When the psychiatrist told the patient’s family:
According to our current preliminary judgment, he should have schizophrenia, which is a serious mental disease.
According to his current condition, we recommend him to be hospitalized.
The main treatment method for schizophrenia is drugs, and there are also some other auxiliary treatment methods. During hospitalization, our goal is to find a suitable drug and dosage for him, control the symptoms well, strive to recover to the state before the onset of the disease, then take the medicine and leave the hospital, go home and insist on taking the medicine, and regularly review the clinic.
I believe that the vast majority of patients’ families will not feel very good when they hear these words.
They usually have the following reactions. Today, I want to help you understand schizophrenia, a serious mental disease, better by interpreting your reactions.
Doctor, why don’t you help me out?
The first reaction of family members who do not know about mental health is this: Is schizophrenia what? I don’t know, I don’t care, I knew my relatives can’t think of it recently, doctor, please help me persuade him.
Family members of patients who usually hold such thoughts often have delusions as the main symptom, and the behavioral disorders may not be serious, and the content of delusions is not bizarre, in plain English, that is, [not looking crazy].
For example, the patient may insist that his wife is having an affair, even if the wife has not left him for almost 24 hours and a moment. Or insist that many people want to harm him, but there is no concrete evidence.
Family members are easy to think that the patient is stimulated and can’t think of it for a while, or his character is too sensitive and suspicious.
However, the above-mentioned manifestations are indeed one of the typical symptoms of schizophrenia. Delusion has reached the level of disease. No matter doctors or relatives, or even going to a psychological consultant, it is impossible to persuade the patient to be normal through [persuasion].
Does he look normal?
When hit, our instinctive reaction is [denial]; Just as the family members of patients hear that their family members [suffer from mental illness], their first reaction is often to refuse: I don’t think my relatives are [very abnormal] ah, how did they become [severe mental illness]? Doctor, you’re not deceiving me, are you?
Determining whether a mental illness is serious is not only judged by what ordinary people look like [normal].
On the one hand, the symptoms of patients will change during the course of the disease, especially in the case of untreated treatment.
For example, today the patient’s symptom is that he heard someone talking to him out of thin air. There is no serious abnormality in his behavior, and after a period of time, he may do all kinds of dangerous things under the control of auditory hallucinations: if [that voice] tells him to hurt himself, commit suicide, hurt others, or [that voice] tells him that a relative is a dangerous person, he may believe it and hurt that relative.
In this way, patients [not particularly abnormal] become [very abnormal] patients.
On the other hand, in the long run, there are many predictors to predict a patient’s final disease will develop to the level of what and how much he can recover (we call it prognosis), such as the age of onset, treatment, type of symptoms, family history, etc., but it does not include [whether it looks normal or not]. So the doctor really didn’t deceive you.
Is that medicine edible?
People, including non-psychiatric doctors, seem to have a fear of psychiatric drugs: they all have effects on the brain. Will they rely on them if they eat too much? Is it stupid? Can you not eat or eat less?
Antipsychotic drugs do directly act on the brain, but mental diseases are brain problems. Of course, drugs must be aimed at the places where problems occur to cure diseases.
On the one hand, antipsychotics are not addictive.
At the current level of medical development, schizophrenia patients need to take drugs for a long time. The longer they insist on taking drugs according to the doctor’s advice, the greater the benefits to the patients. However, this long-term use is different from the commonly understood [dependence] [addiction], and antipsychotic drugs are not addictive.
To some extent, its relationship with patients can be compared to [the relationship between food and people]: people cannot not eat for a day, but no one will say that eating too much will cause dependence.
On the other hand, antipsychotic drugs will not make patients stupid.
In daily observation, sometimes people will find that patients who have been mentally ill for a long time will become stupid. Is it stupid to take medicine? It’s not.
The reasons for this phenomenon include:
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Schizophrenia itself can cause cognitive impairment of patients and organic changes of the brain. Patients with schizophrenia for several years will have obvious brain atrophy, especially frontal lobe, while untreated patients are much more serious than treated patients. Therefore, [becoming silly] is the cause of the disease itself, not drugs. Moreover, drugs can slow down the process of [becoming silly].
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Second, antipsychotic drugs are not perfect. Although there are more and more new drugs, the curative effect on cognitive function is much better than that of old drugs, schizophrenia is still an incurable disease. There are also some refractory patients who do not respond well to various drugs. Objectively speaking, their illness is getting worse and worse and their cognitive function is getting worse and worse.
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Third, looking silly is not really the cause of cognitive function, Antipsychotic drugs have a side effect called [extrapyramidal reaction], one of which is called [delayed dyskinesia]. Patients will become slow, stiff and trembling limbs. The incidence rate is very high in the first generation of antipsychotic drugs. The new antipsychotic drugs have much less extrapyramidal reaction, but it still exists.
Do you want to take the medicine? Of course! What if you don’t eat more [silly]?
It’s terrible. Put him in the hospital!
Although I can somewhat understand the situation of family members, when many family members say so, my heart is actually torturing human nature: I have heard of schizophrenia! It’s really a terrible disease. Doctor, treat him well, drop out of school, and stay in the hospital for a year.
Wrong! Perhaps 100 years ago, this was correct. Because there was really no what treatment for mental diseases at that time, and there was nothing they could do but lock them up, educate them and let them try their best to manage themselves.
It can be imagined how bad the effect of this [treatment] can be, so it is understandable that patients cannot be discharged from hospital to maintain normal life.
But now, there are more and more treatment methods for schizophrenia. Whether we have electroconvulsive therapy, various antipsychotic drugs, and various adjuvant drugs against side effects, the targets and requirements for schizophrenia treatment are also getting higher and higher.
In the latest guidelines for the treatment of schizophrenia, one of the goals of the first onset treatment of patients is to restore the social function of patients and strive to reach the pre-disease level.
What is called social function? It is a person’s ability to take care of his daily life, go to school, go to work, and communicate with other relatives, friends, colleagues and strangers normally. However, it is obviously damaging the social function of the patient to let the patient drop out of school and directly decide to be locked up in the hospital for one year regardless of the recovery level of his illness.
After all, the hospital is a therapeutic place, no healthy person’s life is spent in the ward. Now schizophrenia patients, through one to two months of hospitalization, to achieve stable condition after discharge, can outpatient dispensing to continue treatment, as long as they do not engage in work that is too stressful, is entirely possible.
Write at the end
It is a sad thing for relatives to get sick, but most people are not engaged in relevant majors and it is normal for them not to understand the disease enough.
Therefore, the above misunderstandings are not terrible.
When you think so, or have other ideas about diseases and treatment, there is no problem as long as you can talk to the doctor and communicate fully.
Sometimes, patients and their families have some emotions and different opinions about the disease and treatment, which just provides important information to doctors. Schizophrenia is a chronic disease, and it is of great significance to establish a doctor-patient alliance from the beginning for treatment.