When I first heard of the word Schizophrenia I was in my 2nd year of undergraduate studies and the word was coming from my roommate who was a 3rd year undergraduate student in Psychology Department. It was one of those high sounding, complicated words that left you in awe at the sound of it and filled you with a sense of accomplishment after learning to pronounce it properly. “Schizophrenia” I’d whisper to myself once in a while, rolling the word around my tongue and grinning happily at my new found vocabulary. Months later, when I finally discovered the true meaning of the word, I cringed in fear. Schizophrenia was in reality a technical term used in the field of Psychology and Neuroscience to describe a type of a severe mental illness known generally as Psychosis. In essence it was a word used to describe a mad person.
What is Mental Illness
Mental illness is actually a broad term used to describe a large range of neuropsychological disorders ranging from mild to severe. Different forms of mental illness can be grouped into broad categories according to their etiology and symptoms. Some of these broad categories include:
- Anxiety Disorders
- Mood Disorders
- Eating Disorders
- Psychotic Disorders
Among these broad categories are subsets of specific disorders under which an individual can be classified based on the kind of symptoms s/he exhibits and the duration of the symptom. The Diagnostic and Statistical Manual V i.e. DSM V is the current psychological tool/manual used to diagnose a particular kind of mental illness. It contains list of all categories of mental illness, their subsets, symptoms of each subset and duration of exhibition to enable a trained physician make a precise diagnoses of the mental illness condition in order to recommend appropriate levels of treatment.
What is Schizophrenia
Schizophrenia – the high sounding name I earlier mentioned is a subcategory of the broad category Psychotic Disorder. It is a serious brain disorder characterized by a profound disruption in cognition and emotion, affecting the most fundamental human attributes such as language, thought, perception, affect and sense of self. Its array of symptoms includes:
- Hallucinations i.e. Hearing internal voices or experiencing other sensations not connected to an obvious source
- Delusions i.e. Assigning unusual meanings to normal events or holding fixed personal beliefs
- Others include withdrawal, incoherent speech and impaired reasoning1
These symptoms can be scary to a normal individual such that one begins to imagine what it will be like to find oneself face to face with a schizophrenic patient. Hence, when it was announced last month in my MSc. class that a visit to a neuropsychiatric hospital will constitute part of the coursework for a course I was taking, I was filled with apprehension. The d-day came faster than I expected and before I knew it, we were at the hospital to meet with the patients.
A day of briefing, visits around the facility and in-depth lectures took care of the first day’s activities. The next day was dedicated to encounter with the patients where we were scheduled to carry out psychological assessment sessions as part of our practical. As we were led into the assessment room to meet with the patients, my heartbeat began racing faster and faster, my mouth turned dry, all my mental preparations fled me and I was almost visibly shaking with fear. It was only the memory of the 40 marks the practical session carried that kept me from fleeing the scene. This memory in mind, I braced myself for the ordeal and followed the supervisor into the room where I and my colleagues were each assigned chairs and tables to meet with the mentally ill clients.
Among the clients ushered into the room was a pretty dark skinned lady of about 27 years or there about. Well attired in a loose flowing dress in traditional prints. She had her hair plaited back in corn rows and a little smile played around the corner of her lips. I, still in fright gazed on dazed as the supervisor assigned each client to an assessor. The pretty dark skinned lady however, did not wait to be assigned but walked up to my table smiling and introducing herself as Tara. The supervisor did not find anything wrong with the arrangement and left us together to begin.
I returned her smile – albeit shakily at first – introduced myself, shook her hand, motioned for her to have her sit and struck up a conversation with her in as light a manner as possible, such as I will speak with a “normal” lady friend. Her bright and friendly manner made talking with her so easy that before long, I soon forgot I was speaking with a mentally ill patient. At the end of a two hour, very enlightening and thought provoking session, I concluded the interview, accompanied her to her ward, thanked her for an enlightening and pleasant conversation and took my leave.
Returning to my notes afterwards to write up my report, I was struck by how quickly we had fallen into a pleasant animated conversation that I had momentarily forgotten I was speaking with mentally ill patient. Had our conversation been taken at face value, there seem to be absolutely nothing wrong with Tara as she was quick to remind me every once in a while during our conversation. But using the criteria of the DSM V to classify the information garnered from our two hour long conversation, Tara was suffering from a type of Schizophrenia called Paranoid Schizophrenia.
You see, Tara a 24 years old lady believed she was the daughter of a popular French Canadian Musician and that she Tara, was an American (This was her delusion which she strongly believed in and nobody could shake her from this belief). She also strongly believed she was kidnapped and brought to Nigeria by strange unknown beings. Only she and no one else could see or hear them and she was constantly reported to be having deep conversations with the beings to the bewilderment of everyone around her (Hallucinations). When I questioned her about this, she informed me that the beings were negotiating the terms of her death with her so that she will never see her Canadian pop star mother again. She told me all these in a clear, unwavering voice with the smile never leaving her face, adding that as she was a trained Lawyer – even if she never completed primary education – she was soon going to a court to sit as a judge and pass judgment on the beings in order to thwart their plans of killing her. She then implored me to prevail on the doctors to release her as she was not insane.
As I made my way home with the rest of my colleagues at the conclusion of the visit, I marveled at how one so mentally ill could also be so normal and so like us in some ways. I began to ponder how different their world seemed from ours but how normal it still was in a sad kind of way. Tara could smile and be happy like the rest of us. She ate her meals, did her laundry, interacted with fellow hospitalized colleagues and hospital staff and had her hopes and dreams also. She dreamed of getting married and having beautiful babies like she told me and could not wait for the day she would be released from that place. She informed me of how she loved to sing and dance and even sang a little of a popular western pop song for me as I marveled at the sonorous quality of her voice. Any choir would love to have her on their team.
Life for Tara
The hospital environment was neat and so were the patients’ wards and rest rooms. They were all treated very well and the meal was nutritious and regular. However, Tara came from an indigent background as last of 7 children with aged retired parents. Even her siblings were either petty traders or mechanics and I wondered how they had managed to afford her hospital bills. I also pondered on her eventual discharge what life she would return to and if it wasn’t the social conditions she lived in that induced her condition of mental illness. All her life from early childhood, she has held many menial jobs such as house help, cleaner, laborer, factory worker etc and given her current level of education may not be able to find any better work if she eventually got better and was discharged.
The aftermath of my encounter with Tara got me thinking about what we as individuals, community and government could do to better the lot of people like Tara in order to give them a fighting chance in life. My visit to the neuropsychiatric hospital and eventual meeting with Tara helped change my perception about the mentally ill. I no longer viewed them in a negative light, because in a way, they are quite normal people like us with our same needs, joys and pains. They are not all dangerous as many of us perceive them to be. They need all the love and care they can get to enable them lead as normal as possible a life and to help them transition peacefully and successfully back into society on their eventually cure. In the midst of the “abnormal” I found normality, and I am very grateful for the opportunity of meeting Tara.
- Real names were not used to protect the identity of the patient