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page 5. Schizophrenia:
Understanding the Disorder
Can schizophrenia be cured ?
There is no cure, but medication my help reduce many of the
symptoms of the disorder, so that rehabilitation, in many cases, is possible. Full recovery may occur in a small number of
people, but it cannot be predicted. The
delusions and hallucinations that grip young adults in the throws of their
disorder, usually most severe while in their 20’s and 30’s, tend to decline
somewhat with age. So by the time a
person is in their 40’s or 50’s, they may experience few of these positive
symptoms. Of course, this is not true
for everyone with schizophrenia. Some
individuals may still suffer from hallucinations late in life.
Diagnosing schizophrenia:
Unfortunately, we have no single blood test, x-ray or brain
scan from which we can then say with
certainty: “yes, that is schizophrenia.”
To reach the diagnosis of the disorder, other possible causes must be
ruled out. For example, the use of
street drugs, like cocaine or LSD, can cause hallucinations and delusions. Other physical disorders can also present
symptoms like schizophrenia, such as epilepsy, brain tumors and thyroid
disturbances.
Since there is nothing we can measure, no medical test we can
perform to help define schizophrenia, we are left left only with the symptoms
of the disorder. Because of this,
persons with schizophrenia often acquire different “labels” from healthcare
providers, before a clear diagnosis can be made. This can be extremely frustrating for patients and their
families. But this is a difficult
disorder to diagnose – symptoms may either go unrecognized or not show
themselves, until the disorder is fairly advanced.
For a doctor to diagnose schizophrenia, the symptoms must be
present for at least six months.
That is why the most important information is a detailed
patient history. The diagnosis is based
on the symptoms – what the person says, what the family can provide about the person’s behavior, and what the
doctor observes.
Treating schizophrenia:
Drugs are the cornerstone of treatment for schizophrenia,
just as they are the most important treatment for many physical disorders.
They are not a cure, but are used to help control the symptoms of the disease. Along with medication, social therapy and
rehabilitation are very important tools in the treatment of this disorder.
Depending on the severity of the symptoms and the stage of the disorder, the individual with schizophrenia may have to be treated in the hospital, especially if acutely ill. Other individuals are able to manage their disorder outside the hospital with regular visits to their doctor, and other support staff.
The family is very important in treatment of individuals with
schizophrenia. Family counseling is
often recommended to understand and manage problems associated with the
disorder. Education is extremely
important. Persons with schizophrenia
and caregivers should learn all they can about the treatments and therapies
offered, to be able to take an active role in the management of the disorder.
Medication:
Medications called antipsychotics (or neuroleptics),
developed in the 1950’s, have proven to be one of the most important medical
advances of the century. As a result,
people living with schizophrenia no longer have to be hospitalized for
years. Many are able to live in the
community.
There are well over 30 different antipsychotics available in
North America. Although antipsychotics
are the main drugs used in the treatment of schizophrenia, other drugs are
often prescribed to treat other symptoms like anxiety, and sleeping
difficulties that frequently afflict those with the disorder. In addition, the side effects associated
with conventional antipsychotics often make it necessary for people to take
other medications to lessen them.
Antipsychotics are not perfect. Although they may help control the positive symptoms of
schizophrenia, they have not been proven to be effective against the
debilitating negative symptoms of the disorder (ex. Social withdrawal, lack of
drive) . Some people with schizophrenia
do not respond to these drugs, and the side effects may contribute to people
not taking their medication (noncompliance).
Without medication, one of the critical steps in the treatment of
schizophrenia is missing – and relapses are more likely for these
individuals. And remember, with each
relapse is the chance that chronic symptoms become more severe, making treatment
even more difficult.
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