Schizophrenia is a mental illness which affects one person in every hundred.First onset is usually in adolescence or early adulthood. It can develop in or early adulthood. It can develop in older people, but this is not nearly as common.Some people may experience only one or more brief episodes in their lives. For others, it may remain a recurrent or life-long condition.The onset of illness may be rapid, with acute symptoms developing Over several weeks, or it may be slow, developing over months or even years.During onset, the person often withdraws from others, gets Depressed and anxious and develops extreme fears or obsessions.
SYMPTOMS OF SCHIZOPHRENIA :
Delusions : False beliefs of Persecution, guilt or grandeur or Being under outside control. People With schizophrenia may describe plots against them or think they have special powers and gifts.Sometimes they withdraw from people or hide to avoid imagined persecution.
Hallucinations : Most commonly involving hearing voices. Other less common experiences can include seeing, feeling, tasting or smelling things which to the person are real but which are not actually there.
Thought Disorder : Where the speech may be difficult to follow; for example, jumping from one subject to another with no logical connection. Thoughts and speech may be jumbled and disjointed. The person may think someone is interfering with their mind.
Loss of Drive : Where often the ability to engage in everyday activities such as washing and cooking is lost. This lack of drive, initiative or motivation is part of the illness and is not laziness.
Blunted Expression of Emotions : Where the ability to express emotion is greatly reduced and is often accompanied by a lack of response or an inappropriate response to external events such as happy or sad occasions.
Social Withdrawal : This may be caused by a number of factors including the fear that someone is going to harm them, or a fear of interacting with others because of a loss of social skills.
Lack of insight or awareness of other conditions : Because some experiences such as delusions and hallucinations are so real, it is common for people with schizophrenia to be unaware they are ill. For this and other reasons, such as medication side-effects, they may refuse to accept treatment which could be essential for their well-being.
Thinking difficulties : A person's concentration, memory, and ability to plan and organize may be affected, making it more difficult to reason, communicate, and complete daily tasks.
No single cause has been identified, but several factors are believed to contribute to the onset of schizophrenia in some people:
Genetic factors : A predisposition to schizophrenia can run in families. In the general population, only 1 per cent of people develop it over their lifetime. If one parent suffers from schizophrenia, the children have a 10 per cent chance of developing the condition - and a 90 per cent chance of not developing it.
Biochemical factors : Certain biochemical substances in the brain are believed to be involved in this condition, specially a neurotransmitter called dopamine. One likely cause of this chemical imbalance is the person's genetic predisposition to the illness.
Family Relationships : No evidence has been found to support the suggestion that family relationships cause the illness. However, some people with schizophrenia are sensitive to any family tension which, for them, may be associated with relapses.
Environment : It is well recognized that stressful incidents often precede the onset of schizophrenia. They often act as precipitating events in vulnerable people. People with schizophrenia often become anxious, irritable and unable to concentrate before any acute symptoms are evident. This can cause relationships to deteriorate, possibly leading to divorce or unemployment. Often these factors are then blamed for the onset of the illness when, in fact, the illness itself has caused the crisis. It is not, therefore, always clear whether stress is a cause or a result of illness.
Drug Use : The use of some drugs, especially cannabis and LSD, is likely to cause a relapse in Schizophrenia.
Myths, misunderstanding, negative stereotypes and attitudes surround the issue of mental illness and, in particular, schizophrenia. They result in stigma, isolation and discrimination.
Do people with schizophrenia have a split personality? No, Schizophrenia refers to the change in the person's mental function, where thoughts and perceptions become disordered.
Are people with schizophrenia intellectually disabled? No, The illness is not an intellectual disability.
Are people with schizophrenia dangerous? No, People with schizophrenia are generally not dangerous when receiving appropriate treatment. However, a minority of people with the illness become aggressive when experiencing an untreated acute episode, because of their fears. This is usually expressed to family and friends, rarely to strangers.
Are people on medication for schizophrenia addicted to the medication? No, The medication helps to reduce the severity of the symptoms. The specific medications for treatment of schizophrenia are not addictive.
Is schizophrenia a lifelong mental disorder? Not necessarily, Most people, with professional help and social support, learn to manage their symptoms and have a satisfactory quality of life. It is also a fact that about 20-30 per cent of people with schizophrenia have only one or two psychotic episodes in their lives.
The most effective treatment for schizophrenia involves medication, psychological counseling and help with managing its impact on everyday life. The development of anti-psychosis medications has revolutionized the treatment of schizophrenia. Now, most people can leave hospital and live in the community. Not all people with schizophrenia have to go to hospital and care can be delivered in the community.
These medications work by correcting the chemical imbalance associated with the illness. New but well tested medications are emerging which promote a much more complete recovery with fewer side effects. Schizophrenia is an illness, like many physical illnesses. For example, just as insulin is a lifeline for a person with diabetes, anti-psychosis medications are a lifeline for a person with schizophrenia.
As with diabetes, some people will need to take medication indefinitely to prevent a relapse and keep symptoms under control.
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Headache is a very common disease. Common headache are due to migraine, tension headache, chronic daily headache, cluster headache. This is also due to increased blood pressure. Other causes of continuous headache are depression and persistent stress.
Treatment of headache depends on diagnosis. To diagnose it proper history taking and enquiry about work and associated stress is very important. Before starting treatment we must rule out medical cause of headache by investigations. For example dull, severe and continuous headache must be ruled out by brain radio investigation.
Headache is usually of two types primary and secondary. Primary headache is independent in nature and it could be episodic and continuous. Most common cause of episodic headache is migraine, cluster headache and tension headache. Continuous headache could be due to chronic daily headache and depression and stress.
Secondary headache is due to blood pressure, Tumour, post head injury and subarachnoid haemorrhage etc.
Depression is a state of mind in which person biological function like sleep, appetite and bowel habit are disturbed along with low energy lack of interest in work, surrounding and socialisation. It also leads to helplessness, hopelessness and worthlessness. In severe case person start thinking about suicide. Long standing depression may lead to social cut-off and loss of jobs as well.
In less educated people multiple somatic symptoms such as headache, body ache , gas formation , unexplained other symptoms , sleep disturbance , heaviness or lightheadedness are common symptoms . Educated or intelligent people will complain of lack energy, lack of charm or meaning in life, fatigued feeling, hopelessness and worthless feeling along with sleep disturbance and lack or increased appetite are usual symptoms.
Symptoms of depression can be classified into following groups.
(A) DEPRESSED MOOD- this is hallmark of all depression regardless of other associated symptoms. It is sustained emotional state that is characterised by sadness, low morale, misery, discouragement, hopelessness, emptiness, distress, pessimism etc. it is different in quantitative term as it is more intense than normal emotional response in bad situation.
(B) ANHEDONIA- is loss of interest. Patient is unable to draw pleasure from previously enjoyable activities. In severe cases they abandon most of the things they valued in life.
(c)COGNITIVE SYMPTOMS- difficulty in concentrating, negative thoughts, low self-esteem and self-confidence, suicidal idea are some most common cognitive symptoms. In severe case delusions of nihilism are also present.
(D) PSYCHOMOTOR DISTURBANCE - It can be aggression, agitation or retardation. Aggression is usually associated with irritability and restlessness. Retardation is associated with lack of initiative, mask like facial expression, emotional sluggishness and increased time to answer in response to question.
(E)VEGETATIVE SYMPTOMS - this is characterised by increased sleep or decreased sleep, increased appetite or decreased appetite, decreased libido and motivation.
(F) ANXIETY SYMPTOMS- are usually part of depression.