A Pitfall in Treatment with Schizophrenia

There is a common pitfall that many people with schizophrenia and other mental illnesses fall into. That pitfall is a serious concern that many in the mental health community share. I am talking about when people with a mental illness receive inadequate care for other ailments. Today I will discuss in more detail why this happens, how to avoid it, and how to watch for it. Lets dive in shall we?
Many people are aware of stigma and the impact it has towards getting treatment for your mental health. Unfortunately, this stigma can be found in unexpected places such as hospitals and other medical facilities. While there are many people who are caring and compassionate towards those with schizophrenia, there are some people who are uneducated on the subject that may inadvertently or knowingly mistreat people with schizophrenia. This is particularly noticeable when being treated for something separate from the illness.
Some medical professionals make assumptions about their patients. For example, they might assume that a patient with schizophrenia who is complaining of pain may be hallucinating it or faking it. While this is the exception to the rule, it does happen and can have devastating consequences for the patient involved. While there are some instances where a patient may be hallucinating or faking something, it should never be the initial assumption.
Family and caregivers of people with schizophrenia are often put into a position of advocating out of necessity. It is important to be determined in making sure that your loved one receives proper and adequate care. While you should always try to remain polite and courteous with your loved one’s treatment team, it is vital to ensure that the patient’s medical needs are met. The main avenue of accomplishing this is through advocating for your loved one.
To summarize, there are a few people within the medical community who may not take physical ailments seriously when they work with somebody with a mental illness. One of the best ways to deal with this is to take your loved one’s concerns seriously and to advocate on their behalf. The top priority of all those involved should be the proper and sufficient treatment of your loved one.
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Strategies for Caring for a Loved One in Psychosis

Psychosis is often a legitimate and common driver of fear for those who experience it as well as those caring for them. For some, psychosis can appear suddenly; for others, it comes on over a longer duration. Regardless, it rarely fails to catch people by surprise, especially when you are not prepared or are still coming to terms with it. Thankfully, there are things that you can do as a caregiver that can make it a little less stressful. Bear in mind, psychosis is a very stressful experience for all involved, but the distress can typically be mitigated through certain actions and behaviours. So, what are the do’s and don’ts when you are handling a psychotic episode?

Do’s

Firstly, remain as calm as possible – getting all flustered about what is going on will not help the situation and it can even exacerbate it. As I often tell myself “don’t lose your shit!”. No matter how intense or bizarre the situation may become, do not freak out. You know the saying that dogs can smell fear? I find people are the same in that we can pick up on each other’s emotional state through mediums like body language. Let me give an example. Say somebody walks into the room stomping their feet and clenching their fists with a look that could kill. They seem angry right? I can only speak for myself, but I would pick up on that, might even get uncomfortable. So, with that example in mind, how do you think somebody in psychosis would react when they pick up on your tension and stress? I have seen from my own experience that giving off the wrong emotional vibe can make a tense episode plummet into a tailspin. It can be extremely stressful, but don’t worry – there’s time once things are a little more calmed down, once the situation is under control, where you can let the stress out.

Secondly, you may find it helpful to focus on the task at hand. Try not to worry about all the concerns that may arise after your loved one is stabilized. In fact, I will make it even more simple, because I believe in the K.I.S.S. principle (keep it simple stupid).  You have two jobs:  keep the situation as under control as can be expected, and do the best you can. It would be folly to think that things won’t go wrong, or that you won’t make mistakes, because hey, we are only human, we can’t be perfect all the time. It’s okay to make mistakes and fudge up in a situation like psychosis, it happens, but we must learn from our mistakes so that we can be ready for the next episode. Anyway, back to the main topic, (can’t believe I just got off topic when the topic is to focus) when an episode strikes, the only time that matters is the moment you’re in. The past is not important, and the future is a long way off. Your focus should be on keeping the situation relatively under control and getting any necessary assistance such as an ambulance or crisis team. Alright, onto the next tip.

Third, eliminate any distractions. This could mean turning the tv off, turning down the radio, or politely asking anybody who does not need to be there to leave. When somebody is in psychosis, there is so much going on for them that they can have a really difficult time sifting through what is real and what is not. So, having a tv blaring or having somebody talking that shouldn’t be in the room, that only adds to the cacophony of sensory overload that the person is going through. In short, remember the K.I.S.S. principle.

Lastly, as a little tip that I have used extensively, this one is a life saver when done properly. Try to help the person in psychosis to remain anchored in reality. You can do this by talking to them, trying to keep them calm, and by showing through your emotion and body language that it will pass. When talking to a person in psychosis it is important to be clear and to the point, without raising your voice any more than necessary. While it may feel nearly impossible, it is critical that you try to remain confident and try to instill a sense of security for your loved one. You must be strong in this moment, because they are busy fighting their own struggles, so to say they are vulnerable would be an understatement. Keeping them anchored in reality is vital, as it can sometimes help them to know that there is somebody who loves them and is there with them.

Don’ts

One of the biggest no-no’s is ridiculing or being critical of what your loved one is experiencing. It is important to keep in mind, what they are perceiving as real, is not any less real than you or I. I have heard that it is like dreaming when you are awake. The point is that it feels real, and now is not the time to be condemning a loved one over something that they have as much control over as a person and their skin colour. This one may seem obvious, but many people make this mistake in the heat of the moment.

Similar to the first item in the “Do’s”, do not freak out. When somebody is in an episode it is important that somebody takes charge and tries to keep the situation from escalating, and that can’t happen if everybody is getting stressed out can it? I am not saying that you can’t feel fear, or concern, or any other emotion. What I am saying is that you have to try to keep your own emotions in check and not let them make the decisions for you. It sure as hell is not easy, but it is easier than trying to pick up the pieces after the situation has escalated.

Finally, do not lose hope. It is often in the aftermath of an episode that despair really comes into play. When you get a moment to think and process what has just happened, then all the emotions and fears tend to hit you like a ton of bricks. Try to remember though not to lose sight of hope. Hope is the torch that illuminates dark roads of mental illness. Being in the dark sucks, trust me. So, take hold of that torch and let it burn all the brighter in that night! I know this all sounds corny, but if it wasn’t for hope, I likely wouldn’t be able to manage my life too well. Hold onto hope, no matter what.

Summary

Psychosis, at least with regards to schizophrenia, is often when symptoms flare up to a level that is unmanageable in the moment. Psychotic episodes are typically dominated by hallucinations and delusions. In general, it is often described as losing touch with reality, not being able to tell what is real and what is not. As a caregiver it can be terrifying to witness a loved one go through this, only being able to imagine what they must be going through. Thankfully, psychosis usually is episodic in nature and as such is not always present. I hope that with this article I have been able to share some of the things I have learned the hard way with you.

Stay Strong.

What is Schizophrenia?

A mental disorder characterized by various symptoms such as hallucinations, delusions, among many other symptoms, schizophrenia is often misunderstood or misrepresented. Schizophrenia is commonly mistaken for split personality disorder. This case of mistaken identity is likely because schizophrenia literally means “to split the mind” in Greek. This “split” in the mind simply implies that the mind is disjointed as opposed to multiple personalities.

So just what is schizophrenia? How does it look to observers? Well, like any medical condition schizophrenia is classified by its symptoms. The symptoms of this disorder are most commonly divided into positive and negative symptoms, though depending who you ask there are other categories. Personally, I use three categories for my own explanations, positive, negative, and cognitive. This may seem confusing at first; after all, how can symptoms of something like schizophrenia be positive? Positive symptoms are basically the symptoms that are “added”, while negative symptoms are an absence of certain factors. Cognitive symptoms are simply the ones that revolve around things like thought processes and memory. Confusing, right? Do not worry, this will all get explained in more detail throughout the article.

Positive Symptoms

The presence of positive symptoms often comes in the form of various hallucinations (hearing, seeing, smelling, feeling, and even tasting things that are not real), and delusions which are essentially false beliefs. Hallucinations are one of the hallmarks of the illness, though they are not exclusive to one another. Typically, auditory hallucinations and visual ones are the most common, taking the form of voices and a whole menagerie of figures respectively. The voices many hear due to the illness are often cruel and verbally abusive. It is not uncommon to also have your life narrated or to even be commanded to perform actions by auditory hallucinations.

Visually, hallucinations can range from pleasant to bizarre and even downright terrifying in appearance. For instance, there was a period of time in my life where my wife would consistently see a young woman that strongly resembled something out of a horror movie. As a result, for the longest time she avoided the basement and any dark rooms. The point to keep at the front of your mind is that from the perspective of those who experience these symptoms, they appear real. For many people with schizophrenia, there is no telltale difference between what is real and what is not. If your worst fears seemed as real as everything else around you, would you not be terrified? I sure as hell would be. On that note, onto the next point, delusions.

These beliefs can be just as varied, numerous, and terrifying as the hallucinations. Typically, delusions are referred to as delusions of paranoia, grandeur, control, or reference. Paranoid delusions are pretty straight forward, they are the belief that people are out to harm or persecute you. Examples could include feeling like somebody has poisoned your food, or that the government is after you. Delusions of grandeur are characterized by believing that you are famous, rich, or powerful. For instance, some people with the illness believe they are religious figureheads such as the Pope or Jesus. When somebody believes that somebody or something else can control their thoughts and behavior that is referred to as delusions of control. Delusions of reference are when somebody feels that somebody is trying to communicate or send a message directly to the individual. For example, believing that people are sending you messages through the radio. While there are other types of delusions, these four should cover a large swathe.

While there are other types of positive symptoms, hallucinations and delusions are two of the more predominant ones. Now that we have that covered, lets move on, shall we?

Negative Symptoms

As stated earlier this category is determined by the absence or lack of certain characteristics. These can include a lack of emotional expression of the face (also known as having a flat or blunt affect), a noticeable decrease in the ability to feel pleasure or joy (known as anhedonia), apathy, and alogia or poverty of speech.

Flat affect is likely one of the most obvious negative symptoms. Simply put, there is a distinct lack of emotion in facial expression, almost a blank or empty expression. To be clear, this does not necessarily mean that somebody with the illness does not feel the emotions, it simply means that it is not expressed through body language.

Anhedonia is undoubtedly one of the most distressing negative symptoms. Activities that once brought happiness or satisfaction, now give nothing or very little in terms of emotional reward. This can be particularly frustrating when attempting to find relief in once loved past times. While there may be a lack of satisfaction, many people with the illness are acutely and painfully aware of this absence in their lives.

Apathy typically presents itself through being unmotivated or easily fatigued. Daily tasks such as personal hygiene often suffer as a result.

Poverty of speech can occasionally be frustrating for those around the person with schizophrenia as it may seem like they are not interested, or that the conversation is one sided. It is important to note that just because somebody with the illness is not vocal, does not mean that they do not enjoy the company.

The signs typically classified as negative symptoms are typically more constant and steady as opposed to their positive counterparts. While they may not be as acutely stressful, it is important to understand that for many people, the negative symptoms are more stressful on a day to day basis than some positive symptoms.

Cognitive Symptoms

Thought processes are the name of the game when it comes to this category. Difficulty concentrating, memory issues, and slowed psychomotor speed make up the bulk of cognitive symptoms. As with negative symptoms, cognitive difficulties are commonly rather constant and steady. Having a challenging time paying attention and concentrating is usually caused due to easily being distracted by one’s thoughts and environment. Memory issues typically present in being forgetful; for instance, forgetting to perform certain actions like brushing your teeth. A slowed psychomotor speed simply put is when it takes longer for somebody to absorb and process information and formulate a response. It should also be noted that many people who have schizophrenia struggle with abstract thinking such as metaphors or certain sayings.

Cognitive symptoms can be considered a part of negative symptoms, though for the sake of ease of use I choose to keep it as a separate group. Although not as acute as positive symptoms, cognitive difficulties can be equally as detrimental and aggravating for the person with the illness.

Conclusion

Hopefully after reading this article you have even a little more information to use in your journey to understand schizophrenia. The symptoms and much of the medical jargon can be extremely confusing to those who are not experienced with it. I hope that this article has helped you, even if only a little. Do not forget, knowledge is power. This is especially true when dealing with any medical condition – do not hesitate to go searching and hunting for more information. There is so much information available that whole books could be devoted to symptoms alone. Be sure to check out the resources section of my blog for other websites that may be of benefit.

Stay strong.

Fear: The Biggest Obstacle for Treatment?

As most people who have had to find help for themselves or their loved ones’ due to a mental health concern will likely tell you, treading the path to find treatment is an uphill walk to begin with. Getting in touch with the right people, asking the right questions, making the right choices, none of it is easy, especially at the beginning. If you ask me though, I think one of the biggest stumbling blocks on the way to receiving treatment is a short four-letter word. That’s right, fear.

Why fear? Because its an often crippling emotion. It causes hesitation, or withdrawing from many things. I believe it is one of the most powerful emotions due to its ability to petrify people to the core. So how does this tie in with getting treatment? Well in short, if you’re terrified of what the outcome may be, you probably won’t want to get treatment will you? Maybe the fear of what others will think, fear of hospitals, side-effects, the list could go on for ages. The point is that fear can quite often be debilitating, or cause enough delay that things really go down the tubes.

So what do you do about fear? There really is no right answer if you ask me. Some people are able to transcend their fears and get treatment, others are able to lean on the compassionate shoulder of a loved one in times of need. And sometimes, treatment is downright involuntary. I’m not saying that any of these are going to work for anybody, or that any are more effective than the other. It all depends on the individual situation as it arises. I’m not going to tell anybody what is best for them because I can’t possibly know, what’s best for you is between you and your care team.

So, what can you do about fear? Reach out, ask questions, communicate with those around you who know about your condition. I’ve often found that talking it out with others can usually cut my fears down to size. Because fear feeds on itself, it has a habit of snowballing into what seems like an impossible task. But think of it this way. Whether you have schizophrenia, anxiety, OCD, bipolar, depression, any condition really, think of all the people who have been where you are now, how many of them get past it one way or another? Lots. Just remember that you’re not alone.

Stay Strong.

A Year in Review: Lessons Learned as a Caregiver and Husband

It has been quite a journey since being told of my wife’s diagnosis. Teeming with memorable ups, painful lows, and everything in the middle. There is a plethora of blessings and curses alike to be taken from such a journey. Wisdom and understanding are two such attributes that can be attained as both a caregiver and as somebody with mental illness. But in order to gain insight into wise ways and empathetic understanding it is often necessary to take some lumps and bruises along the way. So what exactly have I learned from our new way of life? Well, let’s look, shall we?
If I were to simply lay out a nice, clean-cut, and definitive list, that would hardly resemble the menagerie of lessons I have had to decipher along the way, would it? I will, however, do my best to lay it out in a way that hopefully allows you to take something from it.
Without a doubt, one of the most prominent lessons I have absorbed is empathy. Looking outside of myself and trying to genuinely see the world in a way that others experience. For instance, in the past I have often looked at my situation and thought “poor miserable me.” What I should be thinking though is “what can I do to make your day better?”. Attempting to “walk in their shoes” would force me to see that while, yes, my situation might not be optimal, there are people around me who could really benefit from me putting on my big boy pants and trying to help them through their struggles. And guess what? It makes me feel better, too. Not only does this empathy open my eyes to helping others, it also allows me to get a very rough idea of their struggles. For example, trying to truly imagine how it would feel to experience even a fraction of her symptoms on a bad day. All I can say is that she handles it better than I could. That brings us to the next lesson, patience.
I have often been told that patience is a virtue. Little did I know just how those words were to ring true. Not only is being patient a useful skill when waiting on results and doctors, it’s also highly beneficial when having to face the inevitable symptoms of mental illness. Marriage makes that importance that much more important. For example, say your partner is on the verge of a psychotic episode, or perhaps they are on the verge of suicide. It is safe to say that these are moments where you do not want to be in a rush or pushy to conclude this stressful scenario. If, however, you allow the resolution to take as long as is necessary, it can help to keep the situation from escalating. Another benefit, especially when working with psychosis, is that being patient can result in making the individual with symptoms feel more calm or assured than if you were to panic or react in a negative manner. This by no means indicates that the situation will resolve immediately. It simply means that it can potentially mitigate stress and harm to everybody involved.
A hard-learned lesson for myself and, I am sure, many other caregivers, is the act of self-care. You strive to be the best caregiver you can be, pushing yourself past limits that would normally break you. Yet you persevere because really, what other option do you have? Your loved one needs you, so you play the herculean role; maybe you have other children who need you too. More than likely you have multiple responsibilities to look after. And you play the role of Atlas, the weight of the world borne upon your shoulders. It’s noble, and many of us do just this for weeks, months, or even years. There is just one problem – we are only human. That means we are vulnerable to that dreaded “b” word. Yup, that bane of any caregiver’s existence, burnout. Many of us have walked this thin line before. How can you avoid burnout? The answer is simple, yet not remotely easy. Self-care, that’s the remedy that can stave off burnout. I will be the first to admit that I was sorely lacking in this department. I poured myself into being a caregiver, on top of my other responsibilities. Things like school, work, family, pets, household chores. I told myself that I could handle it all. Then I started to wear out. The fatigue, loss of drive and ambition, not eating or sleeping enough, the bottoming out of my stress tolerance; even the most minor of stressors like a wrapper on the floor and boom! Day ruined. I lost myself in my role as caregiver. So, what did I do? I started slowly practicing self-care, treating myself to moments where I tried to only worry about myself. That’s not to say I stop caregiving; my role as caregiver and husband has always been a top priority. Along with a billion other things. I just put myself in the top five priorities so as to climb out of the burnout trenches. Think of it like this, when they do the safety presentation on airplanes, you know the ones with the oxygen masks? What do they say? You are instructed to take care of yourself and then any dependents. Sounds a bit ass-backwards, doesn’t it? But how can you help anybody if you are passed out from lack of oxygen? You can’t. So, by taking care of yourself, you are also taking care of those around you. If your wife, kids, parents, or anybody else depends on you then doesn’t it make sense to make sure you are ok? You wouldn’t want to let them in a worn out and unreliable boat. You would want them to be safe and looked after. So why would it be any different as a caregiver? If you can’t take care of yourself, you can’t help anybody else. In order to be an effective caregiver, it is imperative that you be in as good of shape physically, mentally, and emotionally as possible. So, by helping yourself you are also helping those who rely on you. So, help others by helping yourself a little to.
While I have learned countless things over the past 18 months, these three are probably the most critical – at least in my mind. Hopefully there is a little something here for you to take and help you or somebody you know. I wish you all the best on whichever path you are on. Anyway, that’s it from me today.

Why Music is My Therapy

We have all got something that is a simple passion that’s therapeutic. For some, its painting, or working on cars, or fishing, or maybe make-up. For me? I’d say its music. Just listening to music, and enjoying it. The thing that I’ve always loved about music is that it has feeling. Those feelings may be totally different from what the artist intended, but for most people, music carries with it emotion.

Music has always been a great communicator, its been able to transcend barriers of language, colour, age, you name it. That’s why I love music, because it is able to convey all sorts of meanings without saying a word. It doesn’t matter if you listen to death-metal, country, or classical, Music is music and its great. For me? I don’t really care what genre, if I like it, I listen to it. I love music because, for me, its therapeutic. It can keep my feet planted firmly on the ground when everything else tries to make me fly into that cold and void space above or push me down into the ever so lonely depths below. No, I’m not talking about heaven and hell. I’m talking about my bipolar disorder. But that’s an article for another day.

So where do bipolar disorder, or mental illness of any kind really, and music connect? Well for me. Music has always been an extension of my mood. When I’m happy, I like happy music, when im sad, I enjoy more sad or forlorn music. But this extension goes both ways. Have you ever been feeling a negative emotion, such as anger, sadness, jealousy, any of ‘em really? And then a song you like starts playing, and it steadily melts away the freezing loneliness of that negative emotion? I know I have. I’ve always struggled with emotions and feeling them and responding appropriately to them. I’m the guy that used to wanna die because I couldn’t handle being sad. I’m the person who used to be so happy I would think I could almost fly. When I was angry, I was downright scary, to others and myself. So what changed?

What changed was a myriad of different factors in my life ranging from my bipolar/ADHD diagnoses, getting medicated, learning how to cope through the school of hard knocks, and trying to discover who I was. All of these are stories for another time (stay tuned!), but there were a few things that remained constant that probably kept me from really pinballing my life. You know… like a pinball getting thrown around the machine with reckless abandon only to get lost down some bottomless hole? Those things were, in no particular order, were the support of my loved ones, having to face myself, and music of all things.

Music is a pillar that makes up a part of the foundation of my life. How many of us have a favorite tune? Or multiple jams? I know for me, my jam changes constantly. That is because, for me, music is a way of expressing my thoughts and feelings when I don’t have the words or ability to express it myself. And you know what? Sometimes these songs, that somebody else created, teach me about myself. It is as though music is a way of growing my emotional vocabulary, of shedding the light into the very fibre of my being and allowing me to learn about and face myself.

Music is so many things for me, story teller, therapist, friend, coach, the list could go on and on. So, let me ask you. What’s your “music”? What is it that gives you that spark in your eye? If you can’t think of anything, don’t sweat it. These things can take time to become apparent. Heck it’s taken me my whole life to clue into music and how it affects me, and that is okay. Think of it as a new opportunity for adventure, an adventure of emotions and the landscape of who you are.

Burnout: The Silent but Deadly Threat

It’s the bane of any caregiver’s existence. That looming silent shadow at the back of your mind. it’s always there, patiently waiting to worm into the fabric of your life. I’m talking about burnout, specifically as a caregiver. It really isn’t fair, is it? You want nothing more than to help your loved one as best as you can, most of us would happily sacrifice everything in the hopes of helping them. But you can’t, because you know what happens when you give up everything? When you lose yourself in what you do as opposed to who you are? That’s right, burnout. The fact of it is that even with an act like caregiving, you can’t give everything of yourself and hope to get by without yourself.

Caregiver burnout is usually what happens when you’ve been stretched to the max, you just can’t give anymore of yourself. You can be tired, irritable, depressed, anxious, any number of nasties really. It happens when you push too hard and too fast and give all you’ve got until you have nothing left.

That dark looming cloud overhead doesn’t have to stay there though. You can make it go away, its not easy, but its probably worthwhile. Reach out. Hold out your hand and ask for support. Asking for help doesn’t make you weak, far from it. Anybody who has swallowed their pride and allowed others to share the weight will tell you that it only makes you stronger. Think of the bundle of sticks analogy. One twig is pretty easy to break, right? Well try grabbing a handful and break them at the same time. It’s quite a bit harder, isn’t it? The point is, you don’t have to do this alone. I’ve often found that many people want to be helpful but just aren’t sure what to do, so if somebody offers their assistance, take it, be up front about what you could use help with. Many hands make light work, right?

Its all about you finding balance in your life. If you can find that middle ground. That spot where you can be a caregiver AND yourself, it will be better not only for you, but also the loved one who you care for. Just remember that every storm breaks.

Stay strong!