Schizophrenics are often withdrawn and somewhat frightening. Many years ago, societies reacted to their behavior by locking them up miles from their friends and loved ones. Today we are able to keep them with us, but we still need all the patience we can muster to cope with them.
If schizophrenia develops swiftly after age 30, without a family history of the problem, there is a fairly good chance of recovery. Over the last two or three decades, tremendous strides have been made in drug treatment for schizophrenia, and the number of people who need to be institutionalized has dropped steadily. If the disorder develops slowly, with onset during your adulthood, and the suffering person is chronically unable to fend for himself or herself in society, the chances of recovery are not as good. Many sufferers become increasingly withdrawn, they express less emotion, and their thought patterns spin off further and further into unreality as years pass.
One out of every one hundred people in the world will be hospitalized for schizophrenia at some point in his or her life. Six hundred thousand people in the United States are currently being treated for the problem. Schizophrenia occurs more frequently in city dwellers and people of lower income groups. Most schizophrenics suffer chronically, with the problem becoming acute only for a small part of their lives. Most of the time they are able to function marginally in society, although they have difficulty holding jobs and making friends, and people think them a bit odd because their thinking doesn't fit into normal patterns.
There are five types of schizophrenia:
- Disorganized. The patient is aimlessly active, non-responsive, silly, or incoherent.
- Catatonic. The sufferer is usually unresponsive; he or she may assume strange poses, or occasionally become extremely active to the point of exhaustion.
- Paranoid. The sufferer has well-constructed and completely fictitious delusions of persecution. He is often fairly well adjusted in other aspects of life.
- Undifferentiated. Hallucinations, delusions, and confusion.
- Residual. The patient is not suffering acutely, but is withdrawn, unresponsive, eccentric, and has disjointed thought patterns.
To be classified as a schizophrenic, a patient must have the following symptoms:
- Six months of deterioration in his occupation, interpersonal relationships, or ability to support himself.
- This deterioration must occur before age 45.
- The patient must have severe psychotic problems during at least part of the six months.
- He must show some signs of illness currently.
- None of the symptoms should fit into these other categories: Major Affective Disorder, Organic Brain Disorder, or Mental Retardation.
The World Health Organization studied schizophrenia extensively some years ago and discovered that hearing voices was a very important criteria for diagnosing schizophrenia. Many sufferers think they hear voices from God or the devil - sometimes speaking about them rather than to them. Suspiciousness, delusions of persecution, inadequate descriptions of problems, and hopelessness are other common signs of various types of schizophrenia.
As the years pass, people who suffer from schizophrenia have more reason to be hopeful. Modern drugs, when used carefully, are able to alleviate many of the symptoms of the problem. Antipsychotic drugs such as chlorpromazine are useful in alleviating acute symptoms. Fluphenazine is useful for long-term control. More than drug therapy is needed, however. It is also necessary to work with the patient to strengthen the personality and provide him with psychological tools to cope with subsequent attacks. Individual, group and family therapy, or a combination of the three, are very effective in helping a sufferer cope with life.
Schizophrenia, as much as any other psychological problem, demands total commitment from a psychiatrist. There are times, I admit, when I almost despair of helping some schizophrenic patients, and I simply have to look at the man or woman as a suffering person that Jesus loves. Human love is stretched too far by the massive problems - divine love must take over.
I pray often when I work with a schizophrenic patient. Hope is sometimes so dim, and I know that so much depends on the psychiatrist. Sometimes I feel like leaving a therapy session and going to work on someone who will be more responsive. When a patient seems to be the type who will never re-enter society as a functioning human being, there is a great temptation to put forth less effort to find solutions. But one must remember that love can be a powerful treatment tool. It influences attitudes toward the patient, the amount of time spent with him or her, the quality of the time and the overall effort that is put into the treatment. (A Christian therapist ultimately answers to God, not just a family, supervisor, or a review board). Christians are directed to love their fellowmen and serve God by working with the poor and downtrodden, so they are uniquely able to help suffering schizophrenics.
I know Jesus would have been a committed, understanding therapist, if that had been His life's work. He would have had the patience to become a brother to suffering schizophrenics, and He would have been concerned about the victim's entire family unit - even if the family was at the bottom of the social scale (as many schizophrenic families are). He would have walked up and down the streets of inner cities, alleyways, or parks in rundown neighborhoods, helping suffering schizophrenic "bag ladies" and wandering, hallucinatory "bums" that no one else in our society is able to reach.
Anxiety and fear