Schizophrenia

Schizophrenia

What is schizophrenia?

Schizophrenia is an illness, a medical condition that affects the normal functioning of the brain and interferes with a person's ability to think, feel and act. Overtime symptoms do improve and sometimes people who are battling schizophrenia do recover from it completely. However, for many it is an on going illness which can involve numerous years of distressing symptoms and disabilities.

Many believe that those affected by schizophrenia have a 'split personality', however this is a myth, those affected have one 'personality', just like everyone else.

Symptoms

Physical Symptoms of Schizophrenia

• A blank, vacant facial expression. 
• Overly acute senses- lights are too bright, sounds are too loud.
• Staring, while in deep thought, with infrequent blinking.
• Clumsy, inexact motor skills
• Sleep disturbances- insomnia or excessive sleeping
• Involuntary movements of the tongue or mouth 
• Parkinsonian type symptoms - rigidity, tremor, jerking arm movements, or involuntary movements of the limbs
• Eye movements- difficulty focusing on slow moving objects
• Unusual gestures or postures
• Movement is speeded up- i.e. constant pacing 
• Movement is slowed down- staying in bed (in extreme cases, catatonia)

Emotional Symptoms of Schizophrenia

• The inability to experience joy or pleasure from activities
• Sometimes feeling nothing at all 
• Appearing desire less - seeking nothing, wanting nothing
• Feeling indifferent to important events
• Feeling detached from your own body (depersonalisation)
• Hypersensitivity to criticism, insults, or hurt feelings

Mood Symptoms of Schizophrenia

• Sudden irritability, anger, hostility, suspiciousness, resentment
• Depression- feeling discouraged and hopeless about the future
• Low motivation, energy, and little or no enthusiasm
• Suicidal thoughts or suicidal ideation
• Rapidly changing mood - from happy to sad to angry for no apparent reason
• Severe anxiety

The most common symptoms are:

Delusions. These are false beliefs that are not based in reality. For example, you're being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; a major catastrophe is about to occur; or your body is not functioning properly. Delusions occur in as many as 4 out of 5 people with schizophrenia. 

Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination. 

Disorganised thinking (speech). Disorganised thinking is inferred from disorganised speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad. 

Extremely disorganised or abnormal motor behaviour. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation. Behaviour is not focused on a goal, which makes it hard to perform tasks. Abnormal motor behaviour can include resistance to instructions, inappropriate and bizarre posture, a complete lack of response, or useless and excessive movement. 

The behaviour of those affected and the affect of it on their lives

The behaviour of those with schizophrenia varies.

These are some of the changes in behaviour associated with schizophrenia:

• Dropping out of activities and life in general
• Inability to form or keep relationships
• Social isolation- few close friends if any. Little interaction outside of immediate family.
• Increased withdrawal, spending most of the days alone.
• Becoming lost in thoughts and not wanting to be disturbed with human contact
• Neglect in self-care- i.e. hygiene, clothing, or appearance
• Replaying or rehearsing conversations out loud- i.e. talking to yourself (very common sign)
• Finding it difficult to deal with stressful situations
• Inability to cope with minor problems
• Lack of goal-directed behaviour. Not being able to engage in purposeful activity
• Functional impairment in interpersonal relationships, work, education, or self-care
• Deterioration of academic or job-related performance
• Inappropriate responses- laughing or smiling when talking of a sad event, making irrational statements.
• Catatonia- staying in the same rigid position for hours, as if in a daze.
• Intense and excessive preoccupation with religion or spirituality 
• Drug or alcohol abuse
• Smoke or have the desire to want to smoke (70-90% do smoke) - note: this is a very normal behaviour for people who do not have schizophrenia also! 
• Frequent moves, trips, or walks that lead nowhere

The behaviours of schizophrenia can impact home and social life dramatically. Relationships can be challenged due to the tendency to withdrawal from others and the inappropriate mood behaviours. When hearing voices or being delusional, people with schizophrenia is most likely not able to participation in home and family life and chores is, in fact, a family typically begins to revolve around the person with schizophrenia, this is due to the symptoms of schizophrenia taking so much effort to manage. 

The effects of schizophrenia can become severe and harmful if schizophrenia is ignored or improperly treated. Some of the possible effect include:

Relationship problems

Relationships suffer because people suffering fro, schizophrenia often withdrawal and isolate themselves from those around them. Paranoia can also cause a person with schizophrenia to be suspicious of friends and family.

Schizophrenia not only influences people to withdrawal from others, but others may withdrawn from those suffering schizophrenia due to the severe symptoms.

Disruption to normal daily activities

Daily functions are disrupted significantly due to schizophrenia as daily tasks becomes difficult, if not impossible to do. A schizophrenic person's delusions, hallucinations, and disorganized thoughts often prevent him or her from doing normal activities such as bathing, eating, or running errands.

Alcohol and drug abuse

People with schizophrenia frequently develop problems with alcohol or drugs, which are often used in an attempt to self-medicate, or relieve symptoms. In addition, they may also be heavy smokers, a complicating situation as cigarette smoke can interfere with the effectiveness of medications prescribed for the disorder.

Increased suicide risk

People with schizophrenia have a high risk of attempting suicide. Any suicidal talk, threats, or gestures should be taken very seriously. People with schizophrenia are especially likely to commit suicide during psychotic episodes, during periods of depression, and in the first six months after they’ve started treatment.

Treatment

While long-term treatment may be required, the outlook for schizophrenia is not hopeless. When treated properly, many people with schizophrenia are able to enjoy life and function within their families and communities. Schizophrenia does however require lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. 

A psychiatrist usually guides treatment. There is a treatment team which may include a psychologist, social worker, psychiatric nurse and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.

Medications

Medications are the easiest and most common way to treat schizophrenia. However, because medications for schizophrenia can cause serious but rare side effects, people with schizophrenia may be reluctant to take them.

Antipsychotic medications are the most commonly prescribed drugs to treat schizophrenia. They control symptoms of schizophrenia by affecting the brain neurotransmitters dopamine and serotonin. 

Willingness to cooperate with treatment may affect medication choice. Someone who is resistant to taking medication consistently may need to be given injections instead of taking a pill. Someone who is agitated may need to be calmed initially with a benzodiazepine such as lorazepam (Ativan), which may be combined with an antipsychotic.

There is no solid pathway regarding medications as each person is different and requires different medications. 

Atypical antipsychotics

These newer, second-generation medications are generally preferred because they pose a lower risk of serious side effects than do conventional medications. They include:

Aripiprazole (Abilify)

Asenapine (Saphris)

Clozapine (Clozaril)

Iloperidone (Fanapt)

Lurasidone (Latuda)

Olanzapine (Zyprexa)

Paliperidone (Invega)

Quetiapine (Seroquel)

Risperidone (Risperdal)

Ziprasidone (Geodon)

Make sure to always ask your doctor about the benefits and side effects of any medication that's prescribed.

Psychosocial interventions

Psychosocial interventions are important to put people back on track. Some include:

Individual therapy. Learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness.

Social skills training. This focuses on improving communication and social interactions.

Family therapy. This provides support and education to families dealing with schizophrenia.

Vocational rehabilitation and supported employment. This focuses on helping people with schizophrenia prepare for, find and keep jobs.

Most individuals with schizophrenia require some form of daily living support. Many communities have programs to help people with schizophrenia with jobs, housing, self-help groups and crisis situations. A case manager or someone on the treatment team can help find resources. With appropriate treatment, most people with schizophrenia can manage their condition.

Who does it effect and who are most at risk?

Schizophrenia is a disease that typically begins in early adulthood usually between the ages of 15 and 25. Men tend to get develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms later on in there life around 30.

schizophrenia is approximately 1.1% of the population over the age of 18, or at one time as many as 51 million people worldwide suffer from schizophrenia.

Numerous people around the world suffer from schizophrenia.

6 to 12 million people in China

4.3 to 8.7 million people in India

2.2 million people in USA

285,000 people in Australia

Over 280,000 people in Canada

Over 250,000 diagnosed cases in Britain

Help services

• eheadspace.com
• Online chat counselling service
• Available 7 days a week
• Kids Helpline’s web-based and email counselling service
• Available 24/7 for people up to 25 
• Email: http://www.kidshelp.com.au 
• Tel: 1800 55 1800
• Lifeline’s online chat counselling service
• Available 7:30-10:30pm Monday-Thursday
• Location- 148 Lonsdale St, Melbourne VIC 3000 
• Tel: (03) 9666 1244
• Mind Australia
• Lots of centres available that help you with basic things that is difficult with schizophrenia 
• www.mindaustralia.org.au
• Schizophrenia fellowship
• Helpline and a clinic located in NSW
• Tel: 9879 2600

Bibliography 

• http://au.reachout.com/help-services-for-schizophrenia-and-other-psychotic-disorders
• http://www.schizophrenia.com/szfacts.htm#
• http://www.healthyplace.com/thought-disorders/schizophrenia-symptoms/schizophrenia-symptoms-and-the-impact-on-everyday-life/
• http://www.helpguide.org/articles/schizophrenia/schizophrenia-signs-types-and-causes.htm
• http://www.webmd.com/schizophrenia/ss/slideshow-schizophrenia-overview
• https://www.sane.org/information/factsheets-podcasts/187-schizophrenia
• http://hanbleceya.com/intensive-treatment/treatment-specializations/schizophrenia/?gclid=CIaBofn6s8cCFREAvAodsSYEKQ
• http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/treatment/con-20021077
• http://www.schizophrenia.com/earlysigns.htm
• http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/symptoms/con-20021077
• http://psychcentral.com/lib/schizophrenia-treatment/
• http://www.helpguide.org/articles/schizophrenia/schizophrenia-signs-types-and-causes.htm

[All last accessed on 17th August 2015]

Sahel and the food crisis that it faces

Today we are focusing on the food security crisis in the Sahel.

According to the United Nations Food and Agriculture Organisation, in 2012 approximately 18.7 million people in the Sahel region suffered an extreme food crises, this is due to the poor rainfall and thus failed harvests. Currently, 20 million people in the region are at risk of food insecurity and 2.5 million of them need immediate lifesaving food assistance. An estimated 5 million children younger than 5 will suffer from malnutrition in 2014. This food insecurity is threatening the lives of more than 1 million children in 9 countries, Burkina Faso, Cameroon, Chad, Gambia, Mali, Mauritania, Niger, Nigeria and Senegal.

The Sahel is a band of land in central Northern Africa. The bordering countries; Burkina Faso, Cameroon, Chad, Gambia, Mali, Mauritania, Niger, Nigeria and Senegal, have all been affected by the lack of rainfall and are all suffering from hunger.

Areas that are suffering from food insecurity.

Why people are going hungry in the Sahel?

People are going hungry in the Sahel because of degraded solid, erratic rainfall and a high increase in population. All of these are major factors that impact food growth. This leads to food scarcity in food production. The main reason as to why the people in the Sahel are going hungry in because of the infamous Sahel drought. The Sahel drought is a series of historical droughts, beginning in approximately the 17th century. The frequency of droughts in that region is thought to have increased from the end of the 19th century.

The severity of the drought in the Sahel regions.

Impacts of the hunger

Social Impacts:

A major social impact is that people are dying. Children are suffering from malnutrition and are likely to die before the age of five. The problem has escalated to the point that newborns are not registered before the age of five as the death rate is so high. The people of Sahel are now relying heavily on foreign aid who provide the basic necessities such as food and water. Violence in Mali has been further problematic to  the ongoing food crisis in the Sahel region. It has even sent refugees fleeing the conflict into nearby countries. Already, over one million people have fled for their homes in the Sahel and are now refugees or relocated within their own countries. Niger and Chad, neighbouring countries of Mali, are now faced with an influx of refugees and little resources to support them. To make matters worse, diseases such as cholera and measles remain a constant threat. The reoccurrence of the food crisis has taken away the regions resilience and coping abilities which has devastated citizens of the Sahel region who already suffer from long term poverty. Many never recover and are unable to withstand more pressure and setbacks. 

A child suffering from malnutrition.

Economical Impacts:

Due to the shortage of food, prices have risen dramatically. People now cannot afford to pay for a nutritious meal. Some are outraged and are reluctant to pay the high prices. Meanwhile, others can't even afford to buy food for their large families, only living on handouts from organisations. 

Environmental Impacts:

The obvious environmental impact is that the crops cannot grow and the livestock is dying due to the inconsistent rainfall and immense heat. This is the sole cause of their hunger and starvation.

Solutions

There are a few possible solutions to the Sahel food crisis. A drought resistant seed has been introduced throughout the region. 

The Drought Tolerant Maize for Africa (DTMA) project, which was launched in 2006, aims to diminish drought and other constraints to maize production in the Sahel, increase maize yields by at least one ton per hectare under moderate drought and increase farmers' current yields by 20 to 30%. This will then benefit 30-40 million people. The project brings together men and women farmers, research institutions, extension specialists, seed producers, farmer community organizations, and non-government organizations. It is jointly implemented by the International Maize and Wheat Improvement Center (CIMMYT) and the International Institute for Tropical Agriculture (IITA), in close collaboration with national agricultural research systems in participating nations. Millions of farmers in the Sahel region are already benefiting from this particular project, which includes support and training for African seed producers and promoting vibrant, competitive seed markets.

Drought resistance seed.

 Drought tolerant seed multiplied in DTMA countries in 2012.

About approximately 500,000 hectares in Burkina Faso and Niger have been treated with planting pits and other simple water harvesting systems. This has evidently benefited the counties. For example, in Niger, farmers have increased the number of trees on their land. Trees were not planted, instead farmers protected those that emerged spontaneously on their farms. Over the span of 20 years, farmers operating on 5million hectares of land throughout Niger added an estimated 20million trees to the landscape. These trees provide numerous benefits including an increase in soil fertility and provides food for livestock, fruit and leaves for human consumption, fibre, firewood and materials for traditional medicines. But most importantly, farmers are observing that these procedures are significantly improving crop yielding. According to a 2009 report I am international food Policy Research Institute, new systems on five million hectares throughout Niger have increased annual agriculture by about 500,000tonnes. This amount of food can feed 2.5 million people!

Another possible solution is to create awareness of the agroforestry system. While it supports sustainable agriculture it is still not carried out by every farmer. By organising tours for farmers to visit other farms who have increased their crop yielding through this method, we can spread the word and thus increasing the overall food supply. Not only will this spread awareness for the system, it will also prompt farmers to share their successful methods with each other, boosting the overall success rate of crops in the Sahel. 

I'm many countries in Africa, farmers have no legal rights to the trees on their farms. National policies and local authorities need to take action in including agroforestry into agricultural developments to give farmers the right to their trees. This will give farmers motivation to invest in planting trees as they will have a clear right to them. 

Although there are major challenges in reducing famine in the Sahel, we have the resources and knowledge to overcome it. There is no time to lose for food security to be achieved!

References

• Sahel - Food Insecurity and Complex Emergency PDF (compass)
• Food Insecurity and Humanitarian Implications in West Africa and the Sahel PDF (compass) 
• http://www.huffingtonpost.com/anja-tranovich/food-security-solutions-sahel_b_1651153.html
• http://www.acaps.org/en/news/sahel-food-inecurity
• http://www.wri.org/blog/2014/02/improving-food-security-sahel-difficult-achievable
• http://sahelresponse.org
• http://www.unicefusa.org/mission/emergencies/food-crises/sahel-food-crisis
• http://www.care.org/emergencies/sahel-hunger-crisis
• http://www.bbc.com/news/world-africa-26021145
• http://ec.europa.eu/echo/files/aid/countries/factsheets/sahel_en.pdf
• http://www.oxfamamerica.org/take-action/save-lives/past-emergencies/food-crisis-in-the-sahel/
• http://www.abc.net.au/gardening/stories/s2577681.htm
• http://www.un.org/africarenewal/magazine/december-2013/sahel-one-region-many-crises
• http://dtma.cimmyt.org/index.php/about/background

[All sites were last accessed on 09/08/15]