguing. Stress can cause schizophrenia symptoms to explode so it's important to create a structured and supportive environment for your family member. Avoid putting pressure or criticising their shortcomings. Help your loved one set and achieve manageable goals, and be patient with the pace of recovery. But at the same time, ensure that you're not taking over and doing things for your family member that he or she is capable of doing. Try to support your loved one while still encouraging as much independence as possible. Monitoring their medication is a must. To ensure that the correct dosage/tablets are given, the Joshis have a medicine chart pasted on their kitchen cabinet. It is better to give the medications at fixed hours so that this habit becomes ingrained in both patients and their caregivers. It also helps in preventing persons with mental illness from falling into relapses. But sometimes a simple hug can do the magic of potions and pills.