Therapeutic Goals of Schizophrenia Treatment - Term Paper Example

Schizophrenia Mental health is imperative to the well-being of every human being. It is saddening that a percentage of Americancitizens are diagnosed with problems of mental health. While in some individuals it lasts for a few years or months, others develop lifetime mental problems. The World Health Organization explains that mental health is the personal well-being of an individual; perceived self-efficacy, self-sufficiency, capability, and the self-actualization of ones’ rational and emotional perspective. The organization argues that a person who is mentally healthy has the capability of living up to their dreams, and use their abilities to improve their quality of life. Mentally healthy people are also able to handle stress properly and prevent it from affecting other areas of their lives. Personal opinions, differences across cultures and races, and the contradicting scholarly opinions have an effect on the definition of mental health. Some psychology experts consider mental health to be a state of psychological security that a person experiences. Other psychologists define mental health as the psychological state of a person who can relate with others emotionally (Kapur, 2003). According to psychologists, mentally healthy people have emotional and behavioral adjustments that depend on various factors such as extreme joy or grief, but they soon revert to their normal selves. If a person can go through life and create a balance between their emotions and reality, such a person is considered to be mentally healthy. Such people can avoid struggling with issues and facing stress for long periods of time. People who entertain stress usually fall into depression and usually experience relationship problems or other psychological concerns. Schizophrenia is a mental condition affecting the functioning of the brain. There are some psychological symptoms that schizophrenia patients usually display. Persons with this mental condition usually experience hallucinations. The patients hear or see imaginary things and often become delusional. Reports indicate that; some patients start having beliefs that can be defined as unusual. The patients start to believe in things that do not make sense, and they disagree with the facts. Many patients also experience changes in their conduct. There are doctors who regard schizophrenia as a psychotic illness, meaning that a patient loses the ability to differentiate between the hallucinations, delusions and the reality. The causes of this mental condition remain unknown, although some scholars and doctors believe that the condition is caused by the amalgamation of situational and genetic factors. These experts suggest that there are some factors or conditions that can set off the condition and that there are some things that make an individual more susceptible to the mental condition. However, beliefs have no way of verification, since they do not have evidence. Schizophrenia does not discriminate against gender, but patients who have the most serious attacks are usually men. The condition mainly manifests in people when they are young adults, from around the age of fourteen. The diagnosis is usually done after a series of tests have been carried out, since there is no single test sufficient to prove that an individual has schizophrenia (Lehman et. al. 2004). Statistics indicate that 1 in every 100 people in the United States will be diagnosed with schizophrenia. The statistics also indicate that the most vulnerable age group is persons between the ages of 15 and 35. For this reason, medics advise that it is of grave importance that the condition is diagnosed early. If the condition is discovered at an early age, then there are higher chances that the patient will one day attain full mental health. Some doctors believe that if the condition develops very early in the life of an individual, there is a high chance that the condition will be very severe. The earlier in life the condition develops, the more severe it is to the patient. The treatment of this condition brings together use of drugs and therapy. The therapeutic steps which are used on one patient will not necessarily be used on another patient. It might be worthy to know that every patient can recover from schizophrenia. However, there are incidences where a relapse occurs, and the patient has to resume therapy and using medicines. However, the family of the patient needs to be fully involved in the treatment process, most importantly during therapy. Patients need a lot of support from health care providers as well as from the family so that they can achieve a speedy recovery. Providing support to the patient, as well as administering treatment, helps reduce the effects of the condition as well as improving the condition of the patient. Proper management of the condition helps in achieving a speedy recovery for the patient. Additionally, it reduces any chances that the condition of the patient might deteroriate.The family of the patient should be conversant with any signs which are indicative of a heightened occurrence. Training should be accorded to the family members by the medical personnel so that they can be able to respond effectively and accurately. If the family knows how to help their patient through reading the signs, then the management of the patient will greatly improve. Dissemination of information on schizophrenia creates awareness in the public about this medical condition. Disseminating information and making the public understand this condition is a huge steps towards getting rid of the misconceptions about schizophrenia. Many people shun from dealing with persons with mental disabilities. They avoid interactions with mentally unstable people for various reasons. Therefore, patients usually undergo isolation, rejection and humiliation, especially in the public light. Educating the community about schizophrenia also helps in reaching out to patients who have been kept away from interacting with other people due to their medical conditions. The families living with schizophrenic patients can join one of the numerous charities that offer help and advice to persons living with the condition. Joining such an institution for people who face similar challenges is therapeutic to both the patient and the family. Talking to people with similar conditions helps people to learn and share new methods of coping with the same problems, as well as offering emotional support. Psychosocial treatment is given to patients to help them recover social skills lost due to their condition. The treatment is mostly given to individuals who have been taking anti-psychotic medication. Psychosocial treatment is designed to help the patients cope with challenges that they face daily in their lives on a daily basis due their condition (Kapur, 2003). Some of these drawbacks include; creating and upholding interactions in the office and also in personal life. Some patients experience difficulty in communicating while others are unable to groom themselves. During psychosocial treatment, patients learn how to overcome these challenges through use of various coping mechanisms. They also learn how they can socialize at work and also in school without difficulty. Persistence and commitment to psychosocial treatment allows patients to avoid incidences of relapse. Research indicates that patients who attend psychosocial treatment appointments without fail are also more likely to take their medicines faithfully. The patients are also more likely to recover from the condition than those who keep on skipping their appointments, and those who forget or ignore to take medication. Additionally, such patients have a good support system around them, and that is why their rate of recovery is better than that of others. Psychotherapy and rehabilitation meetings are also imperative for schizophrenia patients. Therapists carry out the meetings for groups of people and other times they customize the meeting to fit the needs of an individual person. It is crucial to involve the family in counseling, since they experience feelings of desperation and frustration, especially when the patients seems to be getting worse or when a patient experiences a relapse. The financial burden that accompanies the treatment can also become depressing to the family. Counseling helps family members of the patient to accept the situation, and also encourages them to continue supporting their relative. Therapeutic Goals Medicinal therapy of schizophrenia has some goals that it aims to achieve towards the well-being of the patient. The importance of therapy is to root-out denial. For some patients, therapy is key in assessing the progress of recovery. For other patients, therapy can be used to assist them to tacle their feelings. Other goals may be therapeutic, and these are going to be explained on more. One important factor is to help the patient understand their condition better, as this will help in personal acceptance of the condition. Understanding schizophrenia also helps the patient to take better care of themselves and those around them. Therapy also enables the patient to develop and maintain a better intellectual performance. This helps in maintaining high self-esteem for the patient. Treatment also helps to deal with the symptoms experienced by the patient to reduce the probability of a recurrence in future. Additionally, any side effects that a patient may experience, from their interaction with a drug, can be controlled and eventually avoided. Therapy also improves the value of life of a patient by careful assessments done which ensure that the symptoms they experience are minimal, be they positive or negative. When a patient attends therapy, it also becomes easier to avoid administering drugs that have a negative effect on their well-being. Therapy is crucial in finding out the feelings, fears and concerns of the family members. During counseling and treatment, patients require more care and understanding from the family members. The family will also need to attend therapy sessions to help them familiarize with the condition as well as how to live with their patient. Love, concern and understanding fom the family hastens the recovery of patients. Quick recovery is determined by a sense of security emanating from receiving support and comfort from loved ones. During the recovery process, family members also learn signs and symptoms which will need urgent medical attention. Therefore, they will also know what kind of food and medication to administer alongside the prescribed medication without harming their loved one. During therapy, the patient is also able to interact with other patients , some with the same condition or even worse, hence providing a forum where they can interact and share their experiences as well as their coping mechanisms. More to this, the patients create a channel to meet friends during their therapy sessions, and this broadens their social circle; at times, it can act as an important link to a professional career. Drug of First Choice A drug that can be used effectively is Risperidone, as the after effects associated with it are minimal compared to anti-psychotics. The drug is used in the treatment of various mental conditions such as ADHD, bipolar disorder, as well as with autism. Another advantage of Risperidone is that it interacts well with other drugs administered to a schizophrenia patient. Due to its effects on patients, the drug is not recommended to patients with heart problems and hypersensitive conditions. Examples of these effects include; feeling tired, dizzy, drowsy, light-headedness among others (Lieberman et. al. 2005) Risperidone is an anti-psychotic drug that works by inhibiting the receptors of serotonin and dopamine. It has a high affinity for type 2 receptors of serotonin that bind 5-HT2 receptors. The enzyme CYP2D6 present in the drug is metabolized by the liver.Excretion of the medicine is effective as 70% is in the urine while 14% is in solid waste. The drug clears from the body after one week since the day it was last in use. Carbamazepine is a chemical in the medicine which causes the plasma levels of the drug in the blood to reduce. On the other hand, CYP2D6 has some inhibitors, among them SSRI that may cause the plasma levels of the drug, Risperidone, to increase. Contraindications In the case of an overdose, the patient may feel lethargic, drowsy and may even experience hypertension. Some doctors advise patients to get up slowly from their sitting or lying positions so that they can reduce the risks that are associated with feeling drowsy and dizzy. In extreme cases, a patient may convulse, or develop difficulties when trying to swallow anything as a result of sore throats. Such cases should be given emergency treatment to avoid the loss of the life of a patient. Patients taking the drug are advised to avoid taking alcohol or tea as they will worsen the effects of the drug. The effect of the drug varies with the patient and takes varied timeframes to be evident. Some patients who have used the drug have reported weight gain as a side effect. Additionally, patients who are diabetic need to maintain regular checks of their blood sugar to ensure that they are okay, as the drug may worsen their conditions. Older patients with dementia are advised against the use of this drug as it may cause them to have a stroke, heart failure or pneumonia (Lieberman et. al. 2005). Patients who are using Risperidone alongside other medication for the treatment of depression should be cautious and consult with a doctor before combining drugs.The drug has different reactions to both males and females. In some men, it causes decreased sexual functionality, and inability to produce sperms. A number of patients of the male gender complain that their breast became bigger. Patients of the female gender gave reports of excessive production of milk and complains or menses that are unpredictable. Some women also had phases of secondary infertility. Prolactin is believed to be responsible for the above complaints in patients. If these symptoms persist, then patients should visit their doctors urgently. The price for a 6milligram tablet is sold at 13 Euros. No studies can prove that Risperidone is dangerous for use in children below the age of ten years. Discontinuation Discontinuation of the drug use is encouraged if the patient develops some severe reactions such as seizures. Doctors however suggest that discontinuation of the drug should be done gradually as this would avoid any signs of a withdrawal syndrome from the patient. Withdrawal symptoms are very likely to occur if ingestion of the drugs is abruptly stopped. These withdrawal symptoms include anxiety, headaches, nausea, dizziness, being nervous and inability to sleep among very many other symptoms. A high fever, confusion, problems in balance, and stiffness of the muscles are all problems that will require seeing a doctor as soon as they happen. To prevent any fatality, the patient will remain closely monitored under observation. Administrative Method The drug is given as a tablet, given orally, and can be taken with any fluid except alcohol, cola or tea. For the best results, medication should be taken at definite intervals to avoid an upsurde of the drug levels in the drugs. Patients are advised to follow given instructions, and if they miss their dose, they should take immediately they remember. Taking of a double dose is discouraged as it will be equivalent to an overdose that would call for an emergency situation. In the case of dizziness, feelings of drowsiness or any other effects that arise from the drug, patients should visit the nearest hospital for an emergency checkup, or contact their personal doctor. The medicine is available as an injection and an oral tablet for dissolving. The injection can be given to patients once in every two weeks as it is released into the body in small doses from the site of injection. This method of injections is best used for patients who are deeply affected by schizophrenia and might fail to remember to take their medicines. The Risperidone tablets are found in a 0.5mg form, a 0.25mg tablet as well a 1mg up to the 4mg of the tablet. There is also an oral solution for the treatment of the same. This drug is administered according to the age of the patient and according to the conditions or sicknesses that the patient may have apart from schizophrenia. This helps to prevent a reaction of the two or more drugs so that may prove dangerous or fatal reactions and side effects. Older people and children, for example, receive smaller doses of the drug so as to avoid harsh reactions and to ensure that the child is well. Any kind of swelling that has occurred and is suspected to be associated with the drug should be reported to the nearest health facility or a doctor who would help in such a situation. The drug should be stored in an area without water or moisture, and also away from light. Storage of medicine should be in places where toddlers cannot reach. Disposal of the medicine should be done when the drug has reached its expiry date or it is no longer in use. Unused tablets of the drug should not be given to any other patient even if it is not expired. Instead the disposal of the drugs should be done in the original packaging. This medication should not be flushed down the toilet but disposed of in a garbage bin after carefully wrapping it. Therapy Evaluation Nurses who take care of patients should keep a written record that shows the reactions of the drug to the patient. Upon examining the patients reaction to the drug, the dosage can either be increased or terminated and an alternative drug found for the patient. Check-up visits for patients should be done biweekly to check the performance of the drug. This will be done since some drugs take a long time to work. During the visits, the patient will be asked to give a report of how they have felt since taking the medication and how it has affected their daily activities. Some tests will also be conducted to find out if the medication prescribed is absorbed properly by the body. Sharing medication of any type causes health risks to individuals. The patient should finish the dosage given by the doctor unless they develop unusual and extreme reactions. Misconceptions on Schizophrenia There are many misconceptions that exist about schizophrenia and other mental health problems as well. Many people think that once a person had been diagnosed with schizophrenia it means that the patient has a split personality. Many people also assume that the patient will be calm one minute and become hyperactive in the next minute. Such misconceptions are due to the ignorance of the public and the lack of information on the condition. The media have also been portraying the patients of schizophrenia as precarious people. Branding patients who need help as dangerous only serves to create a stigma despite the fact that a tiny percentage of schizophrenia patients engage in violent activities and crime. Due to the hallucinations that some of schizophrenia patients experience, some people classify the patients as dangerous. However, they overlook the fact that the voices that these patients hear and the images that they see can only be harmful to the patients. People forget that these patients also can decide whether to listen to the voices or to ignore them. Some persons opine that schizophrenia patients have their fate sealed in that no help can be accorded to them. However, medicinal therapy has been assisting many patients to reclaim their livelihoods. The treatment may take several months or a few years before any progress is made, but eventually with patients can recover. Contrary to popular assumptions, schizophrenia is not an extraordinary mental condition. As aforementioned, the condition affects one person in every group of a hundred people in America.The difference is that for some people the condition is mild while for others it is quite severe. Effects of schizophrenia Stigma causes schizophrenia patients to suffer a lot. It sometimes interferes with the progress that the patient has been making. Management of the condition also has to be unswerving and unrelenting. The instruction and the suggestion of a physician should be firmly followed. If the treatment is done improperly done and there is a disregard of the prescription, then the effects of the condition can be very devastating to the patient as well as the people interacting with the patient. One of the major effects is bonding difficulties. Patients who have problems in communicating effectively often pull out from the crowd and detach themselves. The possibility of trying to take ones’ life is very high among schizophrenia patients. Family should be very careful as during the psychotic episodes; the patient might try to commit suicide. Monitoring of the patients should be done very closely to ensure that they do not engage in any harmful behavior. Schizophrenia can also cause patients to experience disruptions in their daily activities. Patients might experience difficulty in running their normal daily errands, and sometimes it becomes impossible for them to do any productive work. The delusions and hallucinations that they experience hamper their ability to become productive and perform simple tasks such as bathing or eating. A number of patients struggle with alcohol and drug adictions. Some people engage in addictions to alcohol and drugs as they try to find workable solutions to their condition. Smokers usually have a hard time in recovering as the medications that are normally prescribed cannot work effectively with the chemicals found in cigarettes. In conclusion, mental conditions are widespread across America. Schizophrenia is one of the many mental conditions that people experience. Due to the ignorance of the public, many do not even know that they live with the condition or that someone they know lives with the condition. The few who know about the condition may be hiding their affected friends or relatives behind closed doors. Some people are even sent to mental asylums and branded as mentally incapacitated. The department of health needs to sensitise the American public about this mental condition and offer subsidies to the families of the patients living with schizophrenia. The media also needs to send out the correct information regarding this condition and put an end to the stigmatization of persons living with schizophrenia. References Kapur, S. (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry, 160(1), 13-23. Lehman, A. F., Lieberman, J. A., Dixon, L. B., McGlashan, T. H., Miller, A. L., Perkins, D. O., & Kreyenbuhl, J. (2004). Practice guideline for the treatment of patients with schizophrenia. The American journal of psychiatry, 161(2 Suppl), 1-56. Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., ... & Hsiao, J. K. (2005). Effectiveness of anti-psychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine,353(12), 1209-1223. Read More