Individuals with Schizophrenia : Do They Breath the Same Air as Us?
Most people define health as the optimal condition their body can achieve. This definition is not completely wrong, but it doesn't include mental health as an important part of a healthy life. Of course, it's easier to grasp the concept of stomach pain or fever than how someone's mind works. Still, someone's mind defines who he is. And just as we aren't equipped with invulnerable body, we aren't equipped with invincible mind. If it's twisted too much, it can break apart.
Mental illness has existed since ancient times. However, in older civilizations, people did not pay much attention to mental illness which still allowed the individual to differentiate reality from something unreal. For example, anxiety disorder or obsessive compulsive disorder. Nowadays, those ailments are termed neurosis or neurotic disorders. Of course, any mental illness directly affects someone's quality of life and performance at work, so I don't consider neurotic disorders as something less important. But we will discuss the topic that has been observed throughout human history, namely psychotic disorders, especially schizophrenia.
Psychosis and Neurosis: What are they?
Psychosis or Psychotic disorders are mental ailments that disallow individual to differ something real from something unreal. The symptom might be hallucination, which is perceiving something that doesn't exist, like seeing a ghost or hearing whispers. It can be a false perception from any of human senses, like hearings (listening to voice that doesn’t exist), sight (seeing things that doesn’t exist), smell (smelling something that doesn’t exist), taste (feeling the taste of something that doesn’t exist), or even touch (the sensation of something crawling or touching while there is nothing there).
The symptom might also be delusion, which is an undebatable belief that doesn't match reality or cultural belief. Someone with delusion cannot be debated, and will think that their delusion is the only truth, regardless of reason. Someone believing something unreal while still being doubtful at times and listen to other people’s view is said to have an ‘idea’, but it can’t be considered a delusion as it’s a milder symptom.
The opposite of psychosis is, as previously mentioned, neurosis. Neurosis is a disorder that still allows the afflicted individuals to differ reality and things unreal. For example, people with major depression or panic disorder certainly has mental disorder, but many of them can understand which is real and which is unreal.
However, this distinction is beginning to blur as some individuals with disorders previously thought as purely neurosis also has psychotic symptoms. There are people with depression and psychotic symptoms, and people with anxiety disorder and psychotic symptom. But despite the unclear distinction, understanding psychosis and neurosis is a good start to understand mental disorders.
Psychosis and Schizophrenia
Some people misunderstand that having a psychosis equals having schizophrenia. However, this concept is wrong. Schizophrenia is only one of disorders known as psychosis. There are other psychotic disorders, like delusional disorder, acute psychotic disorder, depression with psychotic disorders, and many more. Below is a fictional story to better describe the symptoms and consequences of schizophrenia.
Example of Schizophrenia: A Fictional Case
John Glaine was an accountant working for quite a large firm. He was a diligent worker, never showing up late for work, and sometimes used his lunchtime for working whenever he had many tasks unfinished. He socialized well with another workers. Of course, not everyone liked him, but he would do whatever necessary for people he could consider friends.
However, he lost a large amount of money when his daughter got ill. He needed to borrow money from different people. But she didn’t get any better, and by the time she passed away, debts were all he had left.
As time went, he began to show strange behaviors. He once ran out of his office because he heard screams and shouts. Nobody else heard what he heard. In another occasion, he looked panicked and sweated a lot at work. When asked, he said he saw someone watching him and there were whispers talking about him from across the wall. Again, nobody else saw or heard anything. He stopped talking to his friends and often showed up late at works. Soon afterwards, he got fired.
He avoided meeting his neighbors and preferred to stay at home. He told his wife that he got possessed by the spirit of divine horse and he needed to obey it’s commands. He also got angry whenever his wife turned the TV on, because he thought everyone on TV was secretly talking about him in encrypted message. Nothing can shake his belief, although his family had tried to convince him so many times.
Because of local superstition, he was brought to paranormal instead of mental institution. But his symptoms persisted for a year, until his brother decided to admit him in a mental institution.
after long, continuous therapy, he got better despite a few relapses. But he was still required to take his drugs as scheduled. The problem is that his neighbors had become afraid of him. No one wanted to talk to him, and they brought their kids inside their house whenever he passed.
He moved away to get a new environment, and thankfully, everyone accepted him better than people in his old neighborhood. As getting a job was hard, he began to paint for a living.
Characteristic of Schizophrenia
Although John’s case is fictional, it was written with actual symptoms and signs of schizophrenia. Schizophrenia is one of the most severe psychosis. It's characterized by auditory hallucination (ghostly whisper), which is a symptom of serious mental illness; disorganized speech; bizarre behavior; negative symptoms (minimum facial expression); and bizarre delusion persisting for longer than 6 months.
Other kinds of hallucination like visual hallucination is possible, but auditory hallucination is the one with the strongest association with the disease
Bizarre delusion is a delusion that is completely impossible. Someone believing with absolute certainty that everyone is secretly chasing him may have psychosis, but his delusion is not a bizarre delusion. Someone believing that his neighbor has device to insert command into his brain or someone believing that there is a chip in his brain transmitting all his thoughts to NASA are examples of individuals having bizarre delusion. Note that these beliefs should not be something from cultural or religious belief. Someone believing in the arrival the false messiah leading the world war before the doomsday is just adopting the religious belief of Islam or Christianity.
Individual with Schizophrenia is One of Us
Human is in a way, a self-centered creature. Although we are also a social being, we will tend to help others with similarity to us. It might be similarity in race, nationality, religion, gender, or even similar past experience. The problem is, most of us may see nothing in common with individuals with schizophrenia. When schizophrenia is in active phase, they can be hard to reason with, their thought pattern is alien to us, and it's hard to talk about normal hobbies. But the question is: are they really not one of us?
Schizophrenia is actually not that rare. It's expected that 1% of the population will develop schizophrenia at some point in their life. Some may argue that one person among 100 individuals is not a significant number, but it certainly is. If you have 10 persons belonging to close friend or close family category combined, then there is 10% chance that one of them will develop schizophrenia. Yes, your chance of having the disorder is just 1%, but your chance of getting affected by the disorder is ten times as much.
The other problem is that we haven't been able to understand how the disease comes to be. It's already known that over activity of a certain substance called dopamine in human brain causes hallucination or delusion, but we have no idea how this over activity happens. The reason why it becomes a problem is that we cannot prevent it or pinpoint who will likely develop it. It has been suggested that accelerated change in grey matter of the brain may predict future schizophrenia, but the finding is not yet applicable for schizophrenia prevention in most areas.
If we can't predict who will have it, can anyone be sure that it won't affect him? How's your luck with dices? If you are told to roll a dice and the appearance of number 1 will end your life, can you be sure that it will not happen? Although having a close person getting schizophrenia is not the same with the end of someone's life, it's certainly a life-changing experience. There is no such thing as being overly prepared, especially when browsing the net for materials cost almost nothing to many people. We can try to understand the disease, the individuals who have it, and the family and friends affected by the disease. It might be us who will have to deal with it, so we can try to be kinder.
Although people with schizophrenia act differently from us, they used to be someone like us. They ate similar food we did, walked similar path, laughed with their family, or just messed around wasting time with friends. There are certainly difference, but it's just the same with how everyone around differs from us.
Even now, they still breath the same air, live in the same city, and try to blend with society after the disease is under control. They may not even walk the same way, as some may even wave their hands non-stop during the active phase of the disease, but improvement is possible and they can be a functional part of society given the chance and proper treatment. John F Nash even won a Nobel prize in mathematics despite having schizophrenia.
It's saddening how some are shunned after being labeled 'insane'. Other people whisper around while avoiding the afflicted individual. In Indonesia, some people even imprison their afflicted family member at home due to shame. We sometimes forget that the person suffering the condition is also the victim, and he suffers plenty already.
A job is also another issue. Not many people will employ individual with history of schizophrenia. In Indonesia, one of the possible solution is to have them work with art. They can do pottery, paint, or sew some clothes. One of the mental institution near where I live3 even helps selling their handcrafts.
Hopefully, in the future, we can find a cure to completely return the person with schizophrenia to 'normal' without relapses. But until then, everyone's support is necessary. If only one in ten people has to be affected by schizophrenia, the other nine can help lessen his sufferings. It's not just a biological problem, as it's also a big part of social issue.