“I feel like I can never be the kind of person I was before this illness. They say I am weird and scary. It makes me ashamed. My doctors tell me that it’s not my fault. But I fear nobody will see me as ‘normal’ again. It feels like the suffering is endless.”
These are the words of an individual who is recovering from schizophrenia.
Such excerpts are not uncommon. Schizophrenia is one of the severe mental disorders that can be extremely distressing to the individuals experiencing it. If the affected individuals are given the right treatment at an early stage, there’s a good chance of recovery from the symptoms. However, as reflected in the words above, their suffering doesn’t end there. Lack of social acceptance and being treated like outcasts act like roadblocks in the path of their meaningful recovery.
Schizophrenia is a serious mental health condition that affects how a person thinks and perceives his/her environment. It’s a condition where the individual is not fully in touch with reality. They may have disorganised thinking that manifests in the form of irrelevant speech and behaviour. They may hold beliefs that are not real and are unshakable despite evidence to the contrary. They may have hallucinations in the form of hearing voices which are often threatening in nature, seeing, smelling or feeling things that aren’t there. Some also develop paranoia and believe that someone will cause harm to them or their family.
One of the common characteristics of this disorder is a lack of awareness about the illness. Schizophrenia affects 1 in 300 people worldwide and is not as common as other psychiatric illnesses. Like all mental disorders, there’s no single cause for schizophrenia. It stems from an interplay of multiple factors like genetics, environmental and psychological stress, neurological deficits and drug abuse. This illness causes considerable disability in personal, family, social, educational and occupational domains.
As per the World Health Organization (WHO), discrimination, stigma and violation of human rights of people living with schizophrenia is common. Symptoms are often considered “weird” and misattributed to supernatural elements, black magic or intellectual deficits. Individuals living with schizophrenia are thus mistakenly portrayed as violent. The resulting stigma leads to social exclusion of these individuals, which can limit their job opportunities. Stigma also delays treatment access. Along with the affected individual, their families are also discriminated against.
One of the effective ways of combating stigma is talking about it. All forms of discrimination largely stem from ignorance or lack of understanding. What also compounds the stigma is labelling people with mental health issues. People living with schizophrenia are frequently labelled as “crazy”, “weird”, “evil”, “dangerous”, “stupid”, “senseless”, etc. They are also termed as “possessed” or “demonic” and society resorts to magico-religious practices to “cure” them. This can do more damage to the mind and body of an affected individual.
As the saying goes, “We fear what we don’t understand.” For most people, lack of understanding or knowledge about schizophrenia makes them fear the affected individuals. There is significant sensationalism and dramatisation of symptoms of a mentally ill person in the media. We also see some narratives where crime is associated with an individual having schizophrenia. They paint a picture that these individuals cause harm to others and are “out of control” and that they should be isolated and kept behind closed doors. Such a dark depiction is absolutely far from reality.
Individuals with schizophrenia are not aggressive by nature. Rather they often become the victims of violence, abuse and fraud. We sometimes come across people in our clinical practice telling us how even their family members call them “lunatic” or “crazy” during an argument even after their symptoms have reduced. Any behaviour is by default attributed to their illness. These actions of discounting a person’s credibility or opinions by using derogatory labels with reference to their illness can be very detrimental. Treated well and with care, people with schizophrenia can live healthy and productive lives.
Recovery from schizophrenia not only signifies reduction of symptoms but includes functional and social improvement as well. Reintegration with society is a very crucial element to recover from mental health conditions. Especially in illnesses like schizophrenia where the person may have no control over their thoughts and behaviour when they are symptomatic, it can largely affect their self-esteem during recovery. They may have pieces of memory about their illness that may be difficult to make sense of as they get better. They may constantly doubt their ability to judge or understand the situation. There can also be guilt and shame associated with their past behaviour when they exhibited symptoms. If people in their family and surroundings are accepting and encouraging of them, it can help them deal with these issues effectively and eventually lead better lives.
Compared to a few decades ago, people are now more aware of mental health issues. This is optimistic, but there’s a long way to go. Media, lay counsellors, mental health professionals, primary healthcare workers, policymakers—all can play a major role in building an inclusive community with equal rights and opportunities for those suffering from schizophrenia.
Illness is not someone’s fault and they should not be blamed for it. It’s our collective responsibility to eliminate stigma and labelling against schizophrenia by staying informed, fighting misinformation, spreading awareness and caring for those affected. Empathy and education are the key words. This World Schizophrenia Awareness Day, we cannot ask for more.
Vindya V Rai
Consultant Clinical Psychologist, Bengaluru
Dr Debanjan Banerjee
Consultant Psychiatrist, Kolkata