Paranoid Schizophrenia

WHAT YOU SHOULD KNOW

Schizophrenia (SKITS-oh-FREEN-ee-uh)---one of the most damaging of all mental disorders---causes its victims to lose touch with reality. They often begin to hear, see, or feel things that aren't really there (hallucinations) or become convinced of things that simply aren't true (delusions). In the paranoid form of this disorder, they develop delusions of persecution or personal grandeur. The first signs of paranoid schizophrenia usually surface between the ages of 15 and 34. There is no cure, but the disorder can be controlled with medications. Severe attacks may require hospitalization.

Causes

The causes of schizophrenia are still under debate. A chemical imbalance in the brain seems to play a role, but the reason for the imbalance remains unclear. We do know that you're a bit more likely to become schizophrenic if you have a family member with the illness. Stress does not cause schizophrenia, but can make the symptoms worse.

Signs/Symptoms

Schizophrenia usually develops gradually, although onset can be sudden. Friends and family often notice the first changes before the victim does. Among the signs are:

• Confusion
• Inability to make decisions
• Hallucinations
• Changes in eating or sleeping habits, energy level, or weight
• Delusions
• Nervousness
• Strange statements or behavior
• Withdrawal from friends, work, or school
• Neglect of personal hygiene
• Anger
• Indifference to the opinions of others
• A tendency to argue
• A conviction that you are better than others, or that people are out to get you

Care

Drugs such as Thorazine, Haldol, and Risperdal combat symptoms in 4 out of 5 patients. An acute attack usually can be cleared up in 4 to 8 weeks. Counseling and group therapy help recovering patients to understand the disease and to function effectively.

Risks

Without medication and therapy, most paranoid schizophrenics are unable to function in the real world. If they fall victim to severe hallucinations and delusions, they can be a danger to themselves and those around them.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

Treatment for an acute attack can require full-time hospitalization in a locked inpatient unit. As symptoms subside, you may be transferred to a partial care program in which you are able to return home after each day's therapy. Inpatients may wear their own clothes, but are customarily searched for sharp objects such as scissors or nail files, which are held in a staff office. Patients who present a danger outside the hospital can be involuntarily hospitalized for up to 3 days by the police or a doctor. While hospitalized, you may encounter the following procedures.

• Group Therapy: These meetings are somewhat like a support group session, allowing patients to share coping strategies. The meetings are run by medical staff.
• Individual Therapy: This is a time for you to meet alone with your therapist to discuss ways of dealing with the illness.
• Family Meetings: In these sessions, medical staff will prepare you and your family for your return home.
• Time Out: If you become unable to control yourself, the staff may separate you from the other patients, either in your own room or---if you seem violent---in a "safety room."
• Restraints: Patients who pose a danger to themselves or others may be physically restrained with leather bands.
• Electroconvulsive (e-LEK-tro-kun-VUL-siv) Therapy: For patients who become severely withdrawn or depressed, this form of treatment can help speed recovery. Also known as ECT or shock therapy, it applies a mild electric current to the brain. Although the treatment temporarily disrupts the memory, full recall typically returns within 2 weeks.

WHAT YOU SHOULD DO

• Be sure to take your prescribed medication regularly. Symptoms will return if you stop taking the drug. Since these medications can make you drowsy, be cautious when using machinery or driving until you know how the drug affects you. Check with your doctor before taking any other drugs, either prescription or over-the-counter.
• Avoid alcohol and recreational drugs. They can interact with your medication, causing extreme drowsiness and other potentially serious effects.
• Since it's hard to avoid stress, learn to control it with such techniques as deep breathing, relaxing muscles, meditation, or biofeedback. Try not to bottle-up your feelings; talk to your doctors, family, or friends and let them help you. You may also want to join a support group.
• Encourage those close to you to talk to your doctor. He can give them tips on how to respond to the situation.

Call Your Doctor If...

• You're unable to sleep well or find that you are sleeping more than usual.
• You undergo a change in appetite.
• Your medicine makes you drowsy, dizzy, or sick to your stomach.
• You develop any twitches or involuntary movements.

Seek Care Immediately If...

• You begin to have thoughts of suicide or homicide.