One of my relatives was studying abroad for his master's degree and doing well overall until two months before his thesis was due and graduation, his computer crashed and he lost two years' worth of research and work. This loss hit him like a truck and he was in a state of extreme stress and anxiety because his work was unrecoverable and he did not have any backup. Being a naturally cautious person, he could not figure out how he let this happen and devastate him. Everything was out of his hands. He slowly started to withdraw from his friends and family, stopped meeting with people, let go of his activities, and eventually, started hearing voices in his head that told him others were trying to hurt him. With the help of his sister and mother, he did graduate from the university but not the same person he used to be. He visited a psychiatrist who diagnosed him with schizophrenia and started him on antipsychotics but because he was alone, he did not trust the medication prescribed to him by the doctor and refused to take it so his condition continued to worsen.
He returned back home to Pakistan after graduation but was unable to work towards the bright future he was supposed to have and instead became a recluse in his room. He soon was unable to complete simple daily tasks and would even refuse food at times when he suspected someone was trying to poison him. His father tried to help him find simpler office jobs in hopes he would be able to become independent but the culture in Pakistan did not tolerate his unusual behaviour and anti-social nature. He had nowhere to go and no programs available to help him rehabilitate into society. The doctors kept prescribing him pills despite the fact that he refused to take him and there was a delay of several years before he was put on an injectable antipsychotic. Unfortunately, this is an ongoing fight for him now in a country that does not tolerate or accept people with mental illness.
Schizophrenia is a mental disorder that affects all aspects of the person's life because of the recurrent psychosis and it is considered one of the "most disabling and economically catastrophic medical disorders" and is "ranked by the World Health Organization as one of the top ten illnesses contributing to the global burden of disease" [1]. There are many symptoms that could be associated with the disease such as hallucinations, delusions, cognitive impairment, and mood and anxiety symptoms [2]. In Pakistan, there is such a huge stigma working against mental health which means individuals suffering from such conditions do not receive the compassion and dignity to encourage or enable them to live with their condition in an independent way. It is not just the patient that requires education and rehabilitation along with their ongoing care, the family who lives with the patient needs those resources too in order to learn how to cope and support their loved one through this difficult diagnosis.
In Canada, for example, there is a stigma against different mental health disorders however, there are some resources allocated towards such individuals to help them become independent functioning adults if they are capable. From childhood to adulthood, there are programs available, albeit with limited funding and quality, to enable the individual to continue to grow and help them not feel so isolated. To shun individuals from participating in society and moving with their community would push them towards depression which would have even more debilitating consequences on top of what they are already going through.
Also, not everyone is the same, most of the mental health disorders provide a spectrum exhibited by each person. For some, medication provides a positive outcome and they are able to regain some of their original functionality while others are not so fortunate. It is important to give everyone a chance to achieve the most that they can at normalcy.
In Pakistan, the stigma is so strong and contagious that my cousin was unable to find a job in order to support himself, learn basic life skills to move through life, or receive appropriate treatment on time to tackle what ailed him. His parents are aware that he will never marry or have the love of a family or even friends to help him to continue to navigate through life. Can you imagine the burden that puts on aging parents? He needs more than religious rituals to cure him and most importantly he needs love and understanding void of judgment. He is the hardest on himself and trapped within his own mind and does not need to be reminded of that by everyone around him.
It is time for us to be more accepting of individuals' differences and normalize seeking help and resources. Everyone should have the opportunity to live a life with autonomy and dignity as an absolute minimum. None of us know what we will have to face in the future and should not take our privilege for granted and we should not hesitate to use our hands to help those who may need it.
Until Next Time,
References
1. Murray CJL, Lopez AD. The Global Burden of Disease, Harvard University Press, Cambridge, MA 1996. p.21.
2. UptoDate: Schizophrenia in adults: Clinical manifestations, course, assessment, and diagnosis
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