What would it be like if you believed that you were being followed by the CIA as part of a huge conspiracy?
Or if you believed that someone had implanted a chip in your brain that now controls all your behavior?
And if you believed that no matter how hard you try to convince people, no one would believe these things are really happening, even though you knew they were?
How would your life be different if you constantly heard loud and intrusive voices that no one else could hear — voices that yelled at you as you tried to go to work or read a book?
Schizophrenia is a brain disease that affects all aspects of thinking. It usually starts when people reach their early 20s, just when they begin their adult lives with hope for the future and thoughts about how life will be.
The onset of schizophrenia interrupts this process, and makes normal life, normal functions that we otherwise take for granted, difficult or even impossible.
While we do not know how to cure schizophrenia, we do know how to help people with this illness live more stable and satisfying lives.
It is important for the person with schizophrenia and his or her family to have hope that things can get better. Recovery from schizophrenia does not refer to being cured, but rather to having more to life than just illness.
Episodic illness
Schizophrenia is a syndrome, or a set of different diseases that affect similar areas of the brain, rather than a single illness with a single cause.
It often includes psychotic symptoms, such as hearing voices that no one else can hear or having beliefs that do not reflect any obvious reality.
These psychotic symptoms are the most dramatic part of the illness, but not the most disabling. Schizophrenia is commonly associated with what are called negative symptoms. These include loss of motivation, persistence and spontaneity, all qualities needed to function in the world.
People can work even if they hear voices or believe that the CIA is following them. People cannot work if they have lost all motivation, or cannot finish tasks that are started.
What would your world be like if you lost all motivation to work, or be with family, or do much of anything else? If you found you had nothing to say when you try to make conversation, and that just the struggle to have a conversation is overwhelmingly difficult.
Finally, schizophrenia can also interfere with memory and with certain kinds of problem solving needed to rent an apartment, succeed in school, or hold a job.
Even among health professionals, there are many misconceptions about schizophrenia. One is that there is invariably a downhill course to the illness.
Actually, schizophrenia is an episodic illness, often with ups and downs. Most people with schizophrenia are able to live independently, work at jobs they like, have social relationships that are satisfying.
Living with schizophrenia is never easy, but with some help and support, many people with this illness are able to live more complete and normal lives than is commonly believed.
While antipsychotic medication is a critical element of treatment for most people with schizophrenia, it is rarely enough. Even with medication, most people with schizophrenia will need some help learning and relearning skills, and help organizing their lives so that they do not become homeless or have other social disruptions.
People with schizophrenia also need psychological support. These psychosocial programs are as important as medication for most people who are trying to survive with this illness.
With all serious and chronic illness, it is easy to get so focused on the illness that everyone stops paying attention to the person. Whether the person has cancer or a damaged heart or schizophrenia, we can fall into the error of defining the person by their illness.
This is even more common with mental illness than with other kinds of illness. The person becomes “a schizophrenic,” rather than a person with schizophrenia who is also a husband, father, artist, or someone who likes to play basketball.
People with schizophrenia want the same things that other people want. They want to have friends, to have a place to live that feels good, to have a job that they like.
They need to have hope that things can get better, even during periods that might be pretty bad. Hope is what keeps all of us going through our own hard times, and people with schizophrenia and their families can lose this hope and give up.
Hope is important not just for people with schizophrenia, but for their families and support systems. One of the most important changes in the past 30 years has been learning how to better support families, so that they can do a better job supporting their mentally ill family member.
The National Alliance for the Mentally Ill was started in Wisconsin more than 25 years ago, as a way for people with schizophrenia and their families to come together and learn from each other.
Schizophrenia can leave both the person with the illness and the family isolated and alone. People with schizophrenia and their families need a community. As a Jewish community we need to reach out and stay connected.
Madison psychiatrist Ronald J. Diamond, M.D., is medical director of the Mental Health Center of Dane County and a professor of psychiatry at the University of Wisconsin-Madison. He will speak at “Hope and Help: You Are Not Alone,” a Jewish community program on mental illness, on Sunday, June 3, at Congregation Sinai.
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