Schizophrenia: Symptoms, Treatment, and Family Concerns

What is schizophrenia?

My sister (21 years old) has been staying at home without work for a long time.
A year ago, she started feeling like there were hidden cameras in our house, became afraid to watch TV, would sit in the corner and laugh inappropriately, and felt like someone was following her while walking outside.
She has been seeing a psychiatrist for almost a year, and the doctor diagnosed her with paranoid schizophrenia.
Currently, I have noticed that although her feelings of being followed have improved, she has started to exhibit slowed movements and a blank stare.
According to her, she feels weakness in her limbs, is always sleepy, and firmly believes that she is not ill.
She even regrets and questions whether she should have let the family know about the supposed hidden cameras, thinking that it led her to perceive herself as sick when she is not.
Are these conditions normal for her illness? Given her insistence on her beliefs and the various side effects, our family is beginning to doubt whether it was right to take her for treatment in the first place.
If we stop her medication and treatment now, would that be better?

Kang Si Ru, 20~29 year old female. Ask Date: 2002/05/28

Dr. Li Junren reply Psychiatry

Hello, your sister is exhibiting typical symptoms of schizophrenia, which is a brain disorder.
After the onset, patients experience abnormalities in judgment, thinking, emotions, and behavior.
Most patients firmly believe they are not ill (because their judgment of reality is impaired, they cannot recognize their bizarre thoughts or behaviors).
Over 70% of schizophrenia patients can improve with treatment; without it, many will gradually deteriorate.
This is a chronic condition that requires ongoing treatment to be effective.
The symptoms you described, such as slowed movements, lethargy, weakness in the limbs, and constant sleepiness, may be side effects of medication.
However, these side effects can often be improved through medication adjustments.
It is essential to discuss with your sister's treating physician how to minimize these side effects, which should yield satisfactory results.
Stopping medication will not improve her condition; continuous treatment and discussing the treatment plan with the physician is the way to resolve this issue.
Wishing your sister a speedy recovery.

Reply Date: 2002/05/28

More Info

Understanding schizophrenia, particularly in the context of your sister's experiences, is crucial for both her well-being and your family's ability to support her. Schizophrenia is a complex mental disorder characterized by a range of symptoms, including delusions, hallucinations, disorganized thinking, and impaired functioning. In your sister's case, her experiences of believing that her home is under surveillance and feeling followed are indicative of paranoid delusions, which are common in schizophrenia.

Symptoms and Their Implications
Your sister's symptoms, such as the belief in being monitored and her subsequent behaviors (e.g., sitting in a corner and laughing), suggest that she is experiencing significant distress and altered perceptions of reality. The improvement in her paranoia is a positive sign, but the emergence of new symptoms like psychomotor retardation (slowed movements), feelings of weakness, and excessive sleepiness can indicate a few things:
1. Medication Side Effects: Antipsychotic medications, which are commonly prescribed for schizophrenia, can have side effects that include sedation, lethargy, and motor slowing. If she is on medication, these symptoms might be related to her treatment.

2. Progression of the Illness: Schizophrenia can manifest in various ways, and the emergence of new symptoms may suggest that her condition is evolving. It's essential to monitor these changes closely.

3. Psychological Factors: The belief that she is not ill and her regret about disclosing her experiences may reflect a lack of insight, which is common in schizophrenia. This can complicate treatment, as individuals may resist medication or therapy.

Treatment and Family Concerns
The decision to seek treatment for schizophrenia is often challenging for families. It is understandable to question whether bringing her to a psychiatrist was the right choice, especially if she seems to be struggling with new symptoms. However, early intervention is critical in managing schizophrenia effectively. Here are some considerations:
1. Continuing Treatment: Stopping medication abruptly can lead to a relapse of symptoms or worsening of her condition. It is crucial to consult her psychiatrist before making any changes to her treatment plan. The doctor can assess her current symptoms, adjust medications if necessary, and provide guidance on managing side effects.

2. Family Support: Family involvement is vital in the treatment of schizophrenia. Open communication about her feelings and experiences can help her feel supported. Encourage her to express her concerns about her treatment and any side effects she is experiencing.

3. Education and Resources: Educating yourself and your family about schizophrenia can help reduce stigma and improve understanding. Resources such as support groups for families of individuals with schizophrenia can provide valuable insights and coping strategies.

4. Therapeutic Approaches: In addition to medication, psychotherapy can be beneficial. Cognitive-behavioral therapy (CBT) can help her manage symptoms, challenge delusional thoughts, and improve her coping strategies. Discussing the possibility of therapy with her psychiatrist may be worthwhile.

Conclusion
In summary, your sister's symptoms and experiences are part of a complex mental health condition that requires careful management. While it is natural to have doubts about the treatment process, it is essential to maintain open lines of communication with her healthcare providers and to support her through her journey. Stopping treatment without professional guidance can be detrimental, so it is crucial to work closely with her psychiatrist to find the best path forward. Your family's understanding and support can make a significant difference in her recovery process.

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