schizophrenia in Nepal

Mysterious mental illness -Schizophrenia Nabin is 19 years boy. He is a student studying class 12. For last 6 months he appear different. He like to live alone. He hear the voices that people are talking about him. He developed self talking ,self smiling. He suspects other that people are try to kill him. For last 2 months he left study. He need to tell by other to do self care like tooth brushing, washing cloth, bathing. He refused to take participate activity on home. When new guest come to home, he afraid and to come out from room. On many occasion he locked door and live inside and did not open the door.’ People are watching to me” most of the times he become fearful and tense. On many occasion he is telling ‘TV is broadcasting about me ‘news paper also writing about me’ etc interesting things, which are totally wrong. He does not sleep sleeps on night. On many occasion he left home and found on the road alone with muttering .He neglected about dress, food and friend. Family member try to bring him hospital but he refuses and tells ‘ I have nothing wrong’ . Finally he was brought hospital few days back . He was diagnosed as schizophrenia (severe mental illness). Now he is getting better. The patient move here and there because of difficulty on diagnosis. Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions and disordered thinking and behavior. The ability of people with schizophrenia to function normally and to care for themselves tends to deteriorate over time. Schizophrenia is characterized by distortion of thinking, perception, mood and behaviour. It is mainly disorder of thought. Contrary to some popular belief, schizophrenia isn't split personality or multiple personality. The word "schizophrenia" does mean "split mind," but it refers to a disruption of the usual balance of emotions and thinking. Schizophrenia is a chronic condition, requiring lifelong treatment.The prevalence of schizophrenia is about 0.5 to 1% in any community. causes The exact cause of schizophrenia is currently unknown. However, several theories have been propounded to explain its causation. Multiple factors may be involved in causing schizophrenia. I. Biological Factors: - a) Genetic Factors: Genetic factors are very important in making an individual vulnerable to schizophrenia. b) Biochemical Factors: Schizophrenia is presently thought to occur due to increase in the levels of a neuro- chemical called dopamine in brain. II) Psychological Theories:- a) Stress: - In a vulnerable individual, increased number of stressful life events can trigger the onset or lead to a relapse of schizophrenic. Symptoms The symptoms of schizophrenia also can be attributed to other mental illnesses, and no one symptom can pinpoint a diagnosis of schizophrenia. In men, schizophrenia symptoms typically start in the teens or 20s. In women, schizophrenia symptoms typically begin in the 20s or early 30s. It's uncommon for children to be diagnosed with schizophrenia and rare for those older than 40. Signs and symptoms of schizophrenia generally are divided into three categories — positive, negative and cognitive. Positive symptoms In schizophrenia, positive symptoms reflect an excess or distortion of normal functions. These active, abnormal symptoms may include:  Delusions. These beliefs are not based in reality and usually involve misinterpretation of perception or experience. They are the most common of schizophrenic symptoms.  Hallucinations. These usually involve seeing or hearing things that don't exist, although hallucinations can be in any of the senses. Hearing voices is the most common hallucination among people with schizophrenia.  Thought disorder. Difficulty speaking and organizing thoughts may result in stopping speech midsentence or putting together meaningless words, sometimes known as "word salad."  Disorganized behavior. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation. Negative symptoms Negative symptoms refer to a diminishment or absence of characteristics of normal function. They may appear months or years before positive symptoms. They include:  Loss of interest in everyday activities  Appearing to lack emotion  Reduced ability to plan or carry out activities  Neglect of personal hygiene  Social withdrawal  Loss of motivation Cognitive symptoms Cognitive symptoms involve problems with thought processes. These symptoms may be the most disabling in schizophrenia, because they interfere with the ability to perform routine daily tasks. A person with schizophrenia may be born with these symptoms, but they may worsen when the disorder starts. They include:  Problems with making sense of information  Difficulty paying attention  Memory problems Affective symptoms Schizophrenia also can affect mood, causing depression or mood swings. In addition, people with schizophrenia often seem inappropriate and odd, causing others to avoid them, which leads to social isolation. Types of schizophrenia: 1. Paranoid: Disturbance on thought & suspiciousness 2. Hebephrenic: Shows childish like behaviour 3. Catatonic: Disturbance on motor action i.e. stupor, excitements ,etc 4. Undifferentiated: Fulfill the criteria for schizophrenia but not included above there. 5. Residual: Schizophrenia but no active symptoms at all Risk factors Although the precise cause of schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering paranoid schizophrenia, including:  Having a family history of schizophrenia  Stressful life circumstances  Older paternal age  Taking psychoactive drugs during adolescence Complications Left untreated, paranoid schizophrenia can result in severe emotional, behavioral, health, and even legal and financial problems that affect every area of your life. Complications that paranoid schizophrenia may cause or be associated with include:  Suicidal thoughts and behavior  Self-destructive behavior  Depression  Abuse of alcohol, drugs or prescription medications  Poverty  Homelessness  Incarceration  Family conflicts  Inability to work or attend school  Health problems from antipsychotic medications  Being a victim or perpetrator of violent crime  Heart and lung disease related to smoking diagnosis If your doctor or mental health provider believes you may have paranoid schizophrenia or another mental illness, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms and check for any related complications. These exams and tests generally include:  Physical exam. This may include measuring height and weight, checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.  Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.  Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. Treatments Schizophrenia is a chronic condition that requires lifelong treatment, even during periods when you feel better and your symptoms have lifted. You may feel as if you don't need treatment, and you may be tempted to ignore treatment recommendations. But effective treatment can help you take control of your condition and enjoy a happier and healthier life. Treatment options are similar for all types of schizophrenia. But the specific treatment approach that's best for you depends on your particular situation and the severity of your symptoms. The main methods of treatments for schizophrenia are:  Medications  Psychotherapy • Electroconvulsive therapy (ECT) Lifestyle and home remedies  Take your medications as directed. Even if you're feeling well, resist any temptation to skip your medications. If you stop, schizophrenia symptoms are likely to come back.  Pay attention to warning signs. You and your caregivers may have identified things that may trigger your paranoid schizophrenia symptoms, cause a relapse or prevent you from carrying out your daily activities. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Involve family members or friends in watching for warning signs. Addressing schizophrenia symptoms early on can prevent the situation from worsening.  Avoid drugs and alcohol. Alcohol and illegal drugs can worsen schizophrenia symptoms. Get appropriate treatment for a substance abuse problem.  Check first before taking other medications. Contact the doctor who's treating you for paranoid schizophrenia before you take medications prescribed by another doctor or before taking any over-the-counter medications, vitamins, minerals or supplements. These can interact with your schizophrenia medications. How Can We Be Mentally Healthy? • Don’t do deep thinking. • Don’t believe traditional false things like witch, ghost, etc • Try to be happy whatever you got but don’t forget to do hard working • Take as a good way for your friends success. • Don’t abuse Alcohols & Drugs. • Do healthy competition on daily life. • Don’t be too moral and don’t expect it from other also. • Express your problem to other (ventilations). • Make the environment peace and healthy. • Break difficult work into different fraction and try to finish one by one.