content warning: discussions of schizophrenia, mental health
Mental Health with Emily Fry
Each year, on the 25th of July, National Schizophrenia Awareness Day takes place: an annual event that seeks to raise awareness of, arguably, one of the most notoriously misunderstood mental health conditions. National Schizophrenia Awareness Day first came into conception after John Pringle, a retired university professor, wrote an open letter explaining his son’s experiences having been recently diagnosed with schizophrenia. Published anonymously by The Times, Pringle’s article served as an impassioned plea urging for greater action to be taken for those who, like his son, were living with schizophrenia. The response to Pringle’s article was overwhelming; hundreds of people wrote into The Times expressing their support for the article and echoing the sentiments of Pringle. Among them were family members and carers who shared concerns regarding the support available for those with schizophrenia – or, perhaps more accurately, lack thereof. All were in agreement that the available support was well overdue significant improvement and careful revision.
It has been fifty years since John Pringle’s article was originally published and it is undeniable that there has been substantial progress made in the way that people with schizophrenia are supported – most notably, there have been vast improvements concerning secure care and early intervention. Regrettably, however, many of the issues first highlighted in Pringle’s article are still just as prevalent today, creating an unnecessary barrier that can restrict those with schizophrenia from being able to lead independent, meaningful and fulfilling lives. For example, many experience great difficulty when attempting to access welfare provisions, as well as employment opportunities and secure housing.
I would like to add, before I go any further, that schizophrenia is not a condition that I have been diagnosed with, nor is it a condition I have experienced myself. My understanding of schizophrenia and how it effects those living with it is purely born from my own efforts to educate myself about this condition and the information I received when I undertook my youth mental health first aid training. It is time that we all make a conscious and sustained effort to understand schizophrenia: we cannot continue to excuse our ignorance and allow those living with schizophrenia to be subject to such demoralising and harmful discrimination. It is time to distinguish fiction from fact; myth from reality. It is time that we acknowledge our unconscious biases, ensuring that our understanding of schizophrenia is as objective, informed and compassionate as possible. It is time we challenge stigma, calling out stereotypes and exposing them for what they are. Put simply, we need to do better: we must continue to educate ourselves about mental health conditions such as schizophrenia so that those experiencing this condition are not made to feel any less of a person, but someone who is loved and valued.
So, what is Schizophrenia? Schizophrenia is a condition that affects the way a person thinks, affecting approximately 1 in 100 people. It is a condition that is related to psychosis – symptoms that occur when you perceive or interpret reality in a different and often distorted way. It is worth mentioning here that, contrary to popular belief, psychosis is not actually a diagnosis itself. Rather, it refers more broadly to an experience, commonly described as a break from reality. It is due to this that psychosis has more traditionally been recognised as a symptom – a symptom that is episodic in its nature. Not everyone who has experienced psychosis finds it helpful to think of it as a symptom, and so it always worth being mindful of this when communicating with a person who has had a past experience or experiences with psychosis. Examples of psychosis include hallucinations, delusions and disorganised thinking and speech. While experiencing psychosis is usually part of schizophrenia, people living with other mental health conditions can also experience it – for example, those living with bipolar disorder. Some of the most common symptoms of schizophrenia include a lack of motivation and/or loss of drive; loss of interest in previously enjoyed hobbies and activities; changes in body language and emotions; persistent issues with social withdrawal; and thinking difficulties with periodic episodes of hallucinations, delusions, restlessness and distress.
The onset of schizophrenia during childhood is rare; schizophrenia is most commonly observed during a person’s early adulthood/adolescence. This early stage is known as the prodromal phase in which a person’s ability to think and communicate clearly – as well as their sleeping patterns, emotions and motivation – start to change substantially. There are many different types of schizophrenia and since I do not have the words to explain them all with the depth, care and attention they are due, I would highly recommend researching these independently if you’d like to learn about the major different subtypes of schizophrenia – paranoid, hebephrenic and catatonic schizophrenia – and the symptoms that are most recognised for these. As is the case with any mental health condition, however, no two people will experience schizophrenia in the same way: where some symptoms are present for some, they may not be present to the same degree in others.
Schizophrenia is widely regarded as one of the more ‘scary’ mental health issues – unlike the more ‘mild’ and ‘moderate’ everyday conditions such as depression and anxiety – and as such, this comes with a particularly poisonous brand of stigma that has soured both individual and collective conceptions of what schizophrenia actually is. The misconceptions surrounding schizophrenia are so pervasive and it is due to this that people living with schizophrenia are so often discriminated against, depriving these individuals of the dignity and the respect that they deserve. Sensationalised media depictions are largely responsible for this, where such mistaken beliefs about schizophrenia have been taken at face-value and have subsequently dominated public perceptions of the condition. These depictions demonise those living with schizophrenia, painting these individuals as people who are potentially dangerous and possibly even violent; people who are often unpredictable on the account of their ‘split personality’; people who should almost always be approached with caution. Then, of course, is the misconception that those who are diagnosed with schizophrenia have no chance of recovery and that their mental functions will only continue to deteriorate as the condition progresses. This is not only a reductive and oversimplified way of thinking, but it is also incorrect.
So let’s have a look at these perceptions in more detail. Despite what people often think, research has consistently shown that only a small minority of people living with schizophrenia are likely to become violent – the same way in which only a small minority of the general population are prone to violent outbursts. In fact, it has been found that those living with schizophrenia are more likely to be on the receiving end of violence, rather than being the perpetrators of violence themselves. Similarly, this notion of a ‘split personality’ is also misguided: the word schizophrenia itself is derived from two Greek words, meaning ‘split’ and ‘mind’, but the idea that people living with schizophrenia having multiple parts of their personality competing against one another does not represent what living with this condition means at all. Furthermore, research has shown that, in spite of what so many think, recovery is very much possible for those diagnosed and living with schizophrenia: improvements in early intervention treatment methods and effective psychiatric medication have allowed recovery rates to improve significantly. In fact, one systematic review concluded that 25% of people diagnosed with schizophrenia recovered completely from their first episode, and a further 25% improved with treatment where they experienced a recovery of (almost) all previous mental functions with very few relapse events. Providing people are given the right care and treatment that is best matched to their individual needs, recovery is actually very likely for many living with schizophrenia.
When we start to look into all these assumptions about schizophrenia, it suddenly becomes increasingly evident that many of the most prominent beliefs are seldom founded in reality – that they are little more than the product of fabrication and misinformation. In order for society to support those living with schizophrenia, we must continue to have an open dialogue about our present understanding of what this condition is and where we are currently failing, and how we can rectify this. Now that society has become more willing to talk about mental health generally, we must use this opportunity to understand and respond to conditions such as schizophrenia which, historically, have remained shrouded in darkness. It is time we shine a light on schizophrenia and ask those living with it for what we can do to do more. It is time we understood schizophrenia and that we do so urgently.
For further reading about schizophrenia, I would recommend looking at both the Rethink Mental Illness and Mind websites. It would also be remiss of me to not mention Nathan Filer’s writing – his fiction book The Shock of the Fall is a beautifully moving and insightful account of living with schizophrenia, and his non-fiction books The Heartland: Finding and Losing Schizophrenia and This Book Will Change Your Mind about Mental Health are incredibly informative and accessible. Jonny Benjamin is also a campaigner whose work is looking into: while Jonny Benjamin is best known for his C4 documentary, The Stranger on the Bridge, he is also very vocal about his experiences with schizoaffective disorder and travels round the country campaigning and delivering testimonies about his lived experiences.
Image courtesy of Canva