Schizophrenia
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Disability and Schizophrenia

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.

Disability

Schizophrenia can be disabling, but it is not always so. Given effective treatment, including good access to proper medications and supportive counseling, affected people can live reasonably normal lives. The key phrase here is 'reasonably normal'. Very few chronic schizophrenic patients are able to pass for 'normal' people under extended scrutiny; it is likely that some odd behaviors and mannerisms will come across during social interactions even during periods of relative health. Nevertheless, people with milder forms of schizophrenia are frequently able to work and live independently (albeit with some special accommodations and at a level of functioning that is lower than their pre-morbid (pre-illness) condition). Though some people experience only mild symptoms during the course of their illness, an unfortunately large percentage of people with schizophrenia will experience severe to moderate symptoms which can only partially be helped with medical treatment. Lifelong disability of varying degrees can result, affecting both patients and their families.

Deficits in patients' ability to care for themselves and to meet other's expectations is the root challenge faced by schizophrenic people, and the one that leads to disability. It is necessary for people to clean and feed themselves before they can function in society. If a person cannot accomplish these basic tasks, they find it difficult to function with people at work or school. Hallucinations, delusions and other motivational symptoms associated with schizophrenia that can persist into periods of relative recovery make it difficult for schizophrenic people to lead consistently responsible, orderly lives. It is hard to remember to brush your teeth, for instance, when you are hearing a voice commenting on your thoughts, and telling you what a horrible person you are. Likewise, it is difficult to prioritize showing up for work on time when you are concerned that the FBI is out to get you, or that space aliens are broadcasting your thoughts by directly inserting them into other people's heads!

Schizophrenic peoples' difficulty sustaining work causes them to have to rely on others for money and support. In addition, they often have to depend on others for help in getting and taking medication. Adding insult to existing injury, many schizophrenic people end up abusing drugs and/or alcohol, and smoking heavily, contributing to their disability and health issues. Their relationships suffer heavily. Many schizophrenics lose contact with family members and friends who become burned out trying to prevent them from acting out in bizarre ways. As a group, their life expectancy is reduced due to suicide, accidents, and otherwise preventable diseases (that were not prevented due to poor self-care, unhealthy lifestyles, and inadequate medical care).