Alcohol directly affects people without other pre-existing conditions. It can even worsen the state of other mental health problems, as is the case in people diagnosed with schizophrenia.
Unfortunately, schizophrenic alcoholics are more likely to encounter medical, social, and legal problems. According to Drake and Mueser, this duality makes the traditional alcoholism treatment even harder to enforce.
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Schizophrenia: an Overview
As per the National Institute of Mental Health, schizophrenia is a severe, chronic condition. It can change the person’s thinking, behavior, and feelings. To others, the afflicted individual may seem as if he/she has lost touch with reality.
It might not be as prevalent as other diseases, but it affects a lot of people as well. According to the World Health Organization, schizophrenia affects as much as 20 million individuals worldwide.
The condition commonly occurs between the ages of 16 to 30, though it may develop in children as well. As with most mental disorders, why schizophrenia occurs remains unknown. Experts believe that genetics, brain development, and birth complications, among many others, can trigger the onset of schizophrenia.
The condition is categorized into 3 types, namely:
This refers to psychotic behaviors that are not commonly seen in ‘well’ individuals. Positive schizophrenics may demonstrate hallucinations, delusions, dysfunctional ways of thinking, as well as disturbing body movements.
This type of schizophrenia, on the other hand, is characterized by limited speaking, decreased feelings of pleasure, and a flat affect. They may find it difficult to start and keep up with certain activities as well.
Schizophrenics who belong to this category may find it hard to process the information needed to make sound decisions. They may have attention and focus problems, as they may find it hard to process their newly-learned ‘working memory.’
Why Alcohol Abuse is Common in Schizophrenics
According to the study by Regier et al., as much as 37% of alcoholics suffer from a co-existing mental disorder. In fact, alcohol is the most abused substance in schizophrenics, with nicotine coming in next.
The research even goes on to show that as much as 33.7% schizophrenics exhibited signs of alcohol use disorder. This prevalence, according to scientists, maybe due to the easy availability of the said substance. As to why these disorders often occur with one another, experts attribute it to the following factors:
There are three possible biological reactions behind concurrent alcohol abuse and schizophrenia. Firstly, Chambers et al. believe that schizophrenics turn to the bottle as a way of self-medication. These people believe that their symptoms, as well as the side effects of antipsychotics, may be alleviated with the consumption of alcohol.
Secondly, the brain abnormalities in people with schizophrenia may help reinforce their alcohol or substance addictions. To wit, schizophrenics already have abnormal dopamine levels that often lead to hallucinations and delusions. This may explain their preference for alcohol or other drugs, as these substances can flood the brain with high levels of dopamine.
Thirdly, schizophrenics often suffer from impaired thinking and poor impulse control. These make them more likely to abuse alcohol. Even if they start by drinking just a few amounts, the way their brains are wired makes them more likely to binge excessively.
2. Psychological and Socio-environmental
Apart from their biological make-up, schizophrenics abuse alcohol because of several psychological and socioenvironmental factors. According to a study by Dixon et al., they feel less anxious and more energetic when they drink. For some, alcohol can help them establish their identities – and make friends as well.
Some schizophrenics, on the other hand, turn to alcohol to cope up with the stigma of the mental illness. A handful do so because of boredom. Then, there are people who drink to deal with problems such as unequal opportunities and poverty.
A number of adult schizophrenics who abuse alcohol, on the other hand, attribute their problems to deinstitutionalization. Although they live in mental health communities instead of hospitals, they continue to be stigmatized. Such results in a lack of opportunities – and these may have driven some to abuse alcohol.
The Consequences of Alcoholism in Schizophrenics
Schizophrenia alone can direly affect a person’s life. Sadly, the bad outcomes are even more magnified in schizophrenics who abuse alcohol. According to Drake and Brunette, this group is more likely to suffer from the following outcomes:
- Recurrence of psychiatric symptoms
- Illnesses such as hepatitis and HIV
- Other substance abuse disorders
- Legal problems
These consequences often occur due to the presence of other confounding factors. For one, alcoholic schizophrenics often have the predilection to abuse other drugs as well, which can lead to a variety of problems. They may fail to take their medications as recommended, and such could lead to severe symptoms. Additionally, they often live without a strong support network, with the lack of such driving them towards scrupulous activities.
Schizophrenia is treatable with medications and psychosocial therapy. Because of the co-occurrences of two diseases, a special integrative approach is used for schizophrenics suffering from alcohol use disorder. It involves four stages of treatment, which include:
- Engagement, where the therapist and the patient build a trusting relationship.
- Persuasion,where the therapist motivates the client to stay away from alcohol.
- Active treatment, where the person develops his own skills. The patients works towards recovery as well.
- Relapse prevention, where the individual learns strategies that can help eliminate the possibility of alcohol relapse.
The Silver Lining
Since alcoholism makes schizophrenic symptoms more severe, abstinence often paints a better clinical picture. Drake and Brunette’s study shows that symptom recurrence and hospitalization rates were markedly lower in schizophrenics who don’t abuse alcohol. Cuffel’s study also showed the same downward trend in non-drinking patients.
As it was seen in Drake and Brunette’s follow-up study, the positive effects were not short-lived. Results showed that apart from reduced symptoms and institutionalization rates, non-drinking schizophrenics reported better psychosocial stability and vast improvements as well.
Schizophrenia might be severe, but the prognosis can be better if alcoholism is removed from the equation. As such, schizophrenics should be treated for alcohol abuse right away.
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