National Schizophrenia Awareness Day
For National Schizophrenia Awareness Day, we spoke to Dr Maria Antonietta Nettis, a consultant psychiatrist currently working at the National Psychosis Unit at the Bethlem Royal Hospital. Day to day, Dr Nettis works with people who suffer from complex psychosis and schizophrenia that is difficult to treat.
Dr Nettis shed light on the condition, highlighted some of the stigma and why it exists and offered some helpful tips for treating and supporting individuals with Schizophrenia.
What is schizophrenia?
Dr Nettis: “Schizophrenia is a serious mental illness and a long term, often chronic condition. The condition is usually diagnosed between the ages of 16 and 30 depending on a number of factors. It is very important, from a clinical point of view, to identify and treat it early.
It is a condition that can affect the way people think or the way they behave. Often, this can be seen as scary or perceived as distressing for those around them. Those with the condition are not as likely to carry on with their usual activities but with the right medication and support, they can have a very good quality of life.”
What are the symptoms?
Dr Nettis: “The symptoms of schizophrenia can be different for each person but generally speaking, there are three main categories: positive, negative and cognitive.”
Positive symptoms refer to things that are “extras” compared to the general population and shouldn’t be there. For example:
- Hallucinations, such as hearing or seeing things that are not there
- Delusions: false beliefs that cannot be shaken, no matter how strong the evidence against them
Negative symptoms are things that are absent or lost compared to the general population. For example:
- A lack of motivation
- Little to no interest in social activities
- Reduced self-hygiene and personal care
- Feelings of apathy
- Becoming isolated
Cognitive symptoms affect mental processes and include:
- Lack of attention or focus
- Problems with remembering things
- Difficulty processing information
Are there any people who are more at risk?
Dr Nettis: “Schizophrenia has a genetic risk and often runs in families. It doesn’t necessarily mean that if someone has a relative with the condition, they will certainly develop symptoms of schizophrenia, but it does increase their risk. There are also environmental factors that contribute to the risk, such as living in a stressful environment, conditions of poverty, danger, exposure to diseases or malnutrition, all contribute.”
Why is there such a stigma around the condition?
Dr Nettis: “With mental health in general, there is still a strong sense of embarrassment around being mentally unwell or taking medications, for both individuals and their families. One of the big issues with schizophrenia is that it feels like those affected have lost touch with reality which can make them seem unpredictable. This narrative has been exacerbated by the media and movies, painting those with the condition to be angry, dangerous, violent and aggressive. Actually, those with the condition are some of the most vulnerable and likely to be on the receiving end of abuse.”
Can you tell us a bit more about the research going on around the condition?
Dr Nettis: “There is always research being conducted to understand the causes of schizophrenia and possible treatments. A big field of research focuses on the brain structure, on how different brain areas are connected and how this differs from the general population.
There is also a lot of research around the role of the immune system and the role of the gut microbiota. Interest in this field has peaked in the last decades and there is so much that is not yet known. However, it could guide future research for new treatments.
Indeed, the research around treatment is getting much more advanced and is focusing on new targets, and hopefully, we will have new ways to treat the more difficult symptoms in the future.”
What can we do to help and support individuals with schizophrenia?
Dr Nettis: “The most important thing is to gather information about the condition, treatment, symptoms and talk to people with lived experience. We tend to be afraid of what we don’t know, so the more knowledge we have, the better equipped we can be to support and help them.
It is so important to show empathy. We shouldn’t assume that we have all the right answers or that our experience and knowledge is always right. Many of those with the condition have a history of trauma, bullying, losing loved ones or family due to their condition, so we need to keep these factors in mind when building rapport and trust.
We should listen to those supporting or caring for those with schizophrenia. Carers usually have the most valuable information on how their relatives have been, what is working, what isn’t working and often this can be more reliable than us trying to give everyone the same type of care.
Finally, encouraging participation to research is vital. Encourage the patients (if they have capacity and can retain the information), encourage the carers and even other members of staff to participate in research. If we promote an inclusive and diverse research participation, research findings will inform a clinical care that is helpful for all.
