As many as one in four people will experience and mental illness in their lifetime. While people experience mental illness in very different ways, many will share common symptoms and side-effects. 

Hafal works with individuals recovering from mental health problems – with a special emphasis on those with a serious mental illness. Below we provide information on two diagnoses: schizophrenia and bipolar disorder.

Schizophrenia

Schizophreniai a serious mental illness which affects about 1 in every 100 people during their lifetime. Schizophrenia changes how the brain functions. The result is that a person’s thought processes are distorted, altering their emotions, perceptions, beliefs and behaviour.

Men and women are equally likely to be diagnosed with schizophrenia. Symptoms often – although not always – occur first in young adults, and their onset can be sudden or gradual. In men, the first episode often occurs in their teens or twenties; for women, this is more likely to happen when they are in their twenties and thirties.

Some people with schizophrenia will have just the one episode in their lifetime; others may have recurring episodes.

What causes schizophrenia?

There is no definitive answer, just a number of theories:

• Some research suggests that a person can be predisposed to develop schizophrenia owing to hereditary factors, although no single ‘schizophrenia gene’ has been identified.
• Excessive levels of the chemical dopamine in the brain have been identified as a potential cause of schizophrenia.
• Other theories have linked the development of schizophrenia to upbringing, unresolved psychological issues, or abuse.
• A number of other factors have been identified as potentially causing the illness, or triggering its onset, including: stressful events; using illegal drugs; physical injuries to the brain and problems in the brain’s development.

The likelihood is that there is a combination of causes for schizophrenia that may include both genetic predisposition and life events as triggers. Schizophrenia is a complex illness that may have a number of contributing factors. Indeed, some people consider ‘schizophrenia’ as a catch-all term for a number of different illnesses.

It is important to remember that diagnosis of schizophrenia is not a precise science. A patient should insist that they get full explanation from their doctor or psychiatrist of the symptoms they are experiencing, rather than simply focusing on the diagnosis. It is the symptoms which need to be addressed when working towards recovery.

What are the symptoms of schizophrenia?

Symptoms of schizophrenia can be put into two categories: positive symptoms and negative symptoms. Positive symptoms usually occur in the initial phase of the illness but can be present at any stage. They are symptoms of psychosis (losing touch with reality) in one or many ways. Positive symptoms can include:

• Delusions: personal beliefs that are false and based on incorrect perceptions of external reality; these beliefs can be firmly held despite evidence to the contrary. Paranoia can be a significant aspect of delusion. Paranoia means a person thinking that somebody or something is acting against them. Alternatively some people believe that they are special or unique in some way, for example through a divine relationship.
• Hallucinations: this means experiencing or perceiving things that do not exist. This may be through any of the senses: a hallucination might be seen, heard, smelt or felt. Hearing voices is a common form of hallucination; voices may be critical of the person experiencing them which adds to the distress.
• Disturbances in the thought process: these can include a chaotic stream of thoughts or a sudden loss of all thoughts. Negative symptoms tend to be longer-term. They are termed ‘negative’ because they describe a loss of normal functions –that is, a ‘subduing’ of experience. Negative symptoms include:
• A lack of emotion and motivation
• Tiredness or a lack of energy
• Becoming withdrawn and isolated
• A loss of concentration
• A loss of interest in life
• Sleep deprivation.

Bipolar disorder

Bipolar disorder – sometimes called manic depression– is a serious mental illness which affects about 1 in every 100 people during their life-time.

Bipolar disorder causes extreme shifts in a person’s mood. People with bipolar disorder often have recurring episodes of mania and depression throughout their lives, although many are free of symptoms between these episodes.

It is important to distinguish bipolar disorder from depression (even though bipolar disorder is often termed manic depression). Some people with bipolar disorder will mainly have lengthy bouts of depression with symptoms similar to other forms of depression. A very few people only have manic episodes(highs). But for most people what distinguishes bipolar disorder is that it usually involves both highs and lows (depressive episodes). This is not comparable with having mood swings: bipolar disorder usually involves protracted episodes of depression and mania.

What also distinguishes the illness is its severity: highs and lows tend to be extreme and can involve psychosis (losing touch with reality). However, there is a scale of severity when it comes to the symptoms of bipolar disorder. In other words, some people can have more acute symptoms than others.

Hafal suggests that patients do not simply focus on the diagnosis of bipolar disorder. Instead they should insist that they get a full explanation from their doctor or psychiatrist of the symptoms they are experiencing, as it is the symptoms which need to be addressed when working towards recovery. What causes bipolar disorder? There are several theories about what causes bipolar disorder. Some evidence suggests that bipolar disorder runs in families and that genes are a significant factor. Other theories suggest that things that happen to a person, such as stressful life events or physical injuries, can lead to the onset of symptoms of the illness. The likelihood is that there is a combination of causes for bipolar disorder that may include genetic predisposition and life events which trigger the illness.

Symptoms

The main symptoms of bipolar disorder are as follows:

1. Periods of manic behaviour such as:

• A continuous elevated or euphoric mood
• Irritability and restlessness
• Increased energy
• Inflated self-esteem
• Little need for sleep
• Talkativeness
• Increased sex drive
• Racing thoughts
• Inability to concentrate
• Risk-taking
• Reckless spending.

2. Periods of depressive behaviour such as:

• A persistent subdued or sad mood
• Anxiety
• Loss of interest or pleasure in life
• Change in appetite or body weight
• Insomnia/oversleeping
• Fatigue
• Loss of energy
• Lack of sex drive
• Self-harm and suicidal thoughts
• Feelings of guilt and worthlessness
• Difficulty concentrating.

3. A mixed state with symptoms of both mania and depression.

4. Psychosis (losing touch with reality) may also be present during serious episodes of either mania or depression. This can include delusions and hallucinations. Delusions are strongly held, false beliefs often with no basis in reality; hallucinations involve a person experiencing or perceiving things that do not exist.