“khuda ka wasta ha mujhi choro, mujhe nashay kay injection maat lagao”(Translation: please leave me for God’s sake, don’t inject me with drugs).
This heart wrenching statement was made by one of my paranoid schizophrenic patients. It remains etched in my memory. I can only imagine the debilitating torture it would have caused to the patient’s family. This memory will haunt them for life.
Paranoid schizophrenia is a disorder characterised by symptoms of schizophrenia including delusions and hallucinations. These debilitating symptoms blur the line between what is real and what isn’t. They also make it difficult for the patient to lead a normal life.
In all likelihood, a combination of physical, genetic, and environmental factors can make a person more likely to develop the condition. Could intervention at the right time help patients and prevent their mental digression? We should not lose sight of how quickly things can go out of control if our people are not educated on this grave mental health issue.
Our society is on a downward spiral. Our youth are suffering from a plethora of mental health issues, but victims and their families consider it black magic, or the result of evil eye. We are turning a blind eye to victims’ plight. This must change. Sadly, the encounter with psychiatrists or psychologists is mostly when patients have reached their worst condition. As a result, mental health professionals are left with no other option but to use aggressive measures to bring the patient’s condition under control.
Along with imbalance of neurotransmitter (dopamine), rigid schema plays a vital role in this condition. In psychology and cognitive science, a schema describes a pattern of thought or behaviour that organizes categorisation of information and relationship between information.
There are however flaws and basic root causes responsible for the formation of rigid schemes.
We tend to forget that the mind develops right from childhood. What is learnt during childhood cannot be unlearned. Due to lack of child psychologist and career counsellors at school level, children are unable to appreciate the root cause of their disorganized thoughts and realize that irrational thoughts or disorganized behaviour is not black magic or evil eye. Rather it is the result of neurotransmitter imbalance in the brain. Internal Voice of a schizophrenic patient range from: strange music playing in the ears; something that sounds familiar but inability to remember; splitting sense of sadness that always seems to follow the victim etc.
We must understand the importance of visits to psychologist and psychiatrist on time. Cooperation of family is very much necessary because that is the first intervention point for diagnosis if not treatment
Sadly, attributing paranoid schizophrenia to supranatural phenomena, seeking refuge in quackery, maulanas, dum/durud makes symptoms worse and strengthens the victims’ schema about natural phenomena. This is a major obstacle to providing critical insight about the cause of the disease and treatment options.
When our focus is on Islam to cure ailments, then we should understand the essence of Quran namely that it is aimed at educating the superior being: humans. The Quran calls on the superior (rational) being to think and use logic. If logic is applied, then we will understand the need for timely medical intervention to treat the disease through professionals.
If we look at developed countries, we will see that famous people have survived schizophrenia and led normal lives. This includes Sys Barrett 1946-2006 (musician and founder of pink Floyd) and various others. These individuals however had access to proper health care due to their privileged position in society or because they belonged to a society that cared for its people.
On the other hand, the condition of mental health hospitals in Pakistan is despicable. Over the years, the State has not paid any attention to the construction and maintenance of the hospitals. KP Province, which has been the epicentre of conflict, has been at the forefront of this neglect. There are at present two public hospitals in the province both of which are in a pathetic condition and worse than a zoo for housing animals. On the other hand, private hospitals are too expensive for the vast majority to afford.
Most patients are brought to hospitals when it is too late. Many a times, the patients’ become medicine resistant due to unprofessional or improper medical treatment e.g. overmedication. We, clinical psychologists relate with treatment of mental health condition with the example of a bucket full of water: if a bucket full of water has small holes in the bucket that causes the water to gush out from the holes, then it will take time and patience for the holes to be covered and for the water to be secured within the bucket.
But before clinical intervention becomes a necessity, understanding of the condition must begin at home i.e. at the family / personal level. It is far better for a family member to lend crucial support to a patient when the symptoms develop than to wait it out when the situation goes out of hand. What needs to be avoided at all cost is the situation where a patient reaches hospital after his/her condition has worsened
We must understand the importance of visits to psychologist and psychiatrist on time. Cooperation of family is very much necessary because that is the first intervention point for diagnosis if not treatment.
There is dire need for construction of rehabilitation for patients of paranoid schizophrenia so that they do not feel desolate and helpless. We need to tackle this head on as a national issue which is as important as our economy, population and other issues. A healthy body and a healthy society can only result from a healthy mind. We must invest in our future now.
The writer is a clinical psychologist