Schizophrenia

• It is a disease that affects 1% of the world’s population

• It has more impact on urban people than rural people

• It is a disease that affects men and women equally

• It is a disease of the brain

Schizophrenia is not caused by:

• Inadequate parenting

• Overzealous mothers

• Poor family relations

• It is not split personality

Schizophrenia and Genetics

• 70% of persons who develop schizophrenia have a genetic basis for it. That is, there is a relative who has the disease.

• The closer in relation to the ill person, the more likely one is to get the disease.

Schizophrenia and Genetics

• More clearly, if you have an identical twin who has schizophrenia, you have a

50% chance of developing schizophrenia

Schizophrenia: illness features

• Hallucinations

• Delusions

• Decline in social and occupational functioning

Schizophrenia: the affected person may:

• Talk to himself

• Gesture to himself

• Dress in layers in any weather

• Fail to bathe and get a haircut

• Gain an odd interest in ordinary things (like religion)

Schizophrenia: the affected person may:

• May even believe he is God

• See things

• Feel people are out to get them

• Believe in all sorts of conspiracies

• Have ideas that no amount of evidence to the contrary can dislodge

Schizophrenia: the affected person may:

• Be unable to work • Stop talking or greatly reduce conversation • Appear lazy, unmotivated and uninterested • May look like he has dementia • Lose the ability to get and keep friends • Be tense

Schizophrenia treatment

• Biological

• Psychological

• Social

Schizophrenia Treatment: Biological

• Medications – called antipsychotic– (not “antischizophrenic”)

– they deal with some of the symptoms • delusions, hallucinations, disorganized behavior

Schizophrenia Treatment: Psychological

• Patients will need therapy – supportive– “digging deep” can help some, but that is

the exception, not the rule

Schizophrenia Treatment: Psychological

• Those who have family benefit most from families who:– are informed about the illness – have support – and skills to deal with the ill family member

Schizophrenia Treatment: Psychological

• Family member skills:– low key – low demand – use simple sentences – privacy for both the patient and themselves– able to ignore the inconsequential features

of the illness

Schizophrenia Treatment: Psychological

• Family member skills:– are able to respond to dangerous behavior – can accept that their ill member may never

be like he once was

Schizophrenia Treatment: Social

• Rehabilitation

• “Habilitation”

• Social skills training

• Vocational assistance

• Environmental modification – reduce stimuli

Schizophrenia Treatment

• Community resources Black Mental Health Alliance National Alliance for the Mentally Ill (NAMI) Schizophrenia.com Maryland Psychiatric Research Center

Bipolar disorder

• Also known as manic-depressive illness

• The 2 “poles” are mania and depression

Bipolar disorder

• Affects 1% of the population

• Affects men and women equally

• Can start in childhood and throughout adulthood Strong genetic component

Bipolar disorder: illness features

• Mania – Elevated mood – May feel full of energy – May feel she can accomplish anything – May go on spending spree – May go on a sex spree – May travel on a whim

Bipolar disorder: illness features

• Mania – May become irritable – May lose the need for sleep – May feel energized by the lack of sleep – May feel more productive – Can be excessively talkative – Thoughts can race

Bipolar disorder: illness features

• Depression– Poor sleep – Low appetite or weight loss – Low interest in pleasurable things – Low energy – Feelings of worthlessness, hopelessness,

helplessness, irritability

Bipolar disorder: illness features

• Depression– Unable to focus or concentrate– Thoughts of death and suicide

Bipolar disorder: illness features

• A person is rarely seen at one of the poles

• A person may have features of both at the same time to varying degrees

Bipolar disorder: Treatment

• Biological

• Psychological

• Social

Bipolar disorder: Treatment

• Biological – Medications

• Stabilize mood • Dampen mania• Ameliorate depression• Treat psychosis (delusions, hallucinations)

Bipolar disorder: Treatment

• Psychological– Supportive therapy– May “dig deep”– Helps people to deal with the devastation

that their manic behavior has wrought

Bipolar disorder: Treatment

• Social– Support Groups

• DRADA• NDMDA

– Rehabilitation and “habilitation”