Think You Can Recover from Schizophrenia
Do you think you can achieve anything you put your mind to? Henry Ford once said "whether you think you can, or you think can't, you're right". Of course there needs to be some boundaries placed around this statement, but essentially he was saying that what we "think" we can do (or can’t do) shapes our reality. Our attitude about what we are doing determines how we act and how we act shapes the world around us.
So I pose the question: In our health system, are people with schizophrenia and their families led to believe that a full recovery is possible? Of course there are circumstances where it is not, but people need to be given hope by being made aware of the best outcomes that are possible, rather than focusing on the much rarer worst outcome. Recovery rates over 10 years are better than one may imagine, statistically 25% of people make a full recovery from schizophrenia and another 50% are so improved that they can be relatively independent. To some degree we can choose which side of the line we fall on.
Doctors have to be realistic about what can be achieved, but I believe there is room to be more positive when presenting the prognosis to patients and families. Of course positive thinking is not enough on its own. Nothing ever happened simply because someone believed it would. Doctors and caregivers need to present a picture of recovery that they must first believe themselves. If for example, a doctor believed that a full recovery is a possibility if:
1. Medication is taken in accordance with doctors’ orders;
2. Diet is changed to include fresh food high in nutrients and antioxidants;
3. Diet is supplemented by nutrients that people with schizophrenia are low in;
4. Home life is made as stress free as possible;
5. General fitness is improved through exercise; and
6. There is a commitment to stay away from street drugs.
Then he or she should present this as potentially the key to recovery and reinforce that in these circumstances a full recovery is possible.
In the north of Finland a group of family therapists practice a method of therapy called Open Dialogue that gets an 85% drug free rate of recovery from first psychotic break, and they do this largely without medication. This is the highest recovery rate in the western world but they are not astonished by their results, in fact this is considered normal and they continue to achieve these results decade after decade. I wonder what would be possible if doctors in the rest of the west could break with there current beliefs and treat people as though they were able to recover.
In my opinion, too often too much reliance is placed on medication alone. Doctors don't mention the other factors that can help recovery and so the action that needs to be taken is not. Even worse generations of trainee psychiatrists are led to believe in a myth; that true recovery from schizophrenia is not possible. Belief in this myth then impinges upon the perception and therefore treatment of schizophrenia. If you would like to read a study that looks two decades of empirical evidence that explodes this myth and 6 just like it click here. It is written by 2 very respected psychiatrists Courtnay M Harding and James H Zahnier of the University of Colorado, School of Medicine in Denver, USA.
To put a personal perspective on this, I was devastated by the diagnosis that was given to Sam (which is the pseudonym for the close relative of mine who suffered from the illness) but I refused to think that it was hopeless. I could have easily fallen into the trap of imagining a horrible future with Sam in and out of institutions, but if I had my actions would have been different and this would have shaped my future. I was lucky enough to be able to keep these thoughts at bay. With the belief that a full recovery was possible I researched the action I could take to make it happen. Unfortunately, at no point did Sam's doctor recommend any of additional action I could take. I can only assume that he felt that any action I could take would be futile. Nevertheless Sam made a full recovery. Sam's doctor said that he would be on medication the rest of his life but Sam is now medication free!
I know that I am blessed with the situation that I am in and I know that the prognosis for some who are suffering from schizophrenia was never as good as for Sam but no matter what the circumstances are, if you are sure that a full recovery is possible, you are right.
