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Wednesday, February 4, 2009

Recovery Question

Anonymous Drifter from Disjointed Thoughts asked: "I'd like to know why some of those with schizophrenia are so functional despite their illness while others are totally debilitated."

Answer: There are several factors that determine a person's recovery. How one responds to treatment, coping skills, whether negative symptoms are treated, consistent medication compliance, time of treatment, personal history, insight, substance abuse, and support. The statistics mentioned come from a study of 23 cases of schizophrenia patients who have successfully returned to school or work, the study was performed by UCLA.

Everybody is different, Sally may respond to X treatment, but Bob may not. One's success with treatment requires trial and error until the proper medication is found. For example, Carol North tried several treatments for her schizophrenia until finally finding a solution to rid herself of the voices.

How one reacts to stressors is indicative of how they may respond to recovery. A person should limit or reduce responsibilities and stresses for at least six months. After I was diagnosed with schizophrenia I did not go back to work, however, I returned to school after three months, but I only took one class. After one semester I took a break. I just recently started an internship where I work three days out of the week and no more than 25 hours a week. I take everything I do very slow.

Negative symptoms are difficult to treat, once you overcome this you have a pretty good chance at recovery. Negative symptoms include: lack of facial or vocal expression, alogia or poverty of speech, lack of motivation, and decreased pleasure or enjoyment.

Consistent medication compliance helps bring about remission, however, this is not the only element to achieve recovery. Therapy and support play a role as you may discover as you read further. Doctors told my mother I had a better chance of recovery because I was young, very active, and became aware of the illness early on. The sooner somebody treats their illness the better the outcome.

Personal history includes: IQ, education level, work experience, age of onset, intensity of symptoms, and social skills. "A total of 70 percent [of patients]graduated from college before becoming ill, and an additional 13 percent completed two years of college. Three of the remaining four subjects worked full time before their illness began" (http://www.schizophrenia.com/sznews/archives/001994.html).

One study showed the older the person is the better their chances of recovery. This is true because one has been subjected to various life situations where they are able to develop very good social and coping skills in response to stress.

Accordingly, insight into one's illness plays a major role, because they are more likely to try to get treatment for their illness if they accept they have schizophrenia opposed to not sticking to medication regimen and therapy.

Substance abuse is very common among people with schizophrenia for various reasons including self medication to rid oneself of symptoms. However, when one stops abusing alcohol and drugs they have a better chance of recovery. To answer any questions in advance, I was not a victim of substance abuse.

"Though three-quarters of the study participants reported substance abuse prior to treatment, just 17.4 percent reported abuse after the onset of schizophrenia. None reported illicit drug use in the past year, and just two reported occasional alcohol consumption" ( http://www.schizophrenia.com/sznews/archives/001994.html). It is important to not take drugs while on medication, because symptoms can worsen.

In general, having support increases a person's chances of recovery. Good relationships with one's treatment team (i.e. psychiatrist, therapist, social worker, counselor, case manager, etc.) improves stability. Also, family support plays a role too.

Resources:

Christina Bruni, an expert on schizophrenia, from SchizophreniaConnection.com at www.healthcentral.com

The Complete Family Guide to Schizophrenia by Kim T. Mueser, PhD and Susan Gingerich, MSW

10 Keys to Recovery-
http://www.schizophrenia.com/sznews/archives/001994.html

Schizophrenia & Psychosis- Ways to Speed Recovery and Recurrence-
http://www.schizophrenia.com/sznews/archives/004399.html

Prognosis and Recovery Factors of Schizophrenia-
http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=8806&cn=7

2 comments:

Anonymous Drifter said...

Thanks so much for answering my question. I always wondered why some did so well and others didn't.

Summer said...

That makes total sense.