Wellness & Fitness

Coping with mental illness


There are very many factors that influence what outcome one gets in cases of depression. PHOTO | POOL

Question: I was diagnosed with schizophrenia. How do I cope during the holiday with extended family?

Your question raises several concerns. You would like to know how to manage schizophrenia, the condition diagnosed by your doctor, and how the festive season might impact the progression of this condition.

In so doing you have assumed that this season can somehow affect this mental disorder.

It is not clear how old you are or how severe the condition you suffer from is because, as your doctor might have told you, these two factors are important in understanding the disease and how it might progress.

We know for example that early-onset schizophrenia (in adolescence) carries, generally a poorer prognosis than in later onset cases.

To put it differently, if you are a young person, still in school/university, it means that your life will be more affected by the condition than say your uncle diagnosed with the same condition in his 40s.

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We will now assume that a qualified person made the diagnosis and that you were put on a treatment regime that might have included medication to treat the condition.

In most cases, the doctor would have prescribed antipsychotic medication, of which there are many types, each given for a particular reason, and each with a specific mode of action and side effect profiles.

In most cases however and relevant to your question, the doctor would have told you several things about the condition, and how to manage it.

He might, for example, have told, you to continue with the medication until he advises otherwise.

In the festive season, some people are inclined to stop the medication, either because of the side effects such as drowsiness or because they experience pressure from friends and family to take some alcohol ‘to celebrate Christmas’.

Both are temptations you must avoid this season.

In other instances, well-meaning but ignorant “experts” will tell you to take time off medication. You must reject this advice.

The temptation to stay up late with family and friends during this season is real and can be most disruptive for you not only because of the need to have adequate sleep, but also because staying up late sometimes means that one takes the medication late, and so wakes up late the following day feeling drowsy.

The medication is then deemed to be at fault.

The other reality is that many people go away over this season, and some stop their medication because they forget to take it during the holiday season.

One must make sure they have adequate amounts of medication to last the entire festive season. Remember that your doctor might also be going away during this season so make sure you catch him early.

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The holiday season is also disruptive of routine which might also affect your exercise routine so highly recommended for good health for all.

Make sure you spare time for this activity. Less well known is the phenomenon called highly expressed emotion which is known to be a negative factor for people with schizophrenia.

During this season, not only are people expected to be happy to be with their family but they are expected to spend many hours together and bury all their hostilities.

There is adequate scientific evidence to the effect that this type of highly expressed emotion is particularly undesirable in people with schizophrenia and other mental disorders.

In this regard, and with the help of the team that is looking after you, you might be able to convey this concern to members of your family.

Dr Njenga is a psychiatrist and mental health consultant who has authored several scientific papers and books.