The nameschizophreniawas introduced in 1911 by a Swiss psychiatrist, Eugen Bleuler. In 1896 a German psychiatrist, Emil Kraepelin, had named the illnessdementia praecox(early brain loss), thinking it led to a deterioration of the personality at a fairly early age. Bleuler disagreed. He observed that a loss of mental functioning did not invariably develop. The new name,schizophrenia, comes from the Greekskhizo, to split, andphren, mind. Bleuler wanted to emphasize a basic split or loss of connectedness in the personality. This split could take the form of a faulty association of ideas, an inappropriate expression...

Hospitals are not as a rule considered happy places. Most people do not like the idea of leaving their home and entering the hospital. No matter what the illness, hospitalization is an exceptional step.

Why then admit a schizophrenic to the hospital? A doctor may recommend admission to hospital because the patient has an acute and severe illness that requires intensive observation and care. Or the patient may exhibit signs and symptoms that the doctor cannot readily explain or that constitute a possible risk to safety and health. Even when the person is not acutely ill, the doctor may arrange...

Treatment in hospital is only a fraction of total treatment since schizophrenia is potentially there for the rest of a person’s life. About one-third of all individuals who suffer a first acute attack may never have another one. But for the other two-thirds, treatment may need to be lifelong. At this stage in medical knowledge, it is impossible to distinguish those who do from those who do not require long-term treatment. Because of this it is better to err on the safe side and to recommend outpatient treatment to everyone who has suffered an attack of schizophrenia.

In a hospital...

Individuals with schizophrenia, and their families, sometimes find the array of different medicines used in schizophrenia bewildering. They find it hard to sort out which medicines do what.

In other chapters of this book, whenever we refer to ‘medication,’ we mean neuroleptics, which are anti-schizophrenic agents. Whenever we mention ‘staying on medication,’ ‘increasing or decreasing medication,’ or ‘stopping medication,’ we are referring to neuroleptics.

Other kinds of medicines are also used at times in the course of a schizophrenic illness: pills used for neuromuscular side-effects of neuroleptics, anxiolytics, mood stabilizers, and antidepressants. These will also be briefly discussed in this...

Relatives usually want to help the patient but feel helpless. They are not sure about the right way to help. Different authorities give them contradictory advice. When they get involved, they may be told they are overinvolved. When they back off, they may be told they are uninterested. In fact, there is nooneright way. A particular solution may work with one person at one time but not another, or not with the same person the next time around. Much of what follows is advice rather than foolproof prescription. Try one way, give it time, and see what happens....

When a person is ill, he wants to know when he will feel better. He wants to know how long the most troublesome symptoms will last. He wants to know whether, at the end of the illness, he will be feeling his usual self. He wants to know whether there is any risk that he will feel worse, rather than better, over time. Can this illness prove fatal? Are there people who never recover? Will it ever come back, and if it does, will it be milder or more severe than the first time? What effect will this illness have...

Schizophrenic illness presents family and friends with many crises. As with all crises, there are many individuals and agencies who would want to help. At times they do not know how to. Sometimes they try but give the wrong advice. Knowing the right person to turn to in a crisis is very important.

When symptoms have more or less disappeared, one speaks ofremission. When symptoms reappear to a significant degree, one talks ofrelapse. Relapses are distressing for schizophrenics and relatives, though somewhat less so when anticipated and planned for. Schizophrenia, for the most part, is a ‘relapsing’ condition,...

A minority of schizophrenic patients show a complete return to their previous functioning when stabilized on neuroleptics. Most, however, show some disability, sometimes because of mild residual symptoms and often because of psychological reactions to the illness.

It is nevertheless quite feasible to return to school or work after an episode of schizophrenia, although there is usually a period during which attention and concentration are not nearly at the same level as they were prior to onset of the illness.

Often ex-patients are ambivalent about returning to the workforce or have misgivings about returning to school after having lost a...

Attitudes towards schizophrenia have changed to a considerable degree. Since the 1950s, particularly since the introduction of effective pharmacological treatment in 1952, more and more schizophrenics live in the community rather than in psychiatric hospitals. This has allowed the public to come into contact with recovered patients. More and more people have come to realize that there is no reason to be frightened of schizophrenia. Not everyone, however, has been fortunate enough to have had firsthand contact with recovered patients. Many people still live in fear of schizophrenia, imagining the sufferer to possess two unpredictable personalities, a Dr Jekyll and...

About five years ago, at the age of 24, our daughter became very disturbed: she was hearing voices, felt she was being followed, and her days and nights were filled with constant fear and anguish. Her father and I were puzzled and distraught. A few months later Elizabeth was admitted to hospital.

Though her father and I visited her each day of her four-month stay, we remained perplexed by her illness. During the entire period we never met her doctor.Wehad not asked for an appointment with him, andhehad not requested to see us. Just prior to...

My daughter called from Ottawa, Ontario, one day to say, ‘Please send money.’ She had gone on a two-day trip and taken $200.00. We couldn’t see that she would need more. ‘It’s very important,’ she said, ‘a very important person is interested in me.’ This sounded odd but, at first, believable. That was the main problem when she first started getting sick: we didn’t know if it was make-believe, if she was teasing us, if she was angry at us, or if she was just confused. We quickly realized that it was no fun for her. Her so-called adventures with...

My name is Sandra. I was diagnosed as a schizophrenic 11 years ago, at the age of 25. Until then I had danced professionally in various nightclubs and, at one point, taught ballet.

In the course of my illness, I went from being a dancer pursued by millionaires and movie stars, to a divorcee working part-time selling two-dollar earrings, and then on to welfare, before I was able to start picking myself up again.

I am now, thanks to treatment and support, a psychiatric nurse, helping people diagnosed as I am, and many others as well. I graduated from nursing...

Have you ever woken up realizing that something is seriously wrong, and you don’t know if it is physical or mental?

Well this happened to me. I thought that I was going to have a heart attack: the pounding in my chest was ceaseless, my head was spinning. I couldn’t think or do anything. All I could do was lie there and suffer. This was the beginning of my breakdown, brought about by several things. A workaholic, worrying all the time, I was slowly losing touch with reality, preferring instead to daydream all the time.

I phoned a psychiatrist whom...

As a parent of a child developing symptoms of schizophrenia, you cannot understand what is happening. For a long time we thought our son’s strange behavior was due to street drugs, so we tried to handle it with discipline. We feel now that he was sick long before the drugs. What we realize now is that the marijuana temporarily made him feel better: that’s why he used it.

The main question in our minds now is how come we had so little knowledge? As a mother, I did not need a doctor to tell me my children had measles or...

Schizophrenia is a serious illness and involves a long, hard struggle for the patient and those around him. The doctor to whom the care of a patient is assigned has to deal with situations that can at times be very difficult. The real task is to maintain realistic hopefulness in the face of frustrating setbacks and never to ‘give up’ on a patient. I know that many of my actions are perceived as unwelcome or unpleasant, even though they are intended to help.

My view of schizophrenia obviously determines how I approach care and treatment. I consider schizophrenia a severe...