IN THE RING OF LIFE: A CASE OF SCHIZOPHRENIA.

Esra was a middle-aged public servant who had worked diligently for over two decades. He was excellent at his job and a family man with children. As the breadwinner of the home, he took his role and responsibilities as a father seriously and ensured that the needs of his dependants were provided for. However, his employer suddenly asked him to proceed on early retirement. This was met with utter shock and disbelief; he was yet to complete the family building and prepare adequately for his exit from the job.

He had so many unanswered questions but the decision was final. Together with his family, they had few months to pack out of the government home facility. With his wife Emi’s support, they quickly prepared to relocate to their new home. Eventually, the deadline given them elapsed and Esra was compelled to exit the home and profession he had known all his life to begin a new chapter.

Esra later got employed in a private company. The salary and job satisfaction was not close to his former job but he accepted it because he felt it was a better alternative than being unemployed. One day, he returned from a trip and upon entering his home, his family heard him shouting and addressing no one or anything in particular. He told them he could see ghosts running after him, was hearing voices and could even smell them. He was restless repeatedly saying that some people were there to kill him. The months after that, he could not remain at his new job. He became socially isolated, was often aggressive and refused others access to his home. He was certain some forces seen only by him were always present to harm him and his family. Simply put, he had lost touch with reality!

Emi, concerned about her husband’s condition sought help from spiritual healers which did not yield much positive results. Esra was taken to the general hospital and was admitted but he self-discharged and left the hospital the next day. It was obvious now that his condition was a mental health condition which kept deteriorating by the minute although he was physically fit.

Eventually, his wife was advised to seek psychiatric intervention for her husband but she did not like that idea; she preferred to keep him indoors away from public scrutiny. Subsequently however, she decided to explore the psychiatric option. When she informed her husband about the need for psychiatric treatment, Esra refused and insisted that he was “not mad”.

The condition however deteriorated to the point where Esra lost his new job and was unable to secure another one. He stayed home all day and was constantly in an agitated state; he would throw out belongings of the family as well as attempt to inflict harm on others around him. He was uncontrollable and as he continued to see and hear things, he suffered from sleeplessness. His family was thrown into a state of misery and they had to restrain him from engagement with others and keep him indoors at all times to avoid any negative implications.

At this point, his wife had to make the difficult decision of reporting Esra’s case at the psychiatric unit. When she eventually took him to the hospital, Esra was detained, assessed and diagnosed with schizophrenia. He was immediately placed on medication. After over a decade on medication, Esra continues to live fairly well with his family.

According to the National Institute of Mental Health (2023), Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem as though they have lost touch with reality, which can be distressing for them and for their family and friends. It is true that schizophrenia can make it difficult for the patient to participate in everyday activities but effective treatments are available. Many people who receive treatment can engage in school or work, achieve independence, and enjoy personal relationships.

The types of Schizophrenia include paranoid, disorganised or hebephrenic, catatonic, undifferentiated and residual. Research shows that the causes of schizophrenia are genetic, psychological and environmental and the symptoms are positive and negative. Positive symptoms which represent distortions or excesses of normal functioning can diminish in intensity with treatment. They include delusions, perceptual distortions, disorganised thought and speech as well as disorganised motor disturbances. The negative symptoms are associated with a poor prognosis and may be the result of structural abnormalities in the brain. They include an inability to be goal-oriented, lack of meaningful speech and little or no emotion in situations in which strong reactions are expected (an example is when a part of the body is rotting away but the patient shows no concern or worry).

Factors like denial, fear of social stigma associated with seeking psychiatric treatment, beliefs and over-reliance on spiritual healing methods, financial challenges as well as lack of understanding of psychotic conditions and treatment may account for families and individual’s inability to seek early interventions for mental health conditions like schizophrenia. However, early medical assessment and diagnosis by professional mental healthcare providers including community psychiatric nurses, therapists, counsellors, psychologists and psychiatrists is crucial to avoid worsening of such cases. Available treatments for schizophrenia aims at helping individuals with symptom management, improving day-to-day functioning, and achieving personal life goals, such as completing education, pursuing a career, and living fulfilling relationships.

Every day on the streets of Accra in Ghana for instance, many individuals suffering from the condition are left uncared for and unattended to. The sight is heartbreaking and worrisome. A question that begs a response is “where is their family?” As members of society, we are encouraged to embrace people suffering from schizophrenia as well as their families by offering support, care and empathy instead of stigmatisation and withdrawal from them. As we seek appropriate healthcare for malfunctions in other parts of the body, schizophrenic clients and their families should be receptive to the idea of seeking psychiatric or psychological treatment.

Schizophrenia is not a contagious illness. It can affect individuals irrespective of gender, age, race and status. Clients should not be subjected to fears of losing their jobs or social ridicule while they manage the condition and strive to navigate through life. Families should also seek counselling or therapeutic support to enable them cope with the changes related to managing the condition.