Schizophrenia and young people
Schizophrenia frequently presents in the teenage years and this is associated with a poor long-term outcome. It affects girls and boys equally, with boys presenting at an earlier age. About one in 100 of the population are affected and there is a familial tendency, with the child of a schizophrenic having a one in 10 chance of developing the disease.
Initial symptoms of schizophrenia may not always be clear-cut and an eventual diagnosis of schizophrenia may make sense in retrospect, as an explanation of difficult behaviour or strange moods. Depression or social isolation may feature as symptoms and there may be an exaggerated sense of self-consciousness, with the adolescent convinced they have some dreadful facial disfigurement, for example.
Schizophrenic illness may be precipitated by stressful events. If this is the case there is usually a better prognosis than if there is an insidious onset.
The adolescent with schizophrenia may be acutely disturbed, sometimes demonstrating violent behaviour. Committal to hospital may be the only option at this point, with families often accepting this course of action.
In the chronic phase of schizophrenia, interest in social encounters is diminished and personal hygiene may be poor. These may be the hardest things for relatives to cope with and may be interpreted by them as laziness. The parents and family of a newly diagnosed schizophrenic may have confused and bitter feelings about both the diagnosis and their child; if so, family counselling may be appropriate.
Care of the carers is also an important aspect of looking after the family of a schizophrenic. Life may be difficult for both the person with schizophrenia and the other family members. Schizophrenics whose families remain loving and caring towards them without being over-involved have the best prognosis of sustained recovery. This is not easy and the family will need a lot of support.
Advice to parents of a schizophrenic:
- Try not to spend too much time together. Annoying habits will be less irritating.
- Some of the things that cause the most family strife may be symptoms of the disease rather than stubbornness, eg. refusing to get out of bed or wash. It helps to understand this.
- Make sure your child takes medication regularly, even when well.
- Dont try to bring the deluded adolescent back to reality. You wont succeed. Dont agree but rather stay neutral and uninvolved in the teenager's delusionary behaviour.
- Keep life as steady and uneventful as possible. Unexpected events can precipitate episodes. Inform the adolescent in advance if things are going to change.
- Encourage independence in the youngster, with life being as normal as possible.
- Take time off from caring.
- Dont expect too much too soon. Initial recovery may be quite quick and then continuing progress painfully slow.
- Join a support group such as the Schizophrenia Association of Ireland.
- Accept that the time may come when it will be better for your son or daughter to live in a hostel. This is not betrayal or failure as a parent. Many schizophrenics do better living independently away from their families.
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