Playing with the mind

Today is World Schizophrenia Awareness Day. DNA diagnoses an illness that has drastically altered lives and showcases people who have fought it

MUMBAI: Russell Crowe’s portrayal of Nobel Prize-winning mathematician John Forbes Nash in A Beautiful Mind gave us a glimpse into the life of a schizophrenic. While most of us appreciated the movie, not many would know how to deal with a person suffering from schizophrenia in real life. How else can we justify the covert giggles and laughter that hound those who have been diagnosed with the brain disorder? Accepting such people is not easy, for they live in a make-believe world, a world that is far removed from reality.

“There was a patient who fell madly in love with someone and turned into a stalker. Then there was a woman who believed that Lord Krishna was her lover,” says a psychiatrist narrating case histories of some of his patients. A famous industrialist’s schizophrenic son seemed like any normal man. “Except for the fact that he was under the delusion that he was a king,” recalls another counsellor.

It may sound amusing to an unrelated observer, but for those who suffer from schizophrenia, this delusional world is their “reality”. Life is even more difficult for their families and caregivers. They have to constantly shuttle between the make-believe world of the patient and the real world, where their loved one is ridiculed and labelled “insane”.

“Schizophrenia is a brain disorder where the patient experiences an altered reality, delusions, hallucinations, paranoia and suspicion. In addition to chasing his own ghosts, the individual also has to deal with social ostracism, which in turn aggravates loneliness and disconnect with the real world,” explains Dr Fabian Almeida, psychiatrist, Wellspring Counselling Clinic, Kalyan. Almeida has conducted more than 500 workshops to promote mental well-being.

According to experts, nearly one per cent of the population suffers from the disorder. The World Health Organisation (WHO) estimates that one in every 100 persons suffers from schizophrenia while psychiatrists say 1.5 to 2 per cent of people in Mumbai suffer from some psychiatric disorder. Of these almost 80 per cent attempt or contemplate suicide at some point in their lives. Tragically, 10 per cent succeed.

The onset of the illness typically occurs in young adulthood, usually between the ages of 18 and 30. “Early diagnosis is the key, as it outlines the treatment as well as the outcome of the illness,” explains Almeida. “It is essential to create awareness about the disorder, which, in turn, will result in the creation of better support systems for the mentally ill in our society.”

But the most difficult aspect of the disease is the refusal of the patients to accept that there’s something wrong with them. Experts say that at least 20 to 30 per cent of patients do not believe they are ill. Often, patients become paranoid, more so towards those who care for them. Prompt hospitalisation, despite the patient’s reluctance, is necessary at such times, say psychiatrists. “Just as you would rush a family member who has suffered a stroke to a hospital, schizophrenics need medical attention too,” says Almeida. “There are several ways of dealing with un-co-operative patients. They can be given medication in food or administered medicated drops.”

But there is hope, say experts. “In the past 30 years, there has been a remarkable improvement in treatment strategies,” says Dr YA Matcheswalla, president, Bombay Psychiatrists Association, and head of the department of psychiatry at Messina Hospital, Byculla. “A number of drugs are now available, which can control, treat, and to some extent cure the disease. Also, there are psycho-social, behavioural, and rehabilitative programmes for such patients.” Messina Hospital has a special 110-bed ward for psychiatric patients.

Psychiatrists say regular follow-ups are a must for people battling schizophrenia. “When a schizophrenic overcomes the disorder, he begins to question why it all happened. This is known as post-psychotic depression and must be dealt with seriously,” says Almeida.

“Research has shown that the prognosis of patients undergoing treatment in India is better than their counterparts in the Western world,” says Akila Charagi, who has coped with the illness. “Perhaps, this is due to our social environment, where families share a close bond.”

This is where support groups such as Dilaasa come in. Over 150 family members of schizophrenic patients meet every Sunday from 11am to 1pm at Messina Hospital to share their problems.

Explaining the need for such support groups, Matcheswalla says, “Family members dealing with a patient suffering from schizophrenia need emotional support as they have to deal with a lot of difficulties at home.” Citing the example of Western countries where support groups form an integral part of the social fabric, Almeida says, “In the West, there are support groups for everyone — from people who want to lose weight to shopaholics. Similarly, there’s a need for support groups for schizophrenics, survivors, and caregivers.”
 
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