Are we all mad? Lets bust myths

By Dr.Arif Maghribi Khan,

I was forced to write this blog after seeing people seeking mental health counselling being labelled as MAD.

IF you believe in SCIENCE, then follow evidence based work and do not label anyone , if you are educated then first learn then only talk.

I am also working on my own to remove stigma being associated with TB, COVID, DIABETES in young females.

But today let us talk of Psychiatric disorders.

Psychiatry has given a simple classification of psychiatric disorders

1=Neurotic= When contact of individual with reality is not broken like Anxiety, OCD, PTSD, Conversion disorders.

2=Psychotic=When contact of individual with reality is broken like Schizophrenia, Schizotypal disorder.

Lot of literature is available on depression, anxiety, PTSD, today let’s simplify psychotic disorders usually present only in 2 to 3 % of general population. But we unknowingly mix depression, anxiety, with these disorders. 

Major symptoms

Delusions= They are fixed false beliefs far beyond credibility that may be bizarre [for example ‘my right eye is a computer that controls the world or nonbizarre [detectives of my city are after me] and these remain unmodified despite clear evidence to the contrary.

Patients believe that they were born to spread a particular religion or cult; they also wrongly think other persons can hear silent thoughts of patient.

Some patients believe that their wife/husband is not faithful without any sort of evidence or believe family members or neighbors’ want to poison them.

HALLUCINATIONS= Even if Patients family and patient are in single room, patients usually complain of hearing strange voices or seeing strange things when others do not hear or see it. Most common are auditory [voices] which patient perceives as coming from outside the patients head.  Many times in cases of untreated patients these voices ask the patient to walk on water and many die of accidental suicides. In visual hallucinations patients can see angels, fairies, or ghosts.

Other symptoms include>

Loosening of associations= Patients ideas are disconnected, they jump from topic to unconnected topic, speech is incoherent.

Over inclusiveness=Patients continually may disrupt the flow of their thoughts by including irrelevant information.

Neologisms= Patients coin new words which may have symbolic meaning for them.

Blocking= Speech is halted [often in midsentence] and then picked up a moments or minutes later, usually at another place. These patients have short attention sp

Echolalia= Patients repeat words or phrases in musical or singing fashion without an apparent effort to communicate.

To be considered schizophrenic it is of utmost importance to visit psychiatrist near you, only he can diagnose the disorder, also the following criteria is important.

1=Have at least 6 months of sufficiently deteriorated occupational, interpersonal and self-supportive functioning, have been actively psychotic in a characteristic fashion during at least part of that period and must not be able to account for the symptoms by the presence of a schizoaffective or major mood disorder, autism or an organic condition.

It’s very important to mention here contrary to popular belief such patients usually are NOT VIOLENT  towards doctors, although due to lack of insight some of them  will not visit any doctor or counsellor stating that they are healthy and do not need to visit any health care provider.

It’s pertinent to say use of cannabis and genetic factors play significant role in development of Schizophrenia.

Treatment

1=Medical treatment. Do not stop or start treatment without doctor’s advice.

2=Family counselling

And 3rdly gradual rehabilitation of patients in work place ensures great results.

Dr.Arif Maghribi Khan, Kashmir writes on health and social issues.