It would not be an exaggeration to say that this is the most dreaded disorder in the field of psychiatry. It is also very prone to be missed if the clinician is not vigilant about the symptoms and proper evaluation. There is also a disturbing lack of awareness among the common people regarding the availability of proper care and treatment for the disorder.

The disorder generally comes to attention when the afflicted person starts showing abnormalities in his/her behavior. The changes can be varied. The person may start suspecting anyone of trying to harm him without any apparent reason. Due to this suspicion, he may start remaining extra vigilant towards his surroundings. Or, he may start avoiding those person/persons or their related environments. These suspicions may grow to such a level that the patient may try to harm himself or that person. Many a times, the closed ones may not be aware of these things till the extreme steps have been taken by the patient. The themes of suspicions may also vary. Someone may start feeling that he is the god or some very important person on a secret mission. A person may start suspecting the fidelity of his/her spouse. Many a times, he may feel as if his closed ones have been replaced by imposters. And many more….

Sometimes, the person may start talking to imaginary people. It would be seen as if he is talking to himself, making gestures even if no one is around the person. He may hear voices which no one else is able to hear. Those voices may keep interacting with him or start ordering him or keep discussing about the person’s every activity. As the frequency, volume, distress related to the voices grow, the patient may get severely disturbed. He may act upon the orders given by the voices- even to harm self and others. He may not even be able to pay attention to those really around him.

The patient may also stop paying attention to their health and hygiene. He may stop taking bath for months or stop grooming himself according to his social expectations. He would not bother even if the health is failing and would appear to remain in his own world. He would not accept any help and would even get irritable if tried to. He would not appear affected by any events- happy or sad- in his family.  

To conclude, I want to convey that this problem is pretty common in the general population. The main concern is that it is very frequently ignored and thus progress uncontrollably. Even if coming to attention, the person having this problem doesn’t get proper treatment. So, if we want to help our society, our friends and relatives, we must understand that schizophrenia is a REAL DISORDER and POTENTIALLY CURABLE. What is needed is just proper recognition and treatment by professionals trained to manage this illness.

Dr. Ankit Chaudhary

MBBS, MD (Psychiatry)