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This disease affects about 20 million people worldwide. Often it manifests itself between the ages of 15 and 25, and its first symptoms resemble signs of a teenage crisis … Experts answer questions that concern parents.
Six months after her 17th birthday, Yulia refused to leave her room: it began to seem to her that others were reading her thoughts and plotting against her. To all the questions she answered through gritted teeth that everything was in order. The parents thought that the daughter was suffering from a breakup with a young man, and hoped that this was the reason for the strangeness in her behavior. Only when Yulia began to hear voices in an empty room (she suspected that a mysterious transmitter was installed somewhere that was sending them), at the moment of enlightenment, she admitted that something was wrong with her …
“When we think of crazy, most often we imagine a person with a schizophrenic disorder,” says psychologist Philip Zimbardo. “Schizophrenia is a mental disorder in which consciousness breaks into fragments, thinking and perception are distorted, and emotions are dulled.”
Triggers the disease, usually severe stress, a serious illness, or the atmosphere in the family
The disease can begin gradually, and its first signs are easily confused with a crisis of adolescence. Moreover, medical studies (MRI, blood tests) do not reveal schizophrenia. It can take more or less serious forms. Some will sink deeper into the disease and spend most of their lives in the hospital. For others, the symptoms will subside so much that they can lead an independent life, work. To successfully resist the disease, it is important to understand it as best as possible. We asked experts to answer the questions parents are most concerned about.
What are the main symptoms?
Schizophrenia often first appears between 15 and 25 years of age. Withdrawal, inability to act, communication difficulties, mood swings – some of the symptoms of schizophrenia do resemble those of a teenage crisis. But there is no reason to seriously worry, as long as there are no hallucinations, delusions and speech disorders.
To hallucinate is to perceive (see, hear or feel) something that does not exist, but seems real. “A hallucination occurs due to the fact that a person perceives some of his unpleasant thoughts or feelings as something that does not belong to him, separate from him, and they take the form of disturbing visions or voices,” explains clinical psychologist Tatyana Voskresenskaya. For example, a person with severe guilt may hallucinate a gang of torturers (symbolizing punishment) who want to kidnap him.
The usual oddities of a teenager? But if they continue for many months in a row, it can be assumed that the disease
Delusions are false ideas that persist despite facts that testify to the contrary (for example, Yulia explained her “voices” by the existence of a “transmitter”). And, paradoxically, this is also an attempt at self-healing.
“Through an effort of imagination, a teenager creates for himself a picture of the world that is more understandable and less painful than the real one,” says psychiatrist and psychotherapist Sergei Medvedev. “It’s a way to deal with a situation that is unbearable for him. And although this method is not very good and deprives him of the opportunity to adapt to the environment, he simply does not have another at this moment.
Psychiatrist Igor Makarov, in Lectures on Child Psychiatry, talks about a teenager who was visited at night by “dinosaurs and hippos, with red horns, red teeth. “They have brutal voices … wild … And they tell me to quarrel with someone, fight with my mother …” Brad helps the patient “associate his anxiety with some object, find an explanation for her and thereby calm her down at least a little”, – specifies Tatyana Voskresenskaya.
And finally, during acute conditions, speech disorders are observed. The coherence of statements is lost. “The schizophrenic communicates with imaginary characters about an imaginary situation and is not able to clearly tell what is happening to him,” says Tatyana Voskresenskaya. Also, patients invent new words, endowing them with a meaning that is clear to them alone. However, patients have moments of relative peace, when they enter into a dialogue more easily.
Where does schizophrenia come from?
We are forced to admit that no one knows the exact causes of the disease. Three hypotheses are put forward.
The first is genetic. “The risk of being schizophrenic increases if someone from close relatives has this disorder,” says schizophrenia researcher Irving Gottesman. But it’s not just about heredity. The disease is triggered, as a rule, by severe stress, another serious illness or the atmosphere in the family – a sick relative, communicating with a child, can convey to him his fears and behaviors.
The second is biological. From the point of view of biology, adolescence is a period when brain structures are rebuilt. Some neural connections appear, others disappear. “Perhaps some teenagers have “accidents” that impair the ability to cope with stressful situations and strong feelings,” explain psychiatrists Raquel Gore and Godfrey Perlson. “But they can simply accompany the disease, and the cause of it is something else.”
The third hypothesis is psychoanalytic. According to her, “those who unconsciously perceive themselves as part of the mother’s body are prone to illness,” explains psychoanalyst Virginie Meggle. – Such a person is unable to cope with situations that symbolically represent separation from parents: an exam at school, divorce, sexual fantasies, the loss of a loved one. They injure him and can provoke the onset of the disease.
“I must remember that my son and his illness are not the same”
Alexander, father of 23-year-old Nikolai: “I don’t get along well with my son’s illness. What he endures is unbearable, and what he subjects his family to is also unbearable. Schizophrenia distorts relationships: I need to somehow separate my child from his illness. But he does not make this distinction: “It is normal that I do not clean my apartment: I am sick. It’s normal that I call you eight times a working day or that I never answer your messages: I’m sick. To withstand this, we must remember that we wanted this child, that he is not limited only to his illness, that this is a son, brother, grandson …
To hold on, I collected information about the disease, treatment. But in the end, I don’t know much. This is a situation that I will never get used to and that cannot be changed. I have a child. He lives. He is constantly talking to us. He knows no rest and gives us no respite. I tried to put some kind of barrier between him, the illness and myself, which would somehow protect both the family and himself: for example, before sending a reply to his message, I think it over for a long time, I try to evaluate what he says to me , depending on the state in which he, in my opinion, is.
After all, we can never get into the head of another, especially someone who suffers from a mental illness. I am not in his place and have given up trying to put myself in his place. Sometimes it seems to me that he understands me better than I understand him. It’s horrible. I have no confidence in anything … The only thing I know is that love is the best medicine. I try to keep her and love my son.”
Blame the drugs?
Almost one in five of 18-24 year olds report that their acquaintances use drugs. But the number of patients with schizophrenia, according to the World Health Organization, remains stable and the same in all countries (about 1% of the population, which corresponds to almost one and a half million people in Russia). Many of them have never used drugs. However, drugs, including smoking marijuana, can hasten the progression of the disease and affect the frequency and severity of relapses, which is recognized by most psychiatrists.
“Even soft drugs lower the barrier between consciousness and the unconscious, and frightening impulses erupt from there. In some cases, this provokes the disease, ”emphasizes Tatyana Voskresenskaya.
Does illness make a person dangerous?
“The danger of patients with schizophrenia is greatly exaggerated,” Sergei Medvedev is sure. “If they get into criminal situations, then more often as a victim.” The schizophrenic is much more dangerous to himself than to others. Violent tendencies may appear in him mainly under the influence of painful hallucinations – for example, when he begins to think that before him is not his father, but a demon. In moments of acute crisis, the schizophrenic is not aware of the severity of his condition. Sometimes temporary hospitalization is necessary to protect a person from himself, to avoid suicide attempts.
Who to contact?
“It makes sense to choose an experienced specialist, someone you will trust,” recommends Sergey Medvedev. – This is not necessarily a psychiatrist, you can contact a psychologist, social pedagogue or general practitioner. And the specialist will help you decide where to refer the patient for consultation and treatment.”
Under the Psychiatric Care Act, parents have the right to bring a child under the age of 15 to a psychiatrist. “At the same time, they can come for a start even without him,” Sergei Medvedev continues, “their presence is more significant than the presence of a child. Because it is they who have to make decisions and influence the situation.” After that, the patient’s consent is required to contact a psychiatrist. “But it is always not about changing a person, but about helping him,” Sergei Medvedev emphasizes.
Approximately 25% of those diagnosed with schizophrenia eventually stabilize
Does the treatment help?
Treatment options for schizophrenia are constantly evolving. They combine the use of drugs and psychotherapy, which allows the teenager to understand why he was not able to build an inner space for himself. She also helps him find support – it can be literary creativity, drawing, photography, caring for animals, music … “It is very important to see the special gift of each patient,” emphasizes Virginie Meggle. – Yes, indeed, no one knows how to cure schizophrenia, but it can be managed. Try to understand your child.”
Schizophrenics are able to learn to be aware of their illness, even if they cannot fully control it. And about 25% of those diagnosed with schizophrenia eventually stabilize. Sergei Medvedev adds that “modern means of rehabilitation and psychotherapy make it possible to achieve such a remission (reduction of symptoms) that, having seen a schizophrenic during this period, a psychiatrist unfamiliar with his history would not have given him such a diagnosis.”