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How Families Can Cope with Schizophrenia

Schizophrenia
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WebMD Feature

Schizophrenia is a mental disorder characterized by gross distortion of reality, language disturbances, fragmentation of thought and other troubling symptoms. The cost of caring for schizophrenic patients comes to more than $17 billion per year in this country -- but this figure can never capture the emotional cost borne by patients and their families. While schizophrenia is often made worse by stress, it is not caused by bad parenting, "cold" or over-involved mothers, or any other known psychological factor. Rather, schizophrenia probably stems from a combination of genetic factors, biochemical abnormalities in the brain and perhaps very early damage to the developing fetus. Nevertheless, emotional stress -- including pressure from well-meaning family members -- can make the illness worse. What can families do to help their schizophrenic relatives, and to cope with this devastating illness?

Education is certainly paramount. Many parents still blame themselves for causing their son's or daughter's illness; others accuse the afflicted family member of laziness or self-indulgence. This sort of assigning blame is founded in error, and can make matters worse for the individual with schizophrenia. For example, when a family member tells the sufferer, "You don't need those lousy medications! You need to pull yourself together and get a job!" he or she may mean well, but may actually do more harm than good. Individuals with schizophrenia virtually always need to take antipsychotic medication -- they cannot "pull themselves up by their bootstraps" through an act of will.

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Schizophrenia Diagnosis

There is no test that can make a schizophrenia diagnosis. People with schizophrenia usually come to the attention of a mental health professional after others see them acting strangely. Doctors make a diagnosis through interviews with the patient as well as with friends and family members. Psychiatrists have the most experience with diagnosing schizophrenia. A psychiatrist or other licensed mental health professional should be involved in making a schizophrenia diagnosis whenever possible. A schizophrenia...

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On the other hand, babying or coddling a family member with schizophrenia is also unhelpful. There is a realistic middle ground that can be reached through family education and support. This can come from mental-health professionals, mental-health advocacy groups and from patients themselves.

Medication and Job Counseling

Use of the latest "atypical" antipsychotic medications, such as clozapine (Clozaril) and olanzapine (Zyprexa), has made a big difference for many individuals with schizophrenia. These newer medications are better tolerated than older agents like haloperidol (Haldol) and work on a wider range of symptoms. Families can advocate for the use of these newer agents, and encourage their loved ones with schizophrenia to take their medications on a regular basis. But medication is not the whole story.

While it is foolish to "push" schizophrenic individuals into high-pressure jobs for which they may not be ready, it is also unwise to assume that schizophrenia amounts to a permanent disability. Many individuals with this illness can rejoin the workforce, with appropriate vocational rehabilitation and lots of emotional support.

In fact, a recent study by Dr. R.E. Drake and colleagues at Dartmouth Medical School found that many patients get into the job market faster than was once thought. Rather than getting "stalled" in the usual sheltered workshops, the patients in this study were able to secure competitive jobs quite rapidly, and hold these jobs. This was probably because the patients received ongoing counseling, transportation assistance and help in dealing with their employers.

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