Schizophrenia is a severe, chronic mental disorder that affects an individual s ability to think and make decisions, as well as relationships and emotions. The illness is characterized by experiences or unrealistic thoughts, disorganized behaviour and speech, reduced participation in routine activities. A person diagnosed with schizophrenia also experiences difficulty concentrating and memorizing things.

Schizophrenia does not have a definite cure. However, psychological rehabilitation can help the patient manage the symptoms of the illness, and improve the quality of life. This is where psychosocial therapy steps in.

Rehabilitation Psychology for Schizophrenia

Rehabilitation Psychology is a speciality of Psychology that utilizes psychological skills, knowledge, and theories to evaluate and treat people diagnosed with disabilities and chronic health issues in order to maximize functional ability, independence, social participation, and overall health.

A rehabilitation psychologist individualizes services to address different patients with varying health conditions. In order to meet this goal, the discipline adopts a holistic approach and considers individuals within a broad social context.

Different Treatment Approaches

Rehabilitation psychology follows these techniques to address mental disorder like schizophrenia in people  

Individual Psychotherapy   a psychologist/therapist teaches the patient how to deal with their behaviours and thoughts. Patients learn more about the ailment and its effects   and how to distinguish between what is real and what is not. The therapy may also help them manage day-to-day life.

Cognitive Behaviour Therapy   CBT can help the patient change the way they think or behave. A psychologist can show them how to deal with hallucinations and voices. After a couple of CBT sessions, you may be able to identify what triggers psychotic episodes   delusions and hallucinations   and prevent or reduce them.

Cognitive Enhancement Therapy   CET teaches individual ways to recognize triggers, social cues better, and improve memory and attention, and the ability to organize thoughts. The therapy combines group sessions and computer-based brain training.

Social Skills Training aimed towards improving social interactions and communication
Rehabilitation procedures such as problem-solving support and job counselling

Even if the above techniques are able to improve the condition, a schizophrenic person will likely need to continue with special care and education on how to become part of the community. 




How Effective Is Rehabilitation Psychology In Managing Schizophrenia?

Schizophrenia is a disease of the mind that is usually degenerative in nature. The complex disorder is generally characterized by symptoms, such as delusions, hallucinations (both auditory and visual) and disturbances in speech and is usually chronic in nature. The symptoms are not regular and can appear at any point of time. So it is highly possible that a person suffering from schizophrenia may sometimes bear resemblance to any other normal person and all of a sudden, might exhibit symptoms typical of Schizophrenia.

The causes of Schizophrenia include:

Brain Dysfunction: Abnormalities in the cerebral cortex (the cerebrum s outer covering that is vital in regulating consciousness) of the brain is the most common cause of this disorder. This is due to the presence of abnormally enlarged ventricles in that region. The decreased brain size owing to the enlarged ventricles is often related to the hallucinations and delusions experienced by schizophrenics.
Genetic Factors: Studies have also stated  genetics  to be an important cause behind this disorder. Closer the family ties, higher the risks of transmitting the disorder.
Biochemical Factors: More than one neurotransmitter is being targeted by recent drugs to control schizophrenia.

Symptoms which most people do not experience normally, but are found in people diagnosed with schizophrenia are said to be positive symptoms. They are:

Hallucinations: These are sensory experiences of things that do not exist outside the mind. Hallucinations usually manifest in the form of auditory or visual images.
Delusions: Delusions on the other hand are false beliefs one has about oneself. Delusions are of 3 major types:
Grandeur: Wherein the person imagines himself to be a famous personality
Persecution: The belief that somebody somewhere is plotting against you and the whole world is going to get you.
Control: The belief that a larger force, let s say a witch, a demon or even a duck for that matter is controlling your actions.
These positive symptoms generally respond well to medications.
In addition to this, schizophrenics think and speak differently than the rest of the society. They jump from idea to idea, lose track of speech mid-way and often speak in fragmented and haphazardly joined sentences. They are, in fact, unable to fix their attention on anything in particular.
Examples of the most common negative symptoms include:

The flat effect: The individual basically shows no facial expression and always has a flat emotionless mask on while staring into space. At times, they have inappropriate reactions to situations. Example - they might laugh at somebody's death and cry ad get angry when something good happens. 
Avolition: This condition occurs when the individual just sit for hours doing nothing as well as behaves in a way lacking any motivation or enthusiasm.

Schizophrenia -  Can Biochemical Factors be the Cause Behind it?

Chronic health disorders like schizophrenia affect not only the patient, but also the life of their care givers. Though schizophrenia can be treated to improve the patient's quality of life, it cannot be cured. Hence, it falls on the care giver's shoulders to watch out for symptoms of this disease and manage the person and their disorder. What should one do in such a case?

1. Educate yourself: the first step towards looking after a person with schizophrenia is to know the symptoms of the disease. With treatment, these may become better or worse so if you notice any change in the symptoms, bring it to your doctors notice at once.

2. Reduce stress: your goal as a schizophrenic person's caregiver should be to give them a calm environment and boost their confidence. Stress has a negative effect on all people and in schizophrenics this effect is much worse. Hence reduce stress and create an effective support system and structured environment for your loved one.

3. Do not ask the patient to change'his reality: when a person is suffering from schizophrenia, you should not force them to change their behaviour and reality, in order to adjust in the society at large. You should rather support the patient to accept his reality, to be at peace, since there is a very strong genetic component involved in its aetiology. Also, it is important that, both the patient and the family in particular should opt for regular counselling sessions.

4. Regular exercise: schizophrenics need not be cooped up in the house all day. Encourage the patient to go outside and exercise regularly. Exercise reduces stress and produces endorphins that make a person feel energized and happy. This should be complemented by a healthy diet. Minimize the amount of carbs and sugar intake and increase the amounts of omega 3 fatty acids in the patient's diet.

5. Join a support group: joining a support group is a very good idea for both the patient and the caregiver. For the patient, this provides a form of social interaction and for the caregiver is a platform to meet people with similar first hand experiences

6. Encourage treatment: convincing a schizophrenic person to seek treatment can be quite challenging. Suggest treating symptoms of the disorder such as insomnia and lack of energy rather than the disease itself to make the patient feel more comfortable. Give the patient options to choose from to make them feel more in control of the situation.

7. Monitor medication: once the treatment has started, ensure that the patient sticks to the prescription. Maintain a regular schedule by using weekly pill boxes and alarms. Also keep an eye on the possible side effects of these medicines. Ensure that your doctor has a complete list of medicines that the patient takes so that there is no chance of medicines interacting negatively with each other.

8. Prepare for crisis situations: it is always a good idea to have an emergency plan in place. Keep emergency contact details of all the doctors and therapists at hand along with the address and phone number of the closest hospital. Share your situation with friends and family so that in case of an emergency, they can be relied upon to take care of your children and other dependants.

Living with Schizophrenia

Schizophrenia is a neurological disorder that affects an individual s ability to feel, think, or behave properly. Schizophrenia makes it hard for a person to tell reality from fantasy.

The symptoms of schizophrenia are:

  Hearing voices in the head
  Hallucinations
  Fearfulness
  The urge to withdraw from society and social activities
  Difficulty concentrating

Although one can control the symptoms of schizophrenia with antipsychotic drugs, therapy can drastically improve their quality of life. The therapy combines both counselling and medication. Several types of therapy can help a schizophrenic. The most commonly practised are:

Cognitive Behavioral Therapy

This is a kind of interactive therapy session, which works only if a collective relation between the therapist and the individual suffering from schizophrenia is established. It is about analyzing the problem and setting goals to overcome it.

  The therapist focuses on the psychotic elements of schizophrenia (illusions and hallucinations) and helps the schizophrenic separate delusions and reality. It starts simply with learning to de-stress. CBT includes behavioural experiments, reality tests, cognitive restructuring.

  The schizophrenic is taught to avoid being confrontational and not to fear the psychotic experiences. Therapy helps strike a balance between the two extremes of psychotic and non-psychotic experiences.



Art Therapy

Art Therapy acts as a unique medium of expression for a schizophrenic.

  A person suffering from schizophrenia often finds it difficult to express himself/herself. With the patient guidance of a therapist, the individual uses paint, clay or other materials to voice their thoughts, feelings and fears.

  Art therapy also incorporates music, poetry, drama (any art form that the schizophrenic is comfortable with). Art Therapy works in groups as well. Interacting in a group teaches social skills. Communicating with people suffering from similar problems helps them get a better perspective and reduces the symptoms associated with the condition.

Family Therapy

Families are often confused about how to deal with the symptoms of schizophrenia. Family therapy is about establishing a bond between the schizophrenic and his/her family.

  Most importantly, bonding with the family helps gives an emotional boost to the individual. Knowing that she/he has the family s love and support brings down hallucinatory episodes. Surveys suggest that family therapy helps improve the quality of life for a schizophrenic.

Therapy can help suppress the terrifying hallucinations and illusions and help a schizophrenic cope with his/her condition. However, at the end of the day, what a schizophrenic needs more than therapy and anti-psychotic drugs are your understanding and support.

Schizophrenia - Symptoms And Therapeutic Treatments Of It!

Neurological disorders are an enigmatic bunch. There are various ongoing researches to identify the exact cause and how to treat them. While some argue that schizophrenia is a chronic brain disorder, others do not agree with it and debate that the origin is yet to be identified and the factors which produce it are yet to be identified.

Factors supporting it to be a brain disease are listed below.

Scan images (MRI and PET scans) of people who have had schizophrenia are different and have a reduced volume of grey matter, especially in the frontal and temporal lobes. In some people, this loss could be as high as 25%. Serial images have shown that the loss begins in the outer (parietal) region and gradually spreads to the rest of the brain. There is a strong correlation between the extent of this grey matter loss and the severity of the symptoms more the loss, worse the symptoms. Severe symptoms include hearing voices, psychotic thoughts, delusions, hallucinations and severe depression. This grey matter reduction does not depend on whether the person has undergone treatment or not for the condition. 

The counter argument is that grey matter loss is not seen in patients with schizophrenia alone. A number of neurological disorders, including normal ageing, manifest as grey matter loss on the scan images. Also, another consoling news is that this grey matter loss is completely reversible.

The way neurotransmitters respond to stimuli in people with schizophrenia is also slightly different. There are two variations to this debate: that schizophrenia is caused by excessive amounts of dopamine or increased sensitivity to dopamine. There are two proofs for this hypothesis first, dopamine suppressants are useful as antipsychotic drugs and secondly drugs which produce the same effect as dopamine can cause hallucinations similar to those seen in schizophrenics. There could be other neurotransmitters involved too, but the dopamine connection is more strongly established.

The electrical activity of the brain as seen in EEG is very different and abnormal in schizophrenic people. This reduced brain activity is another indication of the fact that schizophrenia is another brain disorder. There is also a strong genetic component to schizophrenia. Family history correlation is also very strong. The correlation extends to the point that where there is a neurologic disorder in the first-degree relatives, the chances of developing schizophrenia is increased.

There are specific genes, mutations of which are also attributed to schizophrenia. While the risk factors are in place (as mentioned above), the environmental conditions (brain infections, head trauma, family/social stressors and toxins can all lead to the manifestation of the symptoms. With medications and support therapy, both prevention and symptom management are possible.

Schizophrenia - Is It Really a Brain Disease?

Bipolar disorder:

Also known as manic-depressive disorder, bipolar disorder is the sudden change in mood, which might take a swing from depression to mania. It is a very severe disorder and can bring about unstable and precarious behavior. The risk of having suicidal tendencies is also quite high. Bipolar disorder is usually treated with medicines alongside therapy.

Symptoms:

1. Bipolar mania
2. Hypomania
3. Depression
4. Mood swings

The mood swings do not follow any particular pattern.

Schizophrenia Disorder

Schizophrenia is a chronic mental disorder which affects the general behavior and lifestyle of a person. Schizophrenics might face a difficulty in distinguishing between the real and the imaginary.
Contrary to public belief, schizophrenia is neither split personality nor multiple personalities. It is not an after effect of any previous traumatic experience. It might be genetic or a result of chemical imbalance in the brain chemicals.

Symptoms:

1. Paranoia
2. Senseless talking
3. Feeling apathetic
4. Insomnia
5. Personality change
6. Hallucinations
7. Delusions
8. Withdrawal from society
9. Attention deficit disorder or add

No specific medicine is available for schizophrenia. Usually, rehabilitation is advised to regain confidence and recover skills required for a productive life.

Psychosis

Similar to schizophrenia, psychosis is another mental disorder which is characterized by hallucinations and delusions. Psychosis is extremely dangerous and harmful as it might spur you to cause self-inflicted wounds and pain. It is of utmost importance to consult a doctor immediately after experiencing psychotic symptoms.

Symptoms:

1. Hallucinations
2. Delusions
3. Depression
4. Anxiety
5. Suspicion
6. Insomnia or hypersomnia
7. Withdrawal from society
8. Attention deficit disorder or add
9. Attention deficit hyperactivity disorder or ADHD

The only available diagnosis for psychosis is a psychiatric evaluation. Certain medical tests and x-rays may also be executed along with it to detect the underlying cause. Psychosis may be caused due to Parkinson's disease, Huntington's disease, brain tumors, Alzheimer's disease, epilepsy, etc.

Although there aren't any medical complications in psychosis, it should not be left untreated due to its harmful effects. Medication and therapy are the known cures of psychosis.

Symptoms of Bipolar Disorder, Schizophrenia Disorder and Psychosis

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