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Dealing with schizophrenia: A first person account.

With the theme for this year's World Mental Health Day being 'Living with Schizophrenia', we look at a first-person account.

You will be punished for being a non-believer ... and will burn in hell," the voices were screaming in his head.

"You are dead and will burn," they kept persisting.

A.M.A. says the voices were very clear and not a figment of his imagination. But, in fact, he was hallucinating and having a psychotic episode.

"I was later told that I was yelling, pulling at my skin, babbling and running around in circles ... I don't remember most of it," says A.M.A whose name has been withheld to protect his identity.

He had to be hospitalised following the episode.

This was the second such psychotic episode and lasted for several hours like the first one.

"I do remember some bits and possibly that is the worst thing because I was partly aware of what I doing, but I didn't have any control," he explains.

A.M.A is a 36-year-old Canadian male of Indian origin who has been suffering from epilepsy since the age of five. Doctors think that there is a connection between his temporal lobe epilepsy and schizophrenia that causes the psychotic episodes.

"I was perfectly fine until the age of 20 when I started performing poorly in my academics. I started feeling very depressed and it was then that I had my first such attack," he says.

Studies were left in between and the family moved to the UAE, which A.M.A says seemed more plausible at the time.

A.M.A remained seizure-free for a long time and thinking he was cured, agreed to an arranged marriage in India. "It went well for three years until she saw me have a seizure ... we got divorced later."

It was then that he had his second episode. Only Kuwaiti Hospital in Sharjah and RAK Hospital agreed to treat him at the time. "A number of private hospitals turned me away and said they couldn't sedate me."

A.M.A had his third attack two years ago when he realised he could not work and had to be financially dependent on his parents.

"I passed out during work one day at my father's company and since then I have been confined to my home in Sharjah for fear of having an attack."

The seizures and psychotic episodes are sudden with no apparent trigger, says A.M.A who is currently taking seven drugs including anti-psychotic and anti-anxiety medicines that are very expensive, too.

"All this has affected my self-esteem and sometimes I resent that I cannot work and that I am totally dependent on my parents," he explains.

But with time, A.M.A, says, he has changed his outlook towards life. "I am more spiritual ... I have found peace and cure in meditation."

A.M.A also does volunteering work in India and says this had given him some direction in life. "My family has been amazingly supportive through this."

He currently attends a support group formed by the German Neuroscience Centre (GNC) but feels that there is no specific support group for epileptic patients.

"I hope to start one soon and put my social life back on track again."

What is schizophrenia?

Schizophrenia is a brain disorder. It affects the way a person acts, thinks and sees the world. Often people with schizophrenia have different perception of reality and even lose contact with reality. They might see things that others do not see or might hear voices that others do not hear (hallucinations).

They might even speak in a confusing way or might believe in their own "reality" (delusion). Some people even feel persecuted or constantly watched (paranoia).

Others have a disorganised behaviour or so-called "negative symptoms" such as lack of emotional expressions or lack of enthusiasm. If a person shows symptoms as a radical change in personality and an impaired functioning plus a distorted or non-existent sense of reality, in medical terms of it is called psychosis.

Schizophrenia typically begins in early adulthood, between the age of 15 and 25.

Early warning signs of schizophrenia could be a social withdrawal, depression, suspiciousness or inappropriate laugh or crying.

The causes of schizophrenia are not fully known. It appears to be a result of a complex interaction between genetic (hereditary) and environmental factors.

Schizophrenia can be treated and should be done in complex settings that includes medication, psychotherapy and the establishment of a strong support network.

Credit: German Neuroscience Centre

Challenging ... tough

Living with mental illness is never easy, says Dr Angela Georgiev-Kill, a psychiatrist at the German Neuroscience Centre (GNC) in Dubai.

"It can be challenging and tough on the patient and family," she explains, especially in societies that stigmatise mental illnesses, she adds.

The theme for this year's World Mental Health Day that was marked on October 10, was "Living with Schizophrenia."

According to GNC statistics, an estimated 50,000 or 0.7 per cent of the adult population in the UAE is living with schizophrenia.

"While schizophrenia is among the common mental disorders, anxiety and mood disorders such as depression are 5 to 10 times more frequent here," says Dr Angela.

"Rates of schizophrenia can vary in different regions due to the influence of cultural, urban and geographic factors," she explains.

"For example migrants have higher prevalence's than native-born individuals and developed countries higher prevalence's than non-developed countries."

Stigma is the main cause of isolation for such patients. "In many cultures, mental health is something that is not openly discussed and is even stigmatised," she says.

In the UAE, psychiatry is among the least served specialties according to authorities, says Dr Angela. "While we have some specialised public and private clinics to support patients, further development is needed to establish the required networks of social workers, psychiatrists, family physicians and psychotherapists. Such networks are needed to provide the patients with the holistic treatment they require," she says.

"An obstacle for many patients with early symptoms is also that mental disorders are often poorly covered by health insurance resulting in further delays of diagnosis and treatment," she adds.

Know the disease

abu dhabi -- Shaikh Khalifa Medical City (SKMC), managed by Cleveland Clinic, urged the public to increase their awareness of schizophrenia on World Mental Health Day which was held on October 10.

Organised by the World Health Organisation (WHO) every year, this year's theme was "Living with Schizophrenia" which targets raising awareness on issues related to this illness, as well as mobilising efforts to support sufferers.

Schizophrenia typically begins in late adolescence or early adulthood. Often, people with this illness face difficult and at times debilitating symptoms, and also find that society stigmatises and isolates them.

"Despite the stigma, schizophrenia is a highly treatable disease and in most cases, people affected by it can lead a productive life and integrate well into society. But, lack of awareness deprives a patient from effective and timely treatment. Many families hesitate to approach mental health services as a result of this stigma," said Dr Tarek Darwish, consultant psychiatrist and chair of psychiatry, Behavioural Sciences Pavilion.

To combat this stigma and lack of awareness, SKMC organised a community campaign at Khalidiya Mall with educational materials and pamphlets, giveaways, and children's activities.

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Publication:Khaleej Times (Dubai, United Arab Emirates)
Date:Oct 20, 2014
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