"Have patience with all things, but chiefly have patience with yourself. Do not lose courage in considering your own imperfections but instantly set about remedying them -- every day begin the task anew."
A Treasured Pearl
"A pearl is a beautiful thing that is produced by an injured life. It is the tear [that results] from the injury of the oyster. The treasure of our being in this world is also produced by an injured life. If we had not been wounded, if we had not been injured, then we will not produce the pearl."
Find Your Joy
"Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy."
9 Ways to Take Care of Yourself When You Have Depression
By MARGARITA TARTAKOVSKY, M.S. Associate Editor 9 Ways to Take Care of Yourself When You Have Depression“Depression is an illness that requires a good deal of self-care,” writes psychologist Deborah Serani, PsyD, in her excellent book Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing. But this might seem easier said than done, because when you have depression, the idea of taking care of anything feels like adding another boulder to your already heavy load. Serani understands firsthand the pain and exhaustion of depression. In addition to helping clients manage their depression, Serani works to manage her own, and shares her experiences in Living with Depression. If you’re feeling better, you might ditch certain self-care habits, too. Maybe you skip a few therapy sessions, miss your medication or shirk other treatment tools. According to Serani, as some people improve, they get relaxed about their treatment plan, and before they know it are blinded to the warning signs and suffer a relapse. Because skimping on self-care is a slippery slope to relapse, Serani provides readers with effective tips in her book. As a whole, the best things you can do to stave off relapse are to stick to your treatment plan and create a healthy environment. I’ve summarized her valuable suggestions below.
1. Attend your therapy sessions. As you’re feeling better, you might be tempted to skip a session or two or five. Instead, attend all sessions, and discuss your reluctance with your therapist. If changes are warranted, Serani says, you and your therapist can make the necessary adjustments. Either way, discussing your reluctance can bring about important insights. As Serani writes: Personally, the times I skipped sessions with my therapist showed me that I was avoiding profound subjects — or that I was reacting defensively to something in my life. Talking instead of walking showed me how self-defeating patterns were operating and that I needed to address these tendencies.
2. Take your meds as prescribed. Missing a dose can interfere with your medication’s effectiveness, and your symptoms might return. Alcohol and drugs also can mess with your meds. Stopping medication altogether might trigger discontinuation syndrome. If you’d like to stop taking your medication, don’t do it on your own. Talk with your prescribing physician so you can get off your medication slowly and properly. Serani is diligent about taking her antidepressant medication and talks with her pharmacist frequently to make sure that over-the-counter medicines don’t interfere. With the help of her doctor, Serani was able to stop taking her medication. But her depression eventually returned. She writes: …At first, it was upsetting to think that my neurobiology required ongoing repair and that I’d be one of the 20 percent of individuals who need medication for the rest of their lives. Over time, I came to view my depression as a chronic condition — one that required me to take medication much like a child with diabetes takes insulin, an adult with epilepsy takes antiseizure medication, or someone with poor eyesight wears glasses…
3. Get enough sleep. Sleep has a big impact on mood disorders. As Serani explains, too little sleep exacerbates mania and too much sleep worsens depression. So it’s important to keep a consistent sleep and wake cycle along with maintaining healthy sleeping habits. Sometimes adjusting your medication can help with sleep. Your doctor might prescribe a different dose or have you take your medication at a different time. For instance, when Serani started taking Prozac, one of the side effects was insomnia. Her doctor suggested taking the medication in the morning, and her sleeping problems dissipated. For Serani, catnaps help with her fatigue. But she caps her naps at 30 minutes. She also doesn’t tackle potentially stressful tasks before bed, such as paying bills or making big decisions. (If you’re struggling with insomnia, here’s an effective solution, which doesn’t have the side effects of sleep aids.)
4. Get moving. Depression’s debilitating and depleting effects make it difficult to get up and get moving. Serani can relate to these effects. She writes: The lethargy of depression can make exercise seem like impossibility. I know, I grew roots and collected dust when I was anchored to my depression. I can still recall how getting out of bed was a feat in and of itself. I could barely fight gravity to sit up. My body was so heavy and everything hurt. But moving helps decrease depression. Instead of feeling overwhelmed, start small with gentle movements like stretching, deep breathing, taking a shower or doing household chores. When you can, add more active activities such as walking, yoga or playing with your kids or whatever it is you enjoy. It might help to get support, too. For instance, Serani scheduled walking dates with her neighbors. She also prefers to run errands and do household chores every day so she’s moving regularly.
5. Eat well. We know that nourishing our bodies with vitamins and minerals is key to our health. The same is true for depression. Poor nutrition can actually exacerbate exhaustion and impact cognition and mood. Still, you might be too exhausted to shop for groceries or make meals. Serani suggests checking out online shopping options. Some local markets and stores will offer delivery services. Or you can ask your loved ones to cook a few meals for you. Another option is Meals-on-Wheels, which some religious and community organizations offer.
6. Know your triggers. In order to prevent relapse, it’s important to know what pushes your buttons and worsens your functioning. For instance, Serani is selective with the people she lets into her life, makes sure to keep a balanced calendar, doesn’t watch violent or abuse-laden films (the movie “Sophie’s Choice” sidelined her for weeks) and has a tough time tolerating loud or excessively stimulating environments. Once you pinpoint your triggers, express them to others so your boundaries are honored.
7. Avoid people who are toxic. Toxic individuals are like emotional vampires, who “suck the life out of you,” according to Serani. They may be envious, judgmental and competitive. If you can’t stop seeing these people in general, limit your exposure and try having healthier individuals around when you’re hanging out with the toxic ones.
8. Stay connected with others. Social isolation, Serani writes, is your worst enemy. She schedules plans with friends, tries to go places she truly enjoys and has resources on hand when she’s somewhere potentially uncomfortable, such as books and crossword puzzles. If you’re having a difficult time connecting with others, volunteer, join a support group or find like-minded people online on blogs and social media sites, she suggests. You also can ask loved ones to encourage you to socialize when you need it. Living with Depression
9. Create a healthy space. According to Serani, “… research says that creating a nurturing space can help you revitalize your mind, body and soul.” She suggests opening the shades and letting sunlight in. There’s also evidence that scent can minimize stress, improve sleep and boost immunity. Lemon and lavender have been shown to improve depression. Serani says that you can use everything from essential oils to candles to soap to incense. She prefers lavender, lilac, vanilla and mango. If you’re sensitive to fragrance, she recommends diluting essential oils, buying flowers or even using dried fruit. You also can listen to music, meditate, use guided imagery, practice yoga and even de-clutter parts of your home a little each time. Serani’s last point involves empowering yourself and becoming resilient. She writes: By learning about your biology and biography, following your treatment plan, and creating a healthy environment, you don’t allow anyone to minimize you or your depression. Instead of avoiding struggles, you learn from them. You trust your own instincts and abilities because they are uniquely yours. If you experience a setback, you summon learned skills and seek help from others to get back on-point. If a person’s ignorance on mental illness presents itself in the form of a joke or stigma, you clear the air with your knowledge of neurobiology and psychology.
whatz up dawg ?.........................!@#$%^&*()
People often imagine a person with schizophrenia as being more violent or out-of-control than a person who has another kind of serious mental illness. But these kinds of prejudices and misperceptions can be readily corrected. Expectations become more realistic as schizophrenia is better understood as a disorder that requires ongoing — often lifetime — treatment. Demystification of the illness, along with recent insights from neuroscience and neuropsychology, gives new hope for finding more effective treatments for an illness that previously carried a grave prognosis. Schizophrenia is characterized by a broad range of unusual behaviors that cause profound disruption in the lives of people suffering from the condition, as well as in the lives of the people around them. Schizophrenia strikes without regard to gender, race, social class or culture.
Delusions & Hallucinations Are Common in Schizophrenia
One of the most obvious kinds of impairment caused by schizophrenia involves how a person thinks. The individual can lose much of the ability to rationally evaluate his or her surroundings and interactions with others. They often believe things that are untrue, and may have difficulty accepting what they see as “true” reality.
Schizophrenia most often includes hallucinations and/or delusions, which reflect distortions in the perception and interpretation of reality. The resulting behaviors may seem bizarre to the casual observer, even though they may be consistent with the schizophrenic’s abnormal perceptions and beliefs.
For instance, someone with schizophrenia may act in an extremely paranoid manner — purchasing multiple locks for their doors, always checking behind them as they walk in public, refusing to talk on the phone. Without context, these behaviors may seem irrational or illogical. But to someone with schizophrenia, these behaviors may reflect a reasonable reaction their false beliefs that others are out to get them or lock them up.
Nearly one-third of those diagnosed with schizophrenia will attempt suicide. About 10 percent of those with the diagnosis will commit suicide within 20 years of the beginning of the disorder. Patients with schizophrenia are not likely to share their suicidal intentions with others, making life-saving interventions more difficult. The risk of depression needs special mention due to the high rate of suicide in these patients. The most significant risk of suicide in schizophrenia is among males under 30 who have some symptoms of depression and a relatively recent hospital discharge. Other risks include imagined voices directing the patient toward self-harm (auditory command hallucinations) and intense false beliefs (delusions)
The relationship of schizophrenia to substance abuse is significant. Due to impairments in insight and judgment, people with schizophrenia may be less able to judge and control the temptations and resulting difficulties associated with drug or alcohol abuse.
In addition, it is not uncommon for people suffering from this disorder to try to “self-medicate” their otherwise debilitating symptoms with mind-altering drugs. The abuse of such substances, most commonly nicotine, alcohol, cocaine and marijuana, impedes treatment and recovery.
The Onset of Schizophrenia
Warning signs that may indicate someone is heading toward an episode of schizophrenia include:
Social isolation and withdrawal
Irrational, bizarre or odd statements or beliefs
Increased paranoia or questioning others’ motivations
Becoming more emotionless
Hostility or suspiciousness
Increasing reliance on drugs or alcohol (in an attempt to self-medicate)
Lack of motivation
Speaking in a strange manner unlike themselves
Inappropriate laughter
Insomnia or oversleeping
Deterioration in their personal appearance and hygiene
Schizophrenia Symptoms
Schizophrenia is a mental disorder that is characterized by at least 2of the following symptoms, for at least one month:
Disorganized speech (e.g., frequent derailment or incoherence)
Grossly disorganized or catatonic behavior
A set of three negative symptoms (a “flattening” of one’s emotions, alogia, avolition; see below)
Only one of the above symptoms is required to make the diagnosis of schizophrenia if the person’s delusions are bizarre or if the hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.
Positive Symptoms
Delusions
Hallucinations
Disorganized thinking
Agitation
Negative Symptoms
Affective flattening - The person’s range of emotional expression is clearly diminished; poor eye contract; reduced body language
Alogia - A poverty of speech, such as brief, empty replies
Avolition - Inability to initiate and persist in goal-directed activities (such as school or work)
Although the above symptoms must be present for at least one (1) month, there also needs to be continuous signs of the disturbance that persist for at least six (6) months. During this period, the signs of the disorder may be present in a milder form, for instance as just odd beliefs or unusual perceptual experiences. During this 6 month period, at least two of the above criteria must be met, or only the criteria of Negative Symptoms must be present — if even just in milder form.
For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset of the symptoms (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).
Schizoaffective Disorder and Mood Disorder With Psychotic Features have been considered as alternative explanations for the symptoms and have been ruled out. The disturbance must also not be due to the direct physiological effects of use or abuse of a substance (e.g., alcohol, drugs, medications) or a general medical condition.
If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).
Paranoid schizophrenia – a person feels extremely suspicious, persecuted, grandiose, or experiences a combination of these emotions.
Disorganized schizophrenia – a person is often incoherent but may not have delusions.
Catatonic schizophrenia – a person is withdrawn, mute, negative and often assumes very unusual postures.
Residual schizophrenia – a person is no longer delusion or hallucinating, but has no motivation or interest in life. These symptoms can be most devastating.
Scientists are continuing to study and better understand the genetic factors related to schizophrenia. We inherit our genes from both parents. Scientists believe several genes are associated with an increased risk of schizophrenia, but that no gene causes the disease by itself. In fact, recent research has found that people with schizophrenia tend to have higher rates of rare genetic mutations. These genetic differences involve hundreds of different genes and probably disrupt brain development.
In addition, factors such as prenatal difficulties like intrauterine starvation or viral infections, perinatal complications, and various nonspecific stressors, seem to influence the development of schizophrenia. However, it is not yet understood how the genetic predisposition is transmitted, and it cannot yet be accurately predicted whether a given person will or will not develop the disorder.
Is Schizophrenia Caused by a Chemical Defect in the Brain?
Basic knowledge about brain chemistry and its link to schizophrenia is expanding rapidly. Neurotransmitters, substances that allow communication between nerve cells, have long been thought to be involved in the development of schizophrenia. It is likely, although not yet certain, that the disorder is associated with some imbalance of the complex, interrelated chemical systems of the brain, perhaps involving the neurotransmitters dopamine and glutamate.
Is Schizophrenia Caused by a Physical Abnormality in the Brain?
There have been dramatic advances in neuroimaging technology that permit scientists to study brain structure and function in living individuals. Many studies of people with schizophrenia have found abnormalities in brain structure. In some small but potentially important ways, the brains of people with schizophrenia look different than those of healthy people. For example, fluid-filled cavities at the center of the brain, called ventricles, are larger in some people with schizophrenia. The brains of people with the illness also tend to have less gray matter, and some areas of the brain may have less or more activity.
Developmental neurobiologists have found that schizophrenia may be a developmental disorder resulting when neurons form inappropriate connections during fetal development. These errors may lie dormant until puberty, when changes in the brain that occur normally during this critical stage of maturation interact adversely with the faulty connections. This research has spurred efforts to identify prenatal factors that may have some bearing on the apparent developmental abnormality.
Schizophrenia Treatment
Successful treatment of schizophrenia, therefore, depends upon a life-long regimen of both drug and psychosocial, support therapies. While the medication helps control the psychosis associated with schizophrenia (e.g., the delusions and hallucinations), it cannot help the person find a job, learn to be effective in social relationships, increase the individual’s coping skills, and help them learn to communicate and work well with others. Poverty, homelessness, and unemployment are often associated with this disorder, but they don’t have to be. If the individual finds appropriate treatment and sticks with it, a person with schizophrenia can lead a happy and successful life. But the initial recovery from the first symptoms of schizophrenia can be an extremely lonely experience. Individuals coping with the onset of schizophrenia for the first time in their lives require all the support that their families, friends, and communities can provide.
With such support, determination, and understanding, someone who has schizophrenia can learn to cope and live with it for their entire life. But stability with this disorder means complying with the treatment plan set up between the person and their therapist or doctor, and maintaining the balance provided for by the medication and therapy. A sudden stopping of treatment will most often lead to a relapse of the symptoms associated with schizophrenia and then a gradual recovery as treatment is reinstated.
Psychotherapy
Psychotherapy is not the treatment of choice for someone with schizophrenia. Used as an adjunct to a good medication plan, however, psychotherapy can help maintain the individual on their medication, learn needed social skills, and support the person’s weekly goals and activities in their community. This may include advice, reassurance, education, modeling, limit setting, and reality testing with the therapist. Encouragement in setting small goals and reaching them can often be helpful.
People with schizophrenia often have a difficult time performing ordinary life skills such as cooking and personal grooming as well as communicating with others in the family and at work. Therapy or rehabilitation therapy can help a person regain the confidence to take care of themselves and live a fuller life.
Group therapy, combined with drugs, produces somewhat better results than drug treatment alone, particularly with schizophrenic outpatients. Positive results are more likely to be obtained when group therapy focuses on real-life plans, problems, and relationships; on social and work roles and interaction; on cooperation with drug therapy and discussion of its side effects; or on some practical recreational or work activity. This supportive group therapy can be especially helpful in decreasing social isolation and increasing reality testing (Long, 1996).
Family therapy can significantly decrease relapse rates for the schizophrenic family member. In high-stress families, schizophrenic patients given standard aftercare relapse 50-60% of the time in the first year out of hospital. Supportive family therapy can reduce this relapse rate to below 10 percent. This therapy encourages the family to convene a family meeting whenever an issue arises, in order to discuss and specify the exact nature of the problem, to list and consider alternative solutions, and to select and implement the consensual best solution. (Long, 1996).
Medications
Schizophrenia appears to be a combination of a thought disorder, mood disorder, and anxiety disorder. The medical management of schizophrenia often requires a combination of antipsychotic, antidepressant, and antianxiety medication. One of the biggest challenges of treatment is that many people don’t keep taking the medications prescribed for the disorder. After the first year of treatment, most people will discontinue their use of medications, especially ones where the side effects are difficult to tolerate.
As a recent National Institute of Mental Health Study indicated, regardless of the drug, three-quarters of all patients stop taking their medications. They stopped the schizophrenia medications either because they did not make them better or they had intolerable side effects. The discontinuation rates remained high when they were switched to a new drug, but patients stayed on clozapine about 11 months, compared with only three months for Seroquel, Risperdal or Zyprexa, which are far more heavily marketed — and dominate sales. Because of findings such as this, it’s generally recommended that someone with schizophrenia begin their treatment with a drug such asclozapine (clozapine is often significantly cheaper than other antipsychotic medications). Clozapine (also known as clozaril) has been shown to be more effective than many newer antipsychotics as well.
Antipsychotic medications help to normalize the biochemical imbalances that cause schizophrenia. They are also important in reducing the likelihood of relapse. There are two major types of antipsychotics, traditional and new antipsychotics.
Traditional antipsychotics effectively control the hallucinations, delusions, and confusion of schizophrenia. This type of antipsychotic drug, such as haloperidol, chlorpromazine, and fluphenazine, has been available since the mid-1950s. These drugs primarily block dopamine receptors and are effective in treating the “positive” symptoms of schizophrenia.
Side effects for antipsychotics may cause a patient to stop taking them. However, it is important to talk with your doctor before making any changes in medication since many side effects can be controlled. Be sure to weigh the risks against the potential benefits that antipsychotic drugs can provide.
Mild side effects: dry mouth, blurred vision, constipation, drowsiness and dizziness. These side affects usually disappear a few weeks after the person starts treatment.
More serious side effects: trouble with muscle control, muscle spasms or cramps in the head and neck, fidgeting or pacing, tremors and shuffling of the feet (much like those affecting people with Parkinson’s disease).
Side effects due to prolonged use of traditional antipsychotic medications: facial ticks, thrusting and rolling of the tongue, lip licking, panting and grimacing.
There are many newer antipsychotic medications available since the 1990′s, including Seroquel, Risperdal, Zyprexa and Clozaril. Some of these medications may work on both the serotonin and dopamine receptors, thereby treating both the “positive” and “negative”symptoms of schizophrenia. Other newer antipsychotics are referred to as atypical antipsychotics, because of how they affect the dopamine receptors in the brain. These newer medications may be more effective in treating a broader range of symptoms of schizophrenia, and some have fewer side effects than traditional antipsychotics. Learn more about the atypical antipsychotics used to help treat schizophrenia.
Coping Guidelines For The Family
Establish a daily routine for the patient to follow.
Help the patient stay on the medication.
Keep the lines of communication open about problems or fears the patient may have.
Understand that caring for the patient can be emotionally and physically exhausting. Take time for yourself.
Keep your communications simple and brief when speaking with the patient.
Be patient and calm.
Ask for help if you need it; join a support group.
Self-Help
Self-help methods for the treatment of this disorder are often overlooked by the medical profession because very few professionals are involved in them. Adjunctive community support groups in concurrence with psychotherapy is usually beneficial to most people who suffer from schizophrenia. Caution should be utilized, however, if the person’s symptoms aren’t under control of a medication. People with this disorder often have a difficult time in social situations, therefore a support group should not be considered as an initial treatment option. As the person progresses in treatment, a support group may be a useful option to help the person make the transition back into daily social life.
Another use of self-help is for the family members of someone who lives with schizophrenia. The stress and hardships causes of having a loved one with this disorder are often overwhelming and difficult to cope with for a family. Family members should use a support group within their community to share common experiences and learn about ways to best deal with their frustrations, feelings of helplessness, and anger.
“Your daughter has schizophrenia,” I told the woman.
“Oh, my God, anything but that,” she replied. “Why couldn’t she have leukemia or some other disease instead?”
“But if she had leukemia she might die,” I pointed out. “Schizophrenia is a much more treatable disease.”
The woman looked sadly at me, then down at the floor. She spoke softly. “I would still prefer that my daughter had leukemia.”
Families and patients alike think there’s no hope. What follows may be shock, shame and confusion. But schizophrenia isn’t a death sentence or an inevitable descent into psychosis and violence, as some movies and shows would have you believe. Even though it may be terrifying, receiving a proper diagnosis is a good thing: It’s one step closer to the right treatment.
“Earlier treatment and shorter duration of untreated psychosis is associated with better treatment response, less likelihood of relapse and better clinical outcome,”
Early Diagnosis of Schizophrenia
Schizophrenia rarely occurs unexpectedly. Instead, it produces a gradual decline in functioning. There are usually early warning signs, referred to as the “prodrome,” which last one to three years, which provide the perfect place to intervene.
The key symptoms to look for are “suspiciousness, unusual thoughts, changes in sensory experience (hearing, seeing, feeling, tasting or smelling things that others don’t experience), disorganized communication (difficulty getting to the point, rambling, illogical reasoning) and grandiosity (unrealistic ideas of abilities or talents),”
“The longer an illness is left untreated, the greater the disruption to the person’s ability to study, work, make friends and interact comfortably with others,”
When building a team keep in mind people who will:
Serve as the primary contact person to help patients navigate through the system
Help patients achieve functional goals (e.g., finding an apartment and job)
Ensure patients get good medical care, understand medication options and learn to use them appropriately
Treat co-occurring problems. Substance abuse is the most common co-occurring disorder in individuals with schizophrenia, but physical health conditions also may be present. Try to find the appropriate professional to treat the co-occurring issues.
When looking for a psychiatrist, search out professionals who specialize in schizophrenia. Ask other families or professionals, like your primary care physician,
Psychosocial Treatments for Schizophrenia
Cognitive Remediation/Related Treatments. While hallucinations and delusions can be devastating, it is thecognitive decline — problems with memory, attention, problem solving, processing information — that complicates daily life. Because medication doesn’t treat problems with attention, concentration and memory, treatments that address these issues are vital. Cognitive remediation strives to strengthen patients’ cognitive skills, helping them “pay attention, remember, process information and plan better,”
This is usually done with cognitive exercises and compensatory behaviors (things like checklists that help individuals compensate for memory loss).
Family psychoeducation. Families may be confused about schizophrenia and what they can do to help their loved one. “Supportive families can be a godsend for people with schizophrenia. They function as de facto case managers, filling in the gaps of the fragmented system that exists in many communities,”
For one, by the time most individuals have been diagnosed with schizophrenia, they have many problems with relationships. Also, individual therapy gives patients a better understanding of their own symptoms. “I see so much suffering and misunderstanding purely because no one has told (patients) what’s going on,”
Cognitive-behavioral therapy (CBT). Though using CBT to treat schizophrenia is fairly new,
In addition to grasping their symptoms, CBT helps individuals set goals, form new ways of relating to people, examine and challenge persistent beliefs and cope with hallucinations.
Supported employment. This program helps individuals find a job based on preferences and abilities and usually assists with training and any issues that may come up on the job. For ideas on what questions to ask, this handbook (in PDF format) offers a detailed questionnaire.
Tips for Taking Medication
When taking medication, keep the following in mind:
Become an active participant. Watching your treatment — or the treatment of a loved one — on the sidelines doesn’t help anyone. Taking an active role leads to more successful treatment
Educate yourself. Whether you or your loved one has schizophrenia, educate yourself “about the various drugs and potential side effects,” Invest the time in learning everything you can about these medications. But, if you come across personal experiences (whether the accounts concern pharmacological or psychosocial treatments), keep in mind that this is an idiosyncratic experience,So don’t rule out a certain medication or treatment because of negative information but do raise the concerns to your provider and do more research.
Be sure it’s a partnership. Because finding the best balance is already a hard process, not having a provider you trust can make it even harder,
Create a medication list. Keep an updated list of your medications handy. Your list should include “all medications taken, the length of time they were taken, the dose and the adverse effects,”
Create a wish list. Another excellent tip : Write out a list of things you wish you could do but that schizophrenia prevents you from doing. What did you do prior to your illness that you wish you could do again? On your list, you might write “read a book, go into a crowded room without panicking, hold a job at least half-time, have a boyfriend,” Essentially, this list includes goals you’d like to attain with the help of medication and other treatments. The list serves as a reminder of why you’re taking medication and why you’re open to trying new medications to improve symptoms,
Take medication as prescribed. Do you forget to take your medication? “You don’t want (the prescribing physician) to raise the dose because you forgot to take the pills half the time,. Have you decided to stop taking them altogether?
Speak up. Maybe you’ve stopped taking your medication because it just doesn’t feel right. Maybe you’re experiencing bothersome side effects. “Communicate with doctors on an ongoing basis to make sure that the medications are safe and effective,” .... “Consumers and doctors constantly need to evaluate medication regimens and weigh the pros and cons of any treatment.”
Create reminders. “No one is very good at remembering to take every dose of medication,” ... To stay on track, find reminders that work for you..... suggested pill containers, voice alarms, signs and checklists.
Minimizing Relapse
A relapse occurs when symptoms worsen or reappear. Here are some ways you can reduce your risk of relapse:
Stay on medication. Medication is the cornerstone of treatment, and discontinuing use without informing your physician is dangerous.
Talk to the team. Ask your psychiatrist, case manager, therapist and other providers you’re working with how to avoid a relapse. They should have many preventative tips.
Be aware of warning signs. Watch out for general warning signs, unique-to-you precursors and changes in sleeping and eating patterns. For instance, bad relationships may trigger a relapse for one person, whereas excessive sleep and desire for isolation do for another.
If a relapse happens, know what to do. Talk with your providers about the best ways to manage a relapse should it happen.
Stay in regular contact with clinicians. Others will usually pick up on the warning signs before you do, so even when “symptoms are in remission and function is good,” stay in contact.
Stay in contact with your support system. Stress is a risk factor for relapse. Drs...suggest to staying involved with loved ones as much as possible.
Disclosing Your Diagnosis
you may want to tell close family and friends, who can “participate in groups that provide education about the illness and how to help their (loved one) manage symptoms.” Telling employers is an “individual decision.”
informing employers in a supported employment program, because the employer will be more willing to work with the employment specialists to help you improve your job performance.
“This is a time of great hope for individuals” with schizophrenia,“There are many new medication treatments and psychosocial treatments that work to improve a broad range of outcomes.”
People with schizophrenia often encounter challenges when it comes to their friends and family. Family often try and cope with someone who has schizophrenia for a period of time, but can become frustrated by their seeming lack of progress in treatment or staying in treatment altogether. A family’s emotional support may wane, and some families cut off all contact with their schizophrenic son, daughter or sibling.
Friends can also not understand a person with schizophrenia’s experiences, and quickly lose interest in continuing the friendship when a person with schizophrenia deteriorates or drops out of treatment. The most common complaint amongst friends and family members of a person with schizophrenia is not understanding how to help them, or give them continued, long-term support that help keeps them from becoming homeless or unemployed.
A person’s support system may come from several sources, including the family, a professional residential or day program provider, shelter operators, friends or roommates, professional case managers, churches and synagogues, and others. Because many patients live with their families, the following discussion frequently uses the term “family.” However, this should not be taken to imply that families ought to be the primary support system.
There are numerous situations in which people with schizophrenia may need help from people in their family or community. Often, a person with schizophrenia will resist treatment, believing that delusions or hallucinations are real and that psychiatric help is not required. At times, family or friends may need to take an active role in having them seen and evaluated by a professional.
The issue of civil rights may enter into an attempt to provide treatment to someone with schizophrenia. Laws protecting patients from involuntary commitment have become very strict, and families and community organizations may be frustrated in their efforts to see that a severely mentally ill individual gets needed help. These laws vary from state to state; generally, when people are dangerous to themselves or others due to a mental disorder, the police can assist in getting them an emergency psychiatric evaluation and, if necessary, hospitalization. In some places, staff from a local community mental health center can evaluate an individual’s illness at home if he or she will not voluntarily go in for treatment.
6 Tips to Help Family Members and Friends
1. The closest family member or friend should speak-up and be an advocate for the person with schizophrenia.
Sometimes only the family or others close to the person with schizophrenia will be aware of strange behavior or ideas that the person has expressed. Since patients may not volunteer such information during an examination, family members or friends should ask to speak with the person evaluating the patient so that all relevant information can be taken into account.
2. Ensure ongoing compliance with treatment, especially when released from inpatient care.
Ensuring that a person with schizophrenia continues to get treatment after hospitalization is also important. A patient may discontinuemedications or stop going for follow-up treatment, often leading to a return of psychotic symptoms.
3. Offer strong emotional encouragement and support for continuing treatment.
Encouraging the person to continue treatment and assisting him or her in the treatment process can positively influence recovery. Without treatment, some people with schizophrenia become so psychotic and disorganized that they cannot care for their basic needs, such as food, clothing and shelter. All too often, people with severe mental illnesses such as schizophrenia end up on the streets or in jails, where they rarely receive the kinds of treatment they need.
4. Know how to respond to bizarre statements or beliefs.
Those close to people with schizophrenia are often unsure of how to respond when patients make statements that seem strange or are clearly false. For the individual with schizophrenia, the bizarre beliefs or hallucinations seem quite real — they are not just “imaginary fantasies.” Instead of “going along with” a person’s delusions, family members or friends can tell the person that they do not see things the same way or do not agree with his or her conclusions, while acknowledging that things may appear otherwise to the patient.
It is very important not to challenge the person’s beliefs or delusions. They are very “real” to the person who experiences them, and there’s little point in arguing with them about the delusions or false beliefs. Instead, move the conversation along to areas or topics where you both agree upon.
5. Keep a record.
It may also be useful for those who know the person with schizophrenia well to keep a record of what types of symptoms have appeared, what medications (including dosage) have been taken, and what effects various treatments have had. By knowing what symptoms have been present before, family members may know better what to look for in the future. Families may even be able to identify some “early warning signs” of potential relapses, such as increased withdrawal or changes in sleep patterns, even better and earlier than the patients themselves. Thus, return of psychosis may be detected early and treatment may prevent a full-blown relapse. Also, by knowing which medications have helped and which have caused troublesome side effects in the past, the family can help those treating the patient to find the best treatment more quickly.
6. Help the person set attainable, simple goals in his or her life.
In addition to involvement in seeking help, family, friends and peer groups can provide support and encourage the person with schizophrenia to regain his or her abilities. It is important that goals be attainable, since a patient who feels pressured or repeatedly criticized by others will probably experience stress that may lead to a worsening of symptoms. Like anyone else, people with schizophrenia need to know when they are doing things right. A positive approach may be helpful and perhaps more effective in the long run than criticism. This advice applies to everyone who interacts with the person. (source internet.....from the site" psych.central"....edited )
A COMMENT ON AYURVEDIC TREATMENTS BY A PATIENT SUFFERING FROM SCHIZOPHRENIA (SOURCE INTERNET...."indiadivine,org")
Posted 08 April 2008 - 08:45 PM
Hello Everyone:
I am not sure if you recall from my earlier postings on the group that I have been a patient of schizophrenia for over 12 years. After I received some advice from the group, I found an Ayurvedic therapist in India who invited me to come over and receive in- patient treatment for about a month. Almost at the verge of loosing my job because the disease was getting worse every day and was coming in the way of performing my tasks and maintaining relationships at work, I decided to take a medical leave and try out the Ayurvedic treatment. I just wanted to share the story of my recovery so far and what it took to accomplish that.
I have always held the belief as all others who have fallen victim to the allopathic psychiatry, that Schizophrenia is not a disease that you can ever get rid of completely (well, they claim that about 24% get cured in 5 years if they are the " lucky " ones, I am not sure how much of that claim is true) -- you just have to remember to take the prescribed dose of your antipsychotics day after day for the rest of your life. For first 6-7 years, my symptoms were somewhat manageable with the use of antipsychotics so that I could hold a job and maintain relationships like anyone else. In last 5-6 years, things started to take a turn for the worse. Not only my mental symptoms got worse gradually, but I also developed additional symptoms that were rather physical in nature. I started burping vigorously and frequently. I developed really bad allergies. And, I had a mouth full of mucus all the time. First I thought that the allergies were because I had recently moved to Florida from up north -- so, I went to see my PCP who ran the standard allergy tests on me -- test results indicated that I was allergic to pretty much everything on the planet earth! I had no choice but to take the anti- allergy pills every day without fail and then like many others, keep switching from this pill to a stronger one year after year.
That is when I started looking for other possibilities -- good God showed me the way when I located a newsletter on alternative medicine while I was waiting for my turn at my PCP's. From that point until now has been a long journey full of changes -- changes in diet, lifestyle, medicine, and above all the way I look at the world now. I first tried Homeopathy to treat my allergies, which did not work at all. Then I came in contact with an Ayurvedic therapist in Chicago who prescribed me some Tulsi tea and asked me to stop taking milk. That was it -- the allergy problems were gone! Since then I read numerous books on Ayurveda -- the most relevant of them all that I recommend to the mental patients is by Dr. David Frawley called " Ayurveda and the Mind " -- it is a must read for those who don't just want to get cured, but stay cured. Despite my readings and trying out numerous Ayurvedic advices and lifestyle changes like eating organic only, eating Khichari only, treating candida problem assuming that was the underlying cause of my mental problems, etc., it was not until I joined " ayurveda " last year that I found the right Vaidya and started on a long term treatment plan.
The treatment took about 2 months. I was in-patient throughout. The vaidya has a unique 8-day detox program that was repeated four times with one week gaps in between two detoxes. All this while, I also got started on Panchagavya medicines as well as several nervine herbs like Brahmi, Ashwagandha, Jatamansi, etc. The detox program featured prescribed diet, oils, and herbs for 6 days followed by two Basti sessions on the 7th and 8th day. I was also asked to do advanced breathing exercises called " Tantrik Pranayama " . In particular, I practiced tantrik versions of alternate-nostril and kapaal-bhati Pranayama. Since the detox sessions, I have continued with the breathing exercises, diet prescription, and the herbs.
Going through the detoxes was like riding a roller-coaster as my condition, mental and physical, was always in a flux due to various toxins getting released into the bloodstream. When the body is trying to get rid of the toxins, it tries every possible means to expel them -- through urine, feces, mucus, sweat, rashes, etc. So, you can expect a lot of them every day. There were times when I got constipated due to toxins, sometimes diarrhea, sometimes severe headaches, etc. The primary goal of the detoxes was to clean the liver and other internal organs so that they start working properly in their full capacity. While the detoxes are going on, those organs obviously do not start working properly right away -- it takes time. So, the 2 in-patient months were challenging in the least. I lost a lot of weight, about 15 pounds, as well.
Since the detoxes got over, I started feeling better almost every day (on average). It has been almost a month since then and now I feel a lot better -- my mental symptoms have started to fade away. The physical symptoms have gotten a lot better as well. In the past week, I have had days when I felt like I never had any problems before! I have cut the dose of the allopathic drug to one-third. I am taking only 100 mg of Amisulpride now -- and that too to avoid the withdrawal symptoms. Tantrik Pranayama is really a blessing -- I have also tried Ramdev Baba versions of alternate-nostril and Kapaal- Bhati Pranayama, but my experience so far has been that what you can achieve with less than 20 minutes of doing tantrik Pranayama, you have to do Pantanjali ones for over an hour!
It all looks positive from here -- I do not fear a relapse due to the fact that I have reduced the dosage of the allopathic drug. In fact, I am looking forward to weaning the drug further out so that I eventually stop taking it in next 5-6 months. I will keep the group posted.
Thanks to everyone who responded to my postings for showing me the way! I sincerely wish that more and more sufferers of mental diseases consider pursuing Ayurveda and Yoga as a cure. What God has given to us, we humans can never find the same on our own! There is an ascending process of gaining/discovering knowledge and there is a descending one -- ascending one being that of research and development, that of trial and error, that of confusion and hipocrisy, that of struggle and wastage of resources; and descending one is the one that comes as a gift of love and caring from God himself in form of age-old scriptures written by the saints and the hermits. It will take a long long time to unfathom the same truth that is revealed in the scriptures.
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