Questions

A. A mental disorder or illness as defined by the National Mental Health Strategy is "…a diagnosable illness that significantly interferes with an individual's cognitive, emotional or social abilities. There are different types and varying degrees of severity of mental illness. Examples of mental illnesses include depression, anxiety, substance abuse, bipolar disorder and schizophrenia." (Mental Health Promotion and Prevention National Action Plan 1999)

Q. Is it common?

A. Yes. The number of people who develop mental illness is very common and on the rise worldwide. About 20% of the Australian population experience some form of mental disorder, and around 3% - more than half a million Australians - will experience psychotic illness such as schizophrenia or bipolar disorder at some stage in their lives. The World Health Organisation has estimated that in the year 2020 depression will constitute one of the greatest health problems worldwide.
 

Schizophrenia Disorder – 2.2 million

Panic Disorder – 2.4 million

Bipolar Disorder – 2.3 million

Obsessive Compulsive Disorder – 3.3 million

Major Depressive Disorder – 9.9 million

Mental health disorders affect more than 44.3 million Americans.¹ Schizophrenia, the most severe of these disorders,² affects nearly 2.2 million Americans.³ The total direct and indirect costs of schizophrenia in the United States in 2000 were approximately $40 billion, more than the entire budgets of the National Institutes of Health ($15.5 billion) and the VA medical system combined ($18.2 billion).
 

Q. What is schizophrenia?

A. Schizophrenia is a serious biological brain disease that affects thinking, perception, mood and behaviour. The term covers a number of related disorders, all with overlapping symptoms. People usually develop the first symptoms of schizophrenia in adolescence or early adulthood. It can develop in older people, but this is not nearly as common. Some people may experience only one or more brief episodes in their life. For others, it may remain a life-long condition. The onset of the illness may be rapid, with acute symptoms developing over several weeks, or it may be slow, developing over months or even years. People who develop schizophrenia may experience the following symptoms:

• Hallucinations: most commonly involving 'hearing' non existant voices. Other less common experiences can include seeing, feeling, tasting or smelling things which are not actually there.
• Delusions: false beliefs or persecution, guilt or grandeur or of being under outside control. People with schizophrenia may describe plots against them or of having special powers and gifts. Sometimes, they withdraw from people or hide to avoid imagined persecution. the following abstract from: Welcome, Silence. Carol North, a psychiatrist who suffered from schizophrenia throughout her childhood and adolescence describes some of these experiences.
  "I continued feeling suspicious of my classmates. They seemed to have a conspiracy. They were going to make me flunk out, simply by pooling their mental powers and willing it into my brain. In my paranoid state of mind I became hyper-vigilant, interpreting my classmates' normal conversational gestures as secret signs to each other about me. A casual glance at the ceiling by one of my classmates was really disguised a cue to someone else. I became preoccupied with trying to put together meaningful ideas from fragments of conversation I overheard, assuming they were part of the conspiracy. It was impossible for my friends to talk me out of my delusions."
• Thought Disorder: where the speech may be difficult to follow, jumping from one subject to another with no logical connection. Thoughts and speech may be so jumbled and disjointed that the person may think someone is interfering with their mind.
• Loss of drive: some people may find it very difficult or even impossible to engage in everyday activities such as washing, cooking etc. This reduced ability to do things is not laziness, it is part of the illness.
• Blunted emotions: is where the ability to express emotion is greatly reduced and is often accompanied by a lack of response or an inappropriate response to external events such as happy or sad occasions.
• Social Withdrawal: this may be caused by a number of factors including the fear that someone is going to harm them, and the fear of interaction with others which may be caused by a loss of social skills.

Q. What causes schizophrenia?

A. No single cause has been identified, but a number of different factors are believed to contribute to the onset of schizophrenia in some people:

• Genetic factors - a predisposition to schizophrenia can run in families. In the general population, only 1% of people develop it. If one parent lives with schizophrenia, the children have a 10% chance of developing the condition - and a 90% chance of not developing it.
• Biochemical factors - Certain biochemical substances in the brain are believed to be involved in this condition, especially a neurotransmitter called dopamine. One likely cause of this chemical imbalance is the person's genetic predisposition to the illness.
• Family relationships - No evidence has been found to support the suggestion that family relationships cause the illness. However, some people with schizophrenia are sensitive to any family tension which, for them, may be associated with relapses.
• Environment - It is well recognised that stressful incidents often precede the onset of schizophrenia. They often act as precipitating events in vulnerable people. People with schizophrenia often become anxious, irritable and unable to concentrate before any acute symptoms are evident.
• Cannabis - Use of street drugs such as Cannabis may cause a condition known as drug-induced psychosis. This usually passes after a few days, however, if someone is vulnerable or has a predisposition to developing a psychotic illness such as schizophrenia , these drugs may precipitate the first episode in what can be a lifelong, disabling condition.
  From Surviving Schizophrenia: Straight Talk for Family and Friends by Maryellen Walsh.
  "At different times in history, people's ideas about the causes of schizophrenia were tied to whatever notions were 'hot' in their particular cultures. In the Middle Ages, for example, when people couldn't think of what to say about the causes of schizophrenia they blamed it on the devil. In the 1950's and 1960s, when people couldn't think of what to say about the cause, they blamed it on the parents. Now people blame schizophrenia on stress. To each age its own scapegoat."

Q. Is schizophrenia curable?

A. Not yet. But scientific progress is being made - albeit slowly. Lack of funding is a big problem, probably our biggest. Despite the prevalence of schizophrenia and the devastation it creates for its victims and their families, funding into this little understood disease is abysmal. Whilst there is no known cure, the effects of the illness can be alleviated for most people with the careful use of medications and professional, social and societal support.

Q. What is the treatment?

A. The most effective treatment for schizophrenia involves medication, psychological & social treatment and rehabilitation in the community. The use of anti-psychotic medications has revolutionised treatment of schizophrenia. Most of these medications work to inhibit the action of dopamine (a "neurotransmitter', or chemical in the brain, that helps cells communicate with each other). Faulty dopamine action has been blamed for some forms of schizophrenia.

Some people will need to stay on medication indefinitely to prevent a relapse. Schizophrenia is an illness, like many physical illnesses. For example, insulin is a lifeline for the person with diabetes; anti-psychotic drugs are a lifeline for a person with schizophrenia.

Medication, along with society's understanding and support makes it possible for many people with schizophrenia to lead reasonably normal lives in the community.

Q. Are mental disorders a form of intellectual disability or brain damage?

A. No. They are illnesses just like any other - heart disease, diabetes, asthma. Yet the traditions of flowers, sympathy and support provided to those with a physical illness are often denied to those with mental disorders.

Q. Are people with a mental illness usually dangerous?

A. No. In fact, this false perception underlies some of the most damaging stereotypes. People with mental disorders are seldom dangerous. Research shows that people being treated for mental disorders are no more violent or dangerous than the general population.

Q. Do people with schizophrenia have a split personality?

A. Absolutely not. Schizophrenia is however, commonly confused with split personality or multiple personality disorders. These are two entirely different disorders with entirely different symptoms and origins.

Q. Do people recover from schizophrenia?

A. Yes.  Many people recover in the short term, over a period of weeks or months.  Most others recover or significantly improve over longer periods of time.  Schizophrenia is not yet curable but it can be effectively treated.

MYTHS AND MISUNDERSTANDING

Myths, misunderstanding, negative stereotypes and attitudes surround the issue of mental illness and, in particular, schizophrenia. The result is stigma, isolation and discrimination. Stigma towards people with a mental illness has a detrimental effect on their ability to obtain services, their recovery, the type of treatment and support they receive, as well as their acceptance in the community. Discrimination and community misconceptions remain among the most significant barriers to people with a mental illness being able to actively participate in the community and gaining access to the services they need.

FACTS as at 1996

• 250,000 Australians suffer from a serious mental disorder
• One in five people have or will develop some form of mental disorder
• 1% of the population (170,000 Australians) live with schizophrenia
• 2% of the population (340,000 Australians) live with bipolar disorder
• 10% of Australian adults suffer from depression
• 15% of adolescents experience some form of mental health problems
• 1% of adolescents have serious psychiatric disorders
• 90% of mental illnesses start in adolescence; 16-18 years
• 246,500 15-20 year olds have psychotic disorders and warrant attention
• 82,000 need psychiatric intervention
• 16,000 require specialist psychiatric care
• 50% of first psychotic episodes are associated with drug use
• 30% of young people in remand and correctional facilities have mental health problems.