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Diagnosis: Schizophrenia, Second Edition

Diagnosis: Schizophrenia, Second Edition: A Comprehensive Resource for Consumers, Families, and Helping Professionals

Copyright Date: 2011
Edition: 2
Pages: 240
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  • Book Info
    Diagnosis: Schizophrenia, Second Edition
    Book Description:

    In this book, thirty-five young, recently diagnosed patients speak about schizophrenia and the process of recovery, while two specialists illuminate the medical science, psychoeducation, and therapeutic needs of those coping with the illness, as well as access to medical benefits and community resources. A remarkably inclusive guide, the volume informs patients, families, friends, and professionals, detailing the possible causes of schizophrenia, medications and side effects, the functioning of the brain, and the value of rehabilitation and other services.

    In their dialogues, participants confront shame, stigma, substance use, and relapse issues and the necessity of healthy eating, safe sex practices, and coping skills during recovery. Clinicians elaborate on the symptoms of schizophrenia, such as violent and suicidal thoughts, delusions, hallucinations, memory and concentration problems, trouble getting motivated or organized, and anxiety and mood disorders. Adopting an uplifting tone of manageability, the participants, authors, and clinicians of this volume offer more than advice-they prescribe hope.

    eISBN: 978-0-231-52102-4
    Subjects: Psychology, Sociology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Foreword to the Second Edition
    (pp. vii-viii)
    Nina Schooler

    When Rachel Miller and Susan Mason asked me to update the foreword for the second edition of Diagnosis: Schizophrenia, my first reaction was to ask, “Can you just use what I wrote in 1999?” They graciously said yes, and we agreed that the foreword to the first edition should be included in the present volume. But the ten years since I wrote those words have seen important advances in our understanding of schizophrenia and specific therapeutics available for people early in the course of their illness, as well as in our views of how and when to engage patients and...

  4. Foreword
    (pp. ix-x)
    Nina Schooler

    In 1966, when I was a student, I attended my first case conference in a psychiatric hospital. Sitting around the table were the psychiatrist who was the director of a 150-bed division in this large urban hospital, the patient’s treating psychiatrist, and other members of the treatment team: a social worker, a clinical psychologist, a clinical psychology intern, and other students. The patient we were discussing was a young man who was experiencing his first hospitalization, and everyone seemed to agree that the evidence pointed to a diagnosis of schizophrenia. When the discussion was over, all eyes turned to the...

  5. Introductory Note
    (pp. xi-xiv)
    Rachel Miller and Susan E. Mason
  6. A Note on the Title
    (pp. xv-xvi)
  7. Acknowledgments
    (pp. xvii-xviii)
  8. About the Authors
    (pp. xix-xxiv)
  9. Using This Book
    (pp. xxv-xxviii)
  10. INTRODUCTION: So They Say We Have Schizophrenia
    (pp. 1-4)

    All illnesses are hard to talk about, but schizophrenia seems even harder. For many people the term carries a stigma so strong that just thinking about it is frightening. It reminds them of the strange thoughts, feelings, and behaviors that resulted in their needing treatment. They remember their weird beliefs and hallucinations or their disorganized, isolated, or moody ways.

    Once the symptoms of schizophrenia improve, people want to put the terrifying events of their illness and treatment behind them. They want to forget. Yet, like all other serious illnesses, schizophrenia needs to be talked about. If people do not talk...

    (pp. 5-18)

    For some of us, schizophrenia came on suddenly and turned our lives inside out overnight. Others became ill over a long period of time, so our lives took a slow downward turn. In both cases, treating the symptoms of schizophrenia required hospitalization to keep us safe until our symptoms were under control. It allowed staff to provide treatment in a more complete way: the medication was adjusted to the right level and any reactions were carefully checked and treated. We also had the opportunity to learn more about caring for ourselves. Despite these advantages, we know the hospital experience can...

  12. 2 SO MANY QUESTIONS: The Quick Reference Guide
    (pp. 19-28)

    Some people who have schizophrenia experience symptoms for a long time, possibly many years, before they get help. Other people seem to develop symptoms very suddenly. But as they begin to feel better, everyone has many questions. For this reason, this chapter discusses issues that often worry people as they begin to recover. Here are the most frequently asked questions, with answers by our team at Zucker Hillside Hospital. If you have more questions, write them down and discuss them with the people treating you. You will also find more information in the chapters that follow.

    Sasha: I came from...

    (pp. 29-37)

    When the brain is healthy, it enables us to think, to learn, to feel, to work, and to move. But the brain is a complex piece of equipment, and sometimes it doesn’t function properly. Imagine a computer that has a serious problem with its hard drive. When this happens, the computer will act in unpredictable ways. The same is true for the brain—if the equipment breaks down or malfunctions, our thoughts, feelings, and behavior can become distorted. It might feel as if someone else is in control or as if your brain has a mind of its own.


    (pp. 38-45)

    Schizophrenia is a disease of the brain that affects about one percent of the population. It affects males and females equally, often occurring between adolescence and young adulthood. It disturbs how the brain functions to differing degrees and in different ways. These disturbances, called symptoms, can include delusions, confused thinking, and hallucinations.

    We know that schizophrenia is a medical illness. We also know that it is not contagious. A number of researchers are investigating different possible causes of schizophrenia, but for now the exact cause is unknown. There may be a combination of factors at work (see chapter 5). But...

  15. 5 WHY ME?
    (pp. 46-54)

    It is natural to want to know why this happened to you. Although there is no complete scientific explanation why some people develop schizophrenia, the same is true for many illnesses. There are many mysteries that scientists are just beginning to unravel.

    Some people with schizophrenia wonder if they did something wrong that brought on this illness. Was there too much stress in their lives? Did they do too many street drugs? They often feel guilty or ashamed, angry or sad, even helpless. Remember not to blame yourself or your family. Stay up to date with the latest research findings....

    (pp. 55-63)

    Some illnesses can be detected with an x-ray or a blood test, but diagnosing schizophrenia is more complicated. Doctors gather information about you from you and people close to you, then decide whether your symptoms fit with a diagnosis of schizophrenia or some other psychiatric disorder.

    There are many psychiatric illnesses that share some of the same symptoms. For example, delusions or hallucinations often occur with severe depression as well as with schizophrenia. For this reason, making an accurate diagnosis can take a few days or even a few months.

    To complicate the task further, there are also several different...

    (pp. 64-77)

    It is not easy to know how people will react to your illness. There is a stigma related to schizophrenia based on common stereotypes of people with schizophrenia as frightening, dangerous, and different. Like all stereotypes, these are based on ignorance and generalizations.

    So how do you handle the worry about what people may be thinking of you? First, think about your own preconceptions regarding people with schizophrenia. What did you think before you were sick? Most of the people writing this book had their own mistaken ideas about this illness.

    Zelda: If you have to put a clear label...

    (pp. 78-96)

    A lot of people dislike taking medicine for a lot of different reasons. Medications often have side effects: they can make some people gain weight, drool, or feel tired, strange, or stiff. Other people do not want to take any kind of medicine because of their religious or health beliefs. Still others feel they should be strong enough to control the symptoms themselves without any kind of help.

    Nevertheless, medicine is absolutely necessary for a return to health. For this reason it is important to become familiar with medicines, how they work, and the problems they may cause.

    Buck: I...

    (pp. 97-118)

    At first it may seem that nothing could be harder than the hospital experience, but in the hospital there are many people helping you to recover. It’s when you go home that you face the real challenge. You have more control over your life, which is good. But you also have many important decisions to make that will play a major role in your recovery.

    You may have several options for follow-up treatment. It is not unusual to have some symptoms when you leave the hospital; if you do, you may need to attend a special program during the day....

    (pp. 119-129)

    Each person’s symptoms improve at different rates. Often the hallucinations and delusions decrease more quickly than other symptoms. You may have problems with simple things like getting out of bed, brushing your teeth, or connecting with other people. With treatment and hard work, the obstacles to getting back to your old self become less overwhelming.

    The best way to get help with your symptoms is to consult your treatment team. They will know your individual needs. However, we have included some suggestions that helped us cope with the symptoms we experienced. For definitions of positive and negative symptoms, see chapter...

    (pp. 130-140)

    In addition to the positive and negative symptoms, you may also have some anxiety problems, a depressed mood, or even problems organizing your time. To make matters more complicated, the medication you take to help alleviate the symptoms of your illness often causes side effects that many people have difficulty adjusting to. In this chapter we discuss some strategies to deal with anxiety, concentration problems, and disorganization, as well as side effects such as the weight gain caused by your medication.

    Van: It started when I went to meet my father—I had to keep it a secret. After finally...

    (pp. 141-161)

    Drugs, alcohol, and safe sex are important topics for everyone to understand. If you already have a drug or alcohol problem, then you need to know how this can affect your schizophrenia and what you can do to eliminate drugs and alcohol from your life. If you do not have a problem, then knowing the facts can keep you from developing one. Knowing how to prevent sexually transmitted diseases is also important because these illnesses can add lots of stress to your life.

    Richie: When I was nineteen I was in high school. I was hanging out with the wrong...

    (pp. 162-169)

    After they get home from the hospital, most people say, their families and friends watch them very carefully to make sure that none of the old problems returns. Sometimes family members seem to be reminding them to take their medication several times a day. Attention like this can make you feel very uncomfortable. But remember, these are the same moms, dads, brothers, sisters, aunts, uncles, cousins, grandparents, and friends who walked through the halls of the psychiatric hospital to visit you. They will become more comfortable as you continue to recover—and so will you.

    Gary: A lot of this...

  24. 14 ZELDA’S STORY
    (pp. 170-180)

    This is Zelda’s story. She wanted to explain in detail all the experiences she remembered. For most of us, reading Zelda’s story was comforting. It reminded us that we shared many of the same thoughts, feelings, and behaviors, and that we really are not alone in this.

    Zelda: It doesn’t ruffle my feathers too much to write about all that happened through the few days leading up to and during my six-week breakdown at the hospital. I think now I have a pretty good understanding of myself and my role in what I have been through and where I’m going....

  25. 15 WHO AM I NOW?
    (pp. 181-190)

    This is everyone’s favorite chapter, because here we tell you what is happening in our lives now. Some of us are doing very well. Others have had a tougher time getting or staying on the road to recovery. This may be because we didn’t take our medication or had a harder time finding the right one, or it might be because we used drugs or alcohol. But for all of us this chapter is a testimony to the fact that life goes on and there is hope for a future.

    Joseph: I’m not ashamed of my illness. Everybody has problems...

    (pp. 191-204)

    There are so many things to worry about when you are first hospitalized for schizophrenia. First people worry about whether they will get well. Then they worry about paying the bills for the hospital, the doctors, their medication, and living expenses. These are legitimate concerns.

    Many people get financial assistance and health insurance benefits from government-sponsored programs, in particular, Social Security, Medicaid, and Medicare. Even if you do not currently require assistance, it is important to know if you qualify for it and when it makes sense to apply. Here is some very basic information about social services. If you...

    (pp. 205-210)

    Vocational rehabilitation refers to job training and support services. Vocational programs offer places to meet new people and programs that can help you decide what you want to do with your life. In the process, they help you to build your self-confidence and enthusiasm while giving purpose to your life. There are all sorts of resources, many of which are mentioned in this chapter, that can help you move ahead.

    Anxiety, depression, or unusual thoughts and sensations are generally the symptoms that bring people to a psychiatrist for treatment. Illness may affect life in other important and practical ways as...

  28. Appendix 1. Client Assistance Program Directory
    (pp. 211-214)
  29. Appendix 2. Vocational Rehabilitation Directory
    (pp. 215-224)
  30. Appendix 3. Other Resources
    (pp. 225-232)
  31. Index
    (pp. 233-237)