What Happens After You've Been Diagnosed with Schizophrenia?

Schizophrenia is a young person's disease. It is not usually diagnosed for the first time after the age of 40. But children as young as 5 have been diagnosed with this illness. Many years ago, it was believed to be cause by a "schizophrenogenic mother" sending "double bind" messages. What that meant was that your mother said one thing and did another and that made you schizophrenic. Needless to say that theory has long been disregarded. Then it was felt that a chemical imbalance in the fluid in the brain was the cause. Medication that seemed to help alleviate psychotic symptoms seemed to justify this belief. Then geneticists jumped in and said the illness was genetic and was dormant until something occurred to trigger psychotic symptoms.

Today they have combined all of that and now say it is the result of bio-psycho-social issues - the bio being genetic, the psycho being the chemical imbalance, and the social being things that happen to you in the world, including bad mothering.

Actually no one is really sure what causes schizophrenia. But everyone agrees it happens to younger people. Similar symptoms in someone older might be diagnosed as dementia or Alzheimer's.

Assuming you or your loved one has just been diagnosed with Schizophrenia, what should you now expect to happen?

The Establishment of Baseline

A professional will establish your baseline functioning. This means determining your highest level of competence intellectually, socially and personally. Since you first psychotic break has moved you to a lower level of functioning the goal will always to help you to return to your prior functioning. This is called decompensating. The older you are prior to the first break, the better your recovery can be. While it is not impossible to continue to achieve greater abilities, it is very difficult, and many people cannot do that. So, if your first break comes after you have your education and have married and had your children, you can hope to return to that level of functioning. One of the most common times for a first break is the first year of college. Many students who find themselves on their own for the first time, with the stress of college, and possibly the dormant gene, experience their first break with reality.

Assessing How Great the Decompensation May be

Mental health professionals will do a complete assessment to determine what skills have been lost and a treatment plan will be created to help the patient to begin their recovery. That plan will usually consist of medication and psychotherapy. Years ago people would be hospitalized for months or years after such a break. Today hospitals can only keep you until you are medicated, and then the recovery is completed in another setting. You may go home or to a residential program to continue your care.

Learning to Understand and Cope With Your Illness

Schizophrenia is an illness which affects your senses and your thinking. So, you may hear or see things that others would not if they were in the same room as you. (Other sensory issues may be smelling, tasting or feeling things that are not there). You may believe things are true that are not - like you are God or you can fly or that TV or radio is speaking directly to you, according to the The National Institute of Mental Health. The medication should help relieve those symptoms. But sometimes they do not go away completely. Therapy will help you to understand why this is happening and teach you how to cope with symptoms that do not go away. If the break occurred before you learned certain social skills - like going on a job interview - day programs will address those needs. If the symptoms include paranoia, treatment will help the person to learn how to cope with 'command hallucinations' so that they do not feel they must respond to the orders they receive from the voices they hear.

How Long Will Medication Be Necessary?

Again, thinking has changed over time. It was always felt that medication would be constant and for a lifetime, and that belief was supported by the decompensations and rehospitalizations patients had if they went off their medication. Today many doctors feel that patients may go on and off medication throughout their lives, only taking it to bring them back to normal functioning during an acute incident. What is really important is to have a doctor who knows you and to follow the plan they create for you. Remember, you want an individualized treatment plan to meet your specific needs and not a cookie-cutter plan based on your diagnosis.

What Schizophrenia is Not

Schizophrenics are not dangerous nor do they have multiple personalities. They are people who have trouble telling reality from delusion because of a malfunction of their thinking process. On occasion, those with paranoia can be dangerous - to themselves as well as others - and so medication is essential to assist with the amelioration of that symptom. Schizophrenics with family support who have as little stress as possible do the best in terms of recovery and maintenance.

SOURCES

National Institute of Mental Health, www.nimh.nih.gov.health

Schizophrenia.com, www.schizophrenia.com

National Institute of Health publication No. 02-3517