Femi is a 25-year-old supermarket attendant who is always calm, diligent with his work, respectful and easy-going. For the past few months, he has been hearing voices which get louder and more distressful for him as the days go by. The voices were always talking about him among themselves and saying terribly bad things about him. So, he became really upset, and started talking back to the voices. But his colleagues were looking at him strangely and wondering why he was talking to himself. They could not hear any voice(s) and told him he was acting strange. He was surprised that they all could not hear the voices he was hearing. Things gradually became worse, and it started to affect his interactions with his colleagues and family members. Eventually, he began to keep to himself and stopped going to work as he will spend the whole day talking and arguing with the voices. He generally stopped caring for himself – not bathing nor brushing- saying that the water had been poisoned by his enemies who wanted to kill him. He knew this because the voices told him about the plans to kill him. Eventually he left the house as he no longer felt safe in the house and preferred to roam the streets, hiding away from those who wanted to kill him.
According to the World Health Organisation (WHO), Schizophrenia affects approximately 24 million people globally. It is about the most severe form of mental illness as it results in a deterioration of functioning if there is no treatment. It affects both gender equally, and usually starts between the ages of 15 and 35 years.
Schizophrenia affects how a person perceives reality, expresses emotion, acts, and relates with others. They may hear voices that other people cannot hear (hallucinations), have abnormal and strange beliefs (delusions) and may behave abnormally and irrationally. It belongs to the group of disorders called Psychotic disorders in which a person cannot distinguish between what is real and what is imagined.
As seen in the case of Femi above, the symptoms of Schizophrenia can be explained as follows:
The positive symptoms: Positive and negative here does not translate into good or bad. Rather, positive symptoms refer to the additional actions that are not based on reality, such as:
- Delusion: A fixed belief that something is true, despite the contrary evidence. Femi believed very strongly that his enemies were trying to kill him.
- Hallucination: The hearing, seeing, smelling, or feeling of things not there. Femi was hearing people talking and saying bad things about him.
Disorganised symptoms: Symptoms may show that the individual is not behaving appropriately or doing things the right way or responding appropriately. They have irrational speech, inappropriate emotional responses, or extreme agitation.
Cognitive symptoms: Persistent difficulties remembering things, paying attention and recognising that they have problems. Their thinking may become disordered and full of abnormal thoughts.
Negative symptoms of schizophrenia: These refer to the absence of normal behaviour and include symptoms such as not showing emotions, withdrawal from family and friends or social activities, lack of motivation and poor hygiene and grooming, as we see in the case of Femi.
What are the causes?
What is clear is that multiple risk factors play a role in the causation of psychotic disorders including schizophrenia. Some people may have family history which increases the risk, but it is important to emphasize that it is not automatic that once you have family history of schizophrenia, everyone in the family will also have it. No, not at all. It is very similar to having family history of hypertension or diabetes. Which does not automatically mean that one will develop hypertension or diabetes.
Conversely, even without a family history of mental illness or schizophrenia; or by extension, diabetes or hypertension, one can still develop these conditions despite not having a family history of such disorders. Thus, we should not discriminate against anyone on account of having family history of a condition, which, any one of us can develop at any time.
What goes wrong when someone has schizophrenia?
Certain chemicals in our brain that controls our behaviour, thinking and mood become excessively high in this condition. And these abnormal levels account for the abnormal and irrational behaviour and thinking that occurs in schizophrenia. Treatment entails using medications that correct these chemical abnormalities and they recover and return to normal functioning.
Can it be treated?
Certainly yes. Schizophrenia can be successfully treated, and individuals can live a normal life when they learn to keep their symptoms in check, take their medications and go regularly to see their psychiatrist. A combination of treatment approaches that combine medications, psychological treatment and psychosocial support and rehabilitation works best. If you or anyone you know is suffering from schizophrenia or other psychotic illnesses, please ensure you see a psychiatrist.
Dr Jibril Abdulmalik
Tribune Article for the column “Your Mental Health & You”
Thursday, 26th May 2022