Schizophrenia

Schizophrenia is a mental illness that is characterized by a loss of touch with reality, trouble maintaining daily schedules/motivation/personal hygiene, as well as trouble understanding information they are given to make decisions with. Schizophrenia is a very serious illness that is still not completely understood. We still aren’t 100% certain what causes it, whether it is a combination of genes and environment, or possibly just a chemical imbalance. What we do know for sure is just how devastating it can be when left untreated. Joblessness, homelessness, and even addiction are common among those who have untreated schizophrenia. It is so important that it is caught early and managed as it does not take very long for someone to lose control.

Although each and every case is different, there are some symptoms that are common between cases. Common symptoms include:

  • Hallucinations: Hallucinations are anything that no one else can see, hear, smell, or touch that the person with schizophrenia is experiencing. These hallucinations vary from person to person, but the more common type of hallucination is voices. These voices will talk about the person, or warn them about danger, or tell them to do things to themselves/others (that are often times harmful). It can be quite some time before the hallucinations are noticed as the person having them will respond internally to them. Until they either talk about the hallucinations or outwardly respond to them, they are undetectable.
  • Delusions: Delusions are beliefs that are untrue about people/places/events. These delusions can vary greatly, but more common delusions are that someone is hurting them (i.e. through poisoning, controlling their mind/body, plotting against them in some way, etc.) or that they are someone they are not (i.e. someone famous/well-known).
  • Disorganized appearance: Those who are suffering from schizophrenia have a hard time taking care of themselves because they either forget or are focusing more on the things that are going on in their heads. They may have poor personal hygiene, live in less than healthy conditions, or they may even appear to be homeless. They can become very sickly looking if they are refusing to eat because they think they are being poisoned, and they can also look very tired/stressed if they are losing sleep due to their hallucinations/delusions.
  • Catatonic/Movement disorders: If a person is repeating movements and/or making unnecessary movements, they are dealing with a movement disorder. Someone with schizophrenia may also not move or respond to others around them (catatonic behaviour).
  • Unusual/Dysfunctional thoughts and disorganized speech/behaviour: The person cannot get their thoughts to make sense or get them organised before they start to speak. This may present as a very confusing loop of explanation of incomplete thoughts and ideas. They may also make up words/places/people in an attempt to make the connections fit in their heads. This can make it very difficult to tell reality from their hallucinations and delusions.
  • Emotional flatness/apathy: This is a particularly troubling symptom as it can present very much like depression. A flat affect (i.e. no change in expression or tone of voice) is also common with those who are struggling with schizophrenia.

Schizophrenia is something that can be very difficult to treat. It largely depends on the severity of the case, as well as their support system. Schizophrenia is treated with a combination of medications and therapy, but the most important thing is that they are consistent with their medication and housing. This helps to keep them on track and in check with the symptoms. If your loved one is struggling with schizophrenia, the best thing you can do is be supportive of their recovery and their hard work. It is also important to remember that they will have good and bad days, but it is important to know the difference between a bad day and crisis. That is why it is also important to educate yourself about the illness and ask the questions that you need to. It is also important that you seek help of your own. Being the caregiver of someone who is chronically mentally ill can put a huge strain on your emotionally and mentally. Having a safe place (i.e. a support group or therapist) is great for keeping yourself in check and helping you be the best support that you can be for your loved one.

Concurrent Disorders

Addiction and mental health problems are often seen as two completely separate entities. However, in quite a significant amount of cases, co-occurring addiction and mental health problems can be seen in clients. Does this happen with all mental health problems or addictions? What does this mean for the client’s symptoms? How does it affect treatment? All of these are important questions we will answer. But first we need take a look at the basic concept of concurrent disorders.

CD-webConcurrent disorder is an umbrella term that is used to describe a diagnosed mental health problem co-occurring with an addiction. Diagnosis is difficult, as addiction and mental health symptoms may not be occurring at the same time or in the same intensity as the addiction, and vice versa. This can make treatment very difficult and determining which came first (the addiction or the mental health problem) nearly impossible. This is why it is very important to consider the addiction and the mental health problem two separate entities that interact with each other.

There are two groups of mental health problems that are most commonly co-occurring with addiction; anxiety disorders and mood disorders. Anxiety disorders (i.e. generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and social anxiety disorder) more commonly co-occur with an alcohol addiction. Mood disorders (i.e. depression, bipolar disorder, etc.) more commonly co-occur with an addiction other than alcohol (i.e. cocaine, heroin, etc.). The addictions do vary from client to client, but the fact of the matter is that a significant number of those diagnosed with mental health problems will also struggle with an addiction or substance abuse problem at some point in their lives. It is important to keep in mind that your loved one is not their mental health problem or addiction, they are still your loved one. Those struggling with concurrent disorders still require love and support, especially through the recovery process. It is important to remain steadfast in your hope for them, while maintaining healthy and appropriate boundaries.

There is a noticeable connection between mental health problems and addiction. Substances are often used to cope with mental health problems when left undiagnosed or unmedicated. An addiction can also mask or mimic the symptoms of a mental health problem, making it significantly harder to diagnose without proper client history. Mental health problems can also be exacerbated by an addiction. Those who choose to self-medicate on top of their prescribed medication run the risk of making their psychiatric medication less effective. They also run the risk of going off of their prescribed medications and having a relapse of mental health symptoms. These interactions between addiction and mental health problems is incredibly problematic. Symptoms can vary greatly for mental health problems when someone is abusing substances. It is also possible for relapse with substance abuse if mental health problems are not being properly treated. It can lead to a vicious cycle of relapse and recovery until the right balance is found.

Part of the reason that diagnosed concurrent disorders are so difficult to treat is that it requires a great deal of coordination within the professional support system for the client. The choice often needs to be made as to what should be treated first, or if treatments should be received at the same time. This can vary greatly from person to person as the severity of both the addiction and the mental health problems needs to be properly assessed and taken into account. What works best for most clients is what is referred to Options-for-the-treatment-of-addiction-imageas integrated treatment. Integrated treatment works on emotional, cognitive, social, and addiction problems all at once. While treatment for these problems can often be provided under one roof, it is important that the client is receiving the best treatment possible. This often involves coordinating agencies and professionals into a care team. The care team leader would be a professional the client trusts who will make plans based on the successes and areas of greatest struggle for their client. By coordinating all those involved in the care process, the client has a much higher chance of having success in treatment of both mental health problems and addiction.

Hope is a very important part of the recovery process. With a diagnosis of a mental health problem coupled with an addiction, it can seem like your loved one will only get worse. However, recovery is more than possible if they are willing to seek treatment and work with people who can help them learn new ways to cope with their struggles. With the research in new medications and methods of therapies, there is a lot of hope for those who are struggling with concurrent disorders. Family and friends can be a great asset in instilling hope. You can help your loved one rediscover the hope in their future. Providing them with support and a safe place to express themselves without judgement is instrumental in a transition from their former instability into the stability of recovery.