Grief and Mourning in Schizophrenia

Schizophrenia refers to a mental disorder that makes it difficult to discern the difference between reality and idealism. It is referred to as a disorder of thought that is characterized by delusions that reinforce idealism. Schizophrenics for instance may have paranoid delusions that someone may be following them. They also experience some types of hallucinations via their sensory system that other people do not experience. Other characteristics include blunted emotions that mean that they do not display many emotions that normal people have. Symptoms that are an addition on the behavior are called positive symptoms while those that decrease behavior are negative symptoms.

People with schizophrenia may respond to the symptoms by withdrawing from the outside world or act in a scared or confused way in the real world. Cases of schizophrenia mostly appear in the late years among teenagers and at this age, the young adults are undergoing major changes in their hormone system that makes them unstable. Schizophrenia also tends to be more rigorous in men than in women. Depression is one of the key symptoms of schizophrenia with many different psychiatrists diagnosing it among such patients. Over the years, schizophrenic patients have also been diagnosed with high levels of depressive behavior. Depression among schizophrenics displays symptoms that are similar to other ailments therefore making it difficult to diagnose (Patterson, 2011).

Depressive symptoms within schizophrenic patients originate from various factors Medical or organic factors acts as one of the causes of depression. Such possibilities may include common medical states such cancer, infections and anemia, medications used to treat problems such as sedative-hypnotics as well as the discontinuation of these medications. Drug and substance abuse can also cause depression among schizophrenics and this factor may assist in explaining why many young adults who abuse drugs end up being schizophrenic. Caffeine and nicotine have been cited as the two most influential substances that triggered depression among schizophrenics. Apart from the two, other drugs and substances cause imbalances in the physical and hormonal state of equilibrium in human beings that contributes towards depression.

Addressing depression among schizophrenics

Appropriate treatment procedures for depression among schizophrenic people commences with an analysis of the possible diagnostic possibilities. The causes of depression are numerous and therefore, the medical practitioner should similarly provide the relevant solution. There are no biological or psychological tests available for diagnosing depression and therefore psychologists depend on clinical forms of diagnosis. Some of the most common possibilities of a new appearance of depression in schizophrenics include a prodrome of a new psychotic episode and acute, transient disappointment reaction, the best course of action would be to increase the surveillance of the next episodes. If the result of the surveillance were a transient disappointment reaction, there would be no further action taken as it will resolve itself spontaneously and no other intervention will be necessary (Patterson, 2011).

Depression arises when the onset of the depression is the indication of a series of psychotic episodes such as bipolar illnesses and schizoaffective disorders that will happen in the future. In such cases, increased surveillance allows the new episode to be monitored and controlled early and efficiently through suitable antipsychotic interventions such as the NIHM-funded clinical Antipsychotic Trials of Intervention effectiveness. Schizophrenics undergoing narcoleptic treatment may also experience continuing episodes of depression and may need to be investigated into whether the neuroleptic medication may be the cause of the depression. Depression could occur in the neuroleptic-induced dysphoria state or the impacts of akenesia. In such cases, reducing the dosage of neuroleptic drugs would be helpful in lowering the degree of depression if this method is acceptable. Attempting atypical antipsychotic agents may also help the situation (Wittmann & Keshavan, 2007).

Suicide tendencies among schizophrenics

Suicidal tendencies are common among schizophrenics and patients that seem to have thoughts of committing suicide should be referred for professional help. The rate of successful suicide attempts among schizophrenic people has been around 40% over a period of three years (Veague, 2007 pg 34). These suicides take place during the upswing order. During this time, symptoms like depression, loneliness and delusions have almost subsided, and the patient has a clearer view of themselves and the environment around them. When patients complete therapy and are discharged, they experience a world that is the complete opposite of what they imagined, and this may be traumatic for some people. Most suicides occur after the schizophrenic person hears of another suicide that triggers their own actions (Veague, 2007 pg 67-8).

Most schizophrenics attempt suicide because after being diagnosed with schizophrenia, most of their lives come to a halt. As discussed earlier, schizophrenia affects almost all aspect of life from relationships, work and family. People having this condition have to struggle with everyday work that increases their anxiety levels, and this triggers the suicidal tendencies. Hallucinations may make the patient believe that suicide is the best option to escape from harm. Coupled with delusion, these people have every reason to kill themselves. A huge part of the treatment is therefore to reduce the possibility of considering suicide as an option (Lewis, 2007).

Safety plan for schizophrenic patients

The safety plan will include proving safe and stable environments for people suffering with schizophrenia to enable them undergo proper treatment and healing. The first part of the plan involves seeking stable environments in which the patient can visualize a normal world. An example would be a mental institution or a special school for gifted schizophrenic children. Therapy and dealing with grief form the main part of the safety plan. Individual therapy is a common treatment for suicidal people. It involves the patient talking about their struggles while dealing with schizophrenia, as well as struggles with life. These therapists are trained to take a wide view of the factors that make a person predisposed to suicide. Therapists can assist by teaching the patient coping mechanisms of dealing with the challenges in life. Psychoanalytic therapy is however disadvantageous especially when therapists dig into a patients’ childhood, which may trigger, or accelerate the suicide process (Lewis, 2004).

The next aspect of the safety plan is family and group therapy. This is similarly effective in coming to terms with the social and physical losses. The family can have personal sessions with the patient and the therapist. Some of the losses associated with schizophrenia include the loss of discernment, long-time careers, health, mobility and even lives. Family therapy plays an important role in helping people to recover. Close friends and family can help people dealing with schizophrenia to come to terms with the reality of their inabilities and learn to deal with them (Wittmann & Keshavan, 2007).

The last part of the safety plan is dealing with losses and grief, which for schizophrenics can be difficult due to the high levels of denial, and the ease with which they can slip back to their make-up world and lock out any attempts to help their situation. Dealing with grief and loss may involve dismissing childhood misconceptions that may not necessarily work such as assuming that time will heal all wounds (Wittmann & Keshavan, 2007). Effectively dealing with losses may involve embracing new conceptions such as allowing the free expression of emotions, as schizophrenic people need to feel the pain associated with losing some of their abilities (Lewis, 2007). An example is that of Michael, an 18-year-old schizophrenic who had rage attacks, imaginary pets and a constant hatred for idleness and inactivity (Veague, 2007).

Conclusion

Schizophrenia has proven to be one of the most difficult conditions that human beings have attempted to manage mainly because it displays different symptoms such as depression, delusions, hallucinations and other characteristics. However, the fact that schizophrenia is a mental condition makes the remedy more difficult and expensive. Management of grief and loss among schizophrenic patients consists of various types of therapy. Applying only one type of therapy is not enough to help the patients recover from the loss, inactivity and helplessness. Family, group and personal therapy have all been proven as mitigating the drastic effects of schizophrenia such as suicide and depression.

References

Lewis, L. (2004). Mourning, insight, and reduction of suicide risk in schizophrenia. Bulletin of the Menninger Clinic, 68, 3, 231-44.

Patterson, P. H. (2011). Infectious behavior: Brain-immune connections in autism, schizophrenia, and depression. Cambridge, Mass: MIT Press.

Veague, H. B. (2007). Schizophrenia. New York, NY: Chelsea House Publishers.

Wittmann, D., & Keshavan, M. (2007). Grief and Mourning in Schizophrenia. Psychiatry: Interpersonal and Biological Processes, 70, 2, 154-166.