SCHIZOPHRENIA IS a devastating, misunderstood and often puzzling illness that dramatically alters an individual’s thoughts, behaviour and mood. It is a biological disorder of the brain and is characterised by psychotic episodes. Its symptoms include delusions, hallucinations, disorganisations speech and bizarre behaviour.
Because patients cannot distinguish between what is real and what they perceive to be real, they may experience symptoms for several months before seeking help.
It is the white elephant in the back room of the family’s conscience that no one talks about.
Myths. Secrecy. Shame. This is the language in which the experience of the mentally ill in Jamaica is draped, especially schizophrenia. The malaise runs deep in civil society.
Scientists don’t know what causes schizophrenia, but the illness normally appears when the body undergoes hormonal and physical changes in late adolescence and young adulthood. Scientists speculate that people with schizophrenia may have an imbalance of dopamine and serotonin, two key brain chemical messengers that affect the way a person’s brain reacts to sensory stimuli.
Consequently, when these people face a crisis or are under stress, their senses become overloaded by sounds, sights, smells and tastes, which can spill over into hallucinations and delusions.
The good news is that treatment has come a long way from the 1960s and early 1970s, said experts, when the severely mentally ill were written off, given debilitating medications and confined to locked wards.
FACTS ABOUT SCHIZOPHRENIA
About one per cent of the world’s population will develop the disease.
The disease strikes men and women in equal numbers, and typically begins in late adolescence or the 20s. However, in Jamaica more men than women are affected.
Between 10 and 13 per cent of those suffering with schizophrenia commit suicide.
It has been estimated that in 1991 schizophrenia cost the United States $19 billion in direct expenditures and $46 billion in lost productivity (indirect costs), a total of almost $65 billion.
Families of patients with schizophrenia face long-term emotional and financial burdens since children who should be moving out on their own remain at home, unable to function independently.
The discrimination because of schizophrenia increases the suffering associated with the disease for the patient.
“Schizophrenia often attacks bright, creative young men, and it affects them in late
adolescence at a time when they are in the process of becoming young men, just as they are about to attend college and
figure out what to do with their lives. It stumps growth, it
torments families for years, it is a wicked disease,” she adds.
Jonathan is a 22-year-old man trapped in the daily routine of his life.
His days read like something out of the dreams of the ultimate bum: 7:00 a.m. Jonathan gets up. He knocks on his mother’s room door and asks for $20 to buy a bag of weed.
He leaves the house, ‘walks’ for a few hours, and then returns home.
He sleeps.
Eats breakfast.
Watches television.
Then he takes another walk.
Eats dinner.
Plays football.
Sleeps.
This would be the perfect scenario for your typical ‘weed-head’ if Jonathan didn’t feel an incredible urge to change his habits, and interrupt the grey flow of time that has become his life.
“I need a job,” he said recently.
But jobs continue to elude him. No one wants to hire him. Even the applications through the H.E.A.R.T Trust/NTA have the ominous question, ‘Have you ever suffered from a mental illness?’. Jonathan has a double-diagnosis of cannabis-dependency and schizophrenia.
“I began smoking weed when I was 10 years old, and living with relatives in Linstead. I have been smoking weed since then, when I went to school, I began to smoke cigarettes, but I’ve always smoked ganja,” he said, admitting that he continued the habit even while attending Calabar High School in Kingston.
Jonathan emigrated to Canada in 1997, however he soon ran afoul of the law and was shipped home by his father after he was charged for ‘breaking off the side mirrors of a van.
“The son who came home from Canada was not the same person I sent away. He was loud, vulgar and he would break furniture. On some days, he would stoop or stand in the back yard, and stay in that position for day. Rain would wet him, the sun would dry him, and he would be there same way, not moving,” Jonathan’s mother, Portia, said.
Jonathan’s manic ‘episodes’ soon became ‘more disturbing’. His mother was forced to hide the knives in the house, and ‘to stop buying nice furniture’.
“He would wake up everyone on the avenue at 2:00 a.m., ranting and raving to be let outside. I would have to get up and open the grill to let him out. He was hearing voices and seeing things that were not there. He wrecked the place, threw figurines into the wall clocks, kicked over tables…it was sometimes frightening the rage he had,” she said.
HE ATTACKED AND PUNCHED HIS SISTER, NOW SHE’S AFRAID OF HIM
Jonathan was diagnosed as a schizophrenic and cannabis-dependent in 1998. Since then, he has had several episodes, some of them violent.
“While I was driving him to see a psychiatrist one morning, he hit me in the head from behind, I thought I was having a stroke. I then pulled the car over to the soft shoulder, and told my daughter, Trudy to pull her seat belt and get out. I got out taking the keys with me, but Trudy didn’t get out in time. By then, he got out the car, slammed the door, and then when he didn’t see the keys, he became enraged, attacked Trudy, punching her several times.
“I ran and grabbed him, and he began to run through the traffic on the Ferry, a policeman ran him down and grabbed him. Later, he took him to the psychiatrist for me, and then to Ward 21. I never got the chance to thank that policeman,” she said.
Understandably, Trudy, Jonathan’s sister does not speak to him anymore.
“She’s afraid of him. After the incident, she had to see at least three doctors, and she shook like a leaf whenever she saw him. Now, she just avoids him.”
Jonathan dismissed the incident with a wave of the hands, ‘I was having a really bad day’.
Asked if he’s tried to make it up to her since the incident, Jonathan said:
“She doesn’t understand herself…she tells me all the chairs in the house belong to her,” he said, nonchanantly.
Mrs. Williams has had a hard time dealing with Jonathan’s illness, especially since neither her son’s biological father, or his step-father have tried to help him during his illness.
“I have had to a do a lot myself, this is a fundamental problem when the child does not belong to the husband; they are just not tolerant. The ironic thing is that my husband and Jonathan’s father are good friends. Jonathan’s father feels Jonathan is just a rebellious good-for-nothing youth who wants to smoke week and not work.
As if to underline this point, Mrs. Williams’ husband comes outside on the verandah.
“We’re speaking about Jonathan,” she explains to him.
“Well, somebody has to,” he says curtly before leaving the house.
Enough said.
“Jonathan’s father is in denial. He is a successful engineer, and he must be saying to himself, how can I produce a son who is like this? Jonathan should be a pilot, lawyer or a doctor, but instead, he has stagnated to this level where he does nothing all day long,” she said.
“Schizophrenia often attacks bright, creative young men, and it affects them in late adolescence, at a time when they are in the process of becoming young men, just as they are about to attend college and figure out what to do with their lives. It stumps growth, it torments families for years, it is a wicked disease.”
At one time, the constant ganja-smoking caused him to lose a lot of weight.
“He looked demonic…I wished he would just die, I just thought he was suffering, and wondered if maybe it would be better if he just died,” she said.?
Over the last two years, Jonathan has improved, he initiates conversations. He is very lucid now. He still sleeps a lot but he readsThe Sunday Gleaner to look for jobs.
“However, he just doesn’t seem to follow through on the application,” she said.
Some people think that Jonathan’s mother encourages his drug addiction. She acknowledges this assessment but added:
“If I don’t give him the $20 to buy weed, he makes my life a living hell. He sneaks into my room, overturns my drawers, uproots my mattress, looking for money. I can’t just abandon him. I don’t know if I have the heart to drive past him while he’s eating out of the garbage on the streets. It’s a strain on the family, but I can’t give up.
He took a four-month computer course last year but the job market continues to give him the cold shoulders. He no longer takes pills because they make him drowsy and sick but he gets his shots once every six weeks.
“I respect my moms, she always bats for me, and I want to repay her, and help her out so I need a job…the last time I worked was as a cashier during the Summer a few years ago…I just need a job,” he said.
Can you stop smoking weed?
“I can go cold turkey anytime. I went six months straight without smoking ganja at one time.”
Right now, Jonathan has no girlfriend because “they can’t call me or come here to see me”.
“The last girlfriend I had was a few months ago, I stopped calling her, and she didn’t call me back, but in the future, I hope to settle down and lead a normal life.”
Who develops schizophrenia and when
EARLY DETECTION of mental illnesses, especially schizophrenia, plays a key role in ensuring the recovery of afflicted individuals so that they can lead normal, productive lives in society.
As it relates to schizophrenia in Jamaica, males seem to be particularly susceptible to the disease than women in Jamaica.
“We see more males than females in the system who are being treated for schizophrenia,” Mylie McCallum, community mental health officer in the Ministry of Health, said.
“There is no conclusive trend that can be established from this but it suggests that women may be going for treatment earlier, are able to arrest the disease quicker than men are able to. There are women with a predisposition for the illness that never suffer a breakdown, because they seek treatment faster, are more willing to accept help, and choose to share and talk about their problems more,” she said.
“Men sometimes behave like they’re too strong and know all the answers, and they ignore the problem in its early stages till it becomes chronic and they get out of control,” Ms. McCallum said.
Schizophrenia usually emerges between the ages of 13 and 25 and often appears earlier in males than females. Symptoms include disordered thinking, paranoid delusions, hallucinations, and extreme apathy and social withdrawal.
Overall, more persons are seeking community mental health services to deal with schizophrenia. In 1999, there were 28,812 schizophrenic cases treated in the island. But last year that number jumped to 31,887.
In Kingston and St. Andrew alone, there was an almost 2,000 per cent increase from 239 cases in 1999 to 4,654 cases in the year 2000.
“The increase is not because there are more cases of schizophrenia, but because of an increase in the overall number of mental health officers, therefore, the service was able to see more patients on a regular basis than before,” Ms. McCallum said.
WARNING SIGNS
When schizophrenia begins in adolescence, the warning signs such as changing moods, personality changes, depression, difficulty concentrating and withdrawing from the family, are sometimes assumed to be just normal teenager behaviour.
However, in normal adolescence, moodiness, depression and other such behaviours only last for a few days at a time, while with schizophrenia, the moods go on and on.
Teenagers who are developing the disease, sometimes withdraw from their friends and families – this is different from most teenagers who may withdraw from their families sometimes, but not usually their friends.
CONTACT PERSONS
MENSANA
Joan Browne: 924-2434; Carol Narcisse:
925-7615;E-mail: carphen@jol.com.jm
FERDIE’S HOUSE (876) 927-6331
Committee for the Upliftment of the
Mentally Ill (CUMI) 957-8737
MINISTRY OF HEALTH
Mylie McCallum 967-1100
You can call 930-1152 in the South East health region of the country, or 852-5100-9 in Western Jamaica for help from community mental health services with a person you suspect or know to be mentally ill.
