Schizophrenia: A Lack of Coherence in Emotions, Thoughts, and Behavior

Although schizophrenia is a serious mental illness, it can be fairly well controlled with appropriate and regular treatment from the onset of the illness. Treatment mainly includes medication and psychotherapy.

Medications help control symptoms noticeable in behaviour such as disturbed sleep patterns, incoherent speech, strange movements, restoring contact with reality, and reducing delusions and hallucinations. To balance the chemicals whose imbalance causes these symptoms, psychiatrists prescribe medications based on the severity and intensity of the symptoms. Medications play a crucial role in improvement, working effectively up to a certain limit. However, neither the patients nor their relatives should make any changes in the medications, doses, or timings on their own. Any decisions regarding medications should be left to the psychiatrists. Carefully recording symptoms, accurately reporting them to the doctors, discussing them regularly, informing the doctors about any side effects, and adopting other techniques to mitigate these side effects can help doctors formulate more effective treatment plans.

Broadly noticeable and troublesome positive symptoms are relatively quicker to control. However, the subsequent subtle cognitive symptoms are better managed with the crucial involvement of psychotherapists or psychological counsellors. Since the counselling process works on the integrated mechanism of thoughts, emotions, and behaviour, it tends to be prolonged. Temporary side effects of this process may include revisiting past events leading to increased complexity of thoughts and emotions, resurfacing of suppressed memories, insomnia, fatigue, and frequent mood changes. However, these side effects are temporary and should be discussed in the following counselling sessions. This stage of the counselling process is important for dealing with suppressed issues due to the mind's defence mechanisms.

The counselling process also involves exploring perspectives on medication, insight into the illness, various ways to manage the condition, accurately recording symptoms, fluctuations in emotions and thoughts, and handling anxiety. Different psychotherapeutic techniques and treatment methods are used in this process. The benefits or success of this process depend on the therapist's knowledge and experience, the patient's acceptance of the treatment methods, their sincerity in working on themselves, the support from family members, as well as the nature of the illness and the complexity of its symptoms.

In mental illnesses, the psychological counselling process addresses seemingly small but deeply impactful aspects such as gradually re-establishing diminished or lost cognitive skills, building confidence and hope, eliminating negative emotions, and helping create a personal support system. Therefore, giving psychological counselling equal priority to medications is beneficial when dealing with mental illnesses.

Overall, by complementing the limited but essential role of medications with appropriate psychotherapy, it is definitely possible to manage schizophrenia and other similar serious or common mental illnesses. Patients can lead happy and meaningful lives, just like us, with some differences. Perhaps, through these illnesses, they attain a deeper level of acceptance in life.

Meenakshi

Psychotherapist

23/05/2024