CLARIFYING PSYCHIATRIC ILLNESS (www.drmjthomas.com)
What is psychiatric illness?
Watch the podcasts below before you read:
If you ask people whether they are sad or tense, many will say ‘yes ‘. Many of them will give a reason and attribute the cause to an event that could trouble them. If you attend a funeral, you will find people crying. If you visit them three months later, you will find them back to their normal lives. Human beings have an inherent capability to cope with stress. Hence, given a little time, they come back to normal life. This behaviour is called ‘Post-traumatic stress disorder’ (PTSD). Normally, professional intervention is not required for them unless it leads to dangerous situations like an attempted suicide or homicide. However, people confuse these stressful reactions with other primary psychiatric illnesses. The lesson to learn here is that stressful events are inevitable in life, and most people can cope with them using the available resources in their society.
What about others? If you ask them what caused their sadness or tension, they often find it difficult to determine the cause and tend to relate it to random, stressful events in their life that may seem acceptable to others. They are the people who suffer from ‘Primary’ psychiatric illnesses. One out of twenty people in society may experience some form of psychiatric illness sometime in their life, and they suffer for a longer time than those who go through inevitable life stresses. Very often, they have no answer as to why they suffer emotionally and are not able to get out of the emotional turmoil despite all their efforts.
Why does this happen? Psychiatric illnesses are primarily inherited. What the genes change is the ‘manner’ in which you think. ‘What’ you think depends on your culture, society, education, etc., and is different from ‘How’ you think. All of us are in control of our thoughts when we are not ill. If we get an inappropriate thought, we will analyse its rationality, decide it is ‘inappropriate’ and discard it immediately. We have a ‘Switch’ to switch off unwanted thoughts and continue to think only what we want to think. However, when someone gets a psychiatric illness, this ‘switch’ disappears and the person cannot switch off the thoughts that come to their mind, irrespective of whether they are ‘appropriate’ or ‘inappropriate’. The abnormal genes interfere with the brain’s functioning by altering the brain chemicals and making the ‘switch’ dysfunctional. The thought comes without an end, and the person can get extremely sad, sometimes resulting in suicide.
Why do these peculiar thoughts come to your mind? The brain stores all your experiences, like Google stores all that you do. Normally, only a fraction of these stored experiences is brought to the foreground. When the ‘switch’ becomes dysfunctional, these stored experiences come to the foreground at random and often without logic, just as you find your computer behaving erratically when it gets infected with a virus. When the switch becomes dysfunctional, these thoughts come to the foreground at random, sometimes illogical, in the form of a language associated with an emotion, and sometimes experienced as a voice.
How does one experience these changes? There are many forms of psychiatric illnesses. Some illnesses are ‘Episodic.’ Others are ‘Continuous.’ Some illnesses show severe depressive mood. Others can switch between an excessively depressed mood to elated mood with free intervals of normal mood in between. In some other illnesses, people experience certain ‘voices’ of others as they would hear them from a mobile phone. Yet others become ‘suspicious’.
How do you then treat the psychiatric illness? One must understand that there is no ‘cure’ for psychiatric illness till now. You can ‘control’ psychiatric illness like you control fever with paracetamol or diabetes with antidiabetic medicines. These medicines are to suppress symptoms if they exist.
Do you take medicines at the same dose always? No. Treating psychiatric illness is needs-based. Hence, you need to consult a psychiatrist to decide about your medicines and their dosage. Medicines are given at the lowest effective dose without side effects, when needed.
Does Psychiatric illness affect other organs? Psychiatric illness affects every organ in the body, directly or indirectly.
Children’s psychiatric illnesses are very different. An addiction to alcohol and an addiction to drugs need a different explanation. Personality disorders are different.
BEHAVIOURAL CHANGES IN PSYCHIATRIC ILLNESS (www.drmjthomas.com)
Will changes in mind and body influence your behaviour?
Every person who faces some form of distress will have unique reactions to it, affecting their mind and body, and will have changed behaviour. If this behaviour is inappropriate to their culture, the person gets ‘branded.’ In the case of psychiatric illness, the person has an abnormality in their thought process along with resultant bodily changes, producing behavioural changes. However, not all behavioural changes are due to psychiatric illnesses. It can also be due to a physical illness or a conscious, manipulative, intentional behaviour. This makes it difficult for observers to conclude the origin of the altered behaviour. This is the reason psychiatrists observe verbal and non-verbal communication before they conclude their diagnosis.
HOW DO CAREGIVERS DEAL WITH PERSONS WITH PSYCHIATRIC ILLNESS? (www.drmjthomas.com)
What should caregivers do when they deal with their loved ones?
If you have a person with a psychiatric illness in your family, you need to take care of them. Caregivers do not understand what the patient expresses during the illness. At the same time, the patient does not understand the caregiver either. Patients describe events around them based on their illogical thoughts while they are ill, while the caregiver understands them based on the real situation on the ground. Very often, caregivers aggressively correct patients from their thoughts and behaviours. As the patient improves, he can conduct daily chores spontaneously. However, his thoughts remain illogical. It will be difficult to correct him from these thoughts since his logic is still irrational. Daily chores get corrected first when he improves, and logical thinking later in this order. Those with longstanding illnesses, however, learn certain inappropriate ‘habits’ during the illness and do not change their habits easily. Caregivers need to encourage the ill person to return to normal functioning, but not force.
People with problems of addiction are usually managed with a punishment and reward paradigm. For inappropriate behaviour, some form of punishment or denial of reward is organised, while appropriate behaviour leads to rewards. These are usually conducted in professional rehabilitation centres. Certain people have personality types that are different from others. There are attention seekers. When they become ill, they exaggerate the symptoms. If they receive continuous sympathetic attention from caregivers, they perpetuate the symptoms and gain from it. There are also very stubborn, obsessive people. They may require medicines to control their stubbornness when they become ill. Some people are manipulative and selfish. They can manipulate the caregivers and split them apart during their illness. The caregivers of these patients need to always be careful to be united in their actions. https://www.youtube.com/watch?v=r93avRTi8mw This video gives you substantial information on how to deal with psychiatrically ill people.
QUICK REFERENCE TO HELP A VERY ILL PERSON (The information below gives some ways to help people who show exceedingly difficult behaviour)
Unfriendly and suspicious patients
- Do not argue with the person about their ideas or thoughts, or try to prove them wrong.
- Change to a concrete topic that is not related to suspicions.
- Be friendly and accepting. Do not get angry with the person.
- Do not whisper or talk secretly when the person is in the same room or nearby.
- Do not talk or do things behind the person’s back.
Restless, constantly walking back and forth or overly excited.
- Do not try to hold on or restrict the person.
- Talk to him and get his attention.
- Firmly but without anger, ask him to come to you and do what you say.
- Tell him his behaviour is disturbing you and you would like him to stop.
Avoids people and will not let others come near
- Approach the person slowly and friendly. Stop in front beyond his reach to avoid aggression and greet him in the usual way.
- Talk to him about things you both can see and discuss. For example: Is that chair comfortable?
- If he answers, continue with small talk.
- If he stops talking, try again to get him to answer. If he becomes restless, thank him and leave.
- Repeat this small talk many times until he allows you to come near and talk to you about how he is feeling.
- Have the family members continue their activities near the person so that they can watch him.
- Family members should continue to talk to the person even if he does not answer.
Aggressive behaviour and suddenly strikes out
- Stay calm and do not show that you are frightened, but quickly go for help.
- Speak in a firm, loud and commanding voice: “I would like you to stop this behaviour”.
- Remember that the person does not always know what he is saying or doing.
- Give the person an activity which requires them to use their energy and get distracted.
- Do not let him use objects that are sharp or that can be used as a club.
- Instruct other persons not to argue with the person and to stay away until he calms down.
- Talk to him about his behaviour when the person is calm. Make suggestions about other activities he can do that will help the anger disappear.