Schizophrenia
By: Whitney Holderness and Brandon Mendel
CAN EXERCISE REDUCE SYMPTOMS OF SCHIZOPHRENIA?
The term schizophrenia defines a group of brain disorders that can cause hallucinations, delusional thinking and behavioral abnormalities. According to MayoClinic.com, the word schizophrenia means "split mind." Individuals with a form of schizophrenia interpret reality differently. This is a chronic mental condition that tends to worsen over time. While exercise alone is not enough to control the illness, it is a positive way to lessen some of the side effects and symptoms.
Psychomotor Agitation
Those suffering from schizophrenia will exhibit psychomotor agitation, activity triggered by anxiety. Movements vary but can include pacing, squeezing of the hands and dressing and undressing repeatedly. Any action that becomes repetitious would fall into this category. Exercise can serve as a distraction for those who exhibit psychomotor agitation. A person can be taught to exchange potentially harmful behavior, such as tearing at skin, into a positive movement, such as jogging in place. The agitation comes from stress and exercise helps to relieve tension and relax the mind.
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Depression
Schizophrenics lose the ability to make plans and express emotions, such as joy. Northwestern University's Medill Reports Chicago website states this lack of emotion often is construed as depression and can lead to a sedentary lifestyle. According to Medill, those with schizophrenia fall into a cycle of weight gain and lack of exercise. Schizophrenics benefit from structure and routine. A scheduled exercise program will help organize thoughts and increase activity levels to fight weight gain.
Chronic Illness
An affect of a sedentary lifestyle is chronic illness. Exercising on a regular basis increases overall health. This is vital for those with schizophrenia. The tendency to avoid exercise can reduce the ability of the immune system to fight off infection and illness. By increasing activity, you boost the immune system and stave off colds, bronchitis and viral infection.
Considerations
Exercise should be seen as a tool to help manage the condition, but is not a cure. Schizophrenia is a complicated mental illness that requires treatment including psychotherapy, a support system and drug protocols. The symptoms of the illness typically begin in the late teens or early 20s. Individuals develop disorganized behavior, delusions, difficulty speaking and unpredictable agitation. Do not rely solely on exercise to manage schizophrenia. If someone you know exhibits symptoms, they require medical diagnosis and treatment.
Read more: http://www.livestrong.com/article/360770-can-exercise-reduce-symptoms-of-schizophrenia/#ixzz2DH8xkBZU
Support Groups for Schizophrenia
People who have schizophrenia often have a tough time coping with everyday life because of their symptoms. They also experience added difficulty because most other people don't understand the unique challenges that the disorder presents. The vast array ofschizophrenia symptoms, including delusional beliefs, hallucinations and emotional indifference, can occur at any time and in a variety of combinations.
All of these factors can make it particularly tough for people with schizophrenia to recover successfully and lead independent lives.
Leaning on Each Other: Schizophrenia Support Groups
Loren Booda, 49, has been living with schizophrenia for 30 years. Now a volunteer for the National Alliance on Mental Illness (NAMI), Booda says support groups can help people deal with challenges that are specific to schizophrenia.
"It was either a support group or sit around, watch TV, or play video games," says Booda. "It gives us a social outlet. It functions for us like Alcoholics Anonymous for those who need it. We confront a whole bunch of disparate elements of schizophrenia, such as drug abuse, overeating, and emotional problems. A mental health support group covers all of the functions that would take four or five specialized groups to cover."
Booda, who lives in Washington, D.C., is a NAMI support group facilitator and works on NAMI's national Help Line. He says he learned the benefits early in his schizophrenia treatment.
"I started with support groups in the mid-1980s," he says. "At first I was ambivalent. I thought some people were monopolizing the group. But I soon learned that they were just trying to be helped. We invite everyone to say as much as they wish about whatever is going on, about how they are feeling. Their limit is three minutes. We concentrate on issues that are affecting the person in the group who is the most distraught on that particular day."
Support Groups: The Third Leg of Schizophrenia Treatment
Booda's experience with support groups is a testament to the fact that they are an important third leg of the treatment stool, which also includes medication and psychotherapy.
"There is this ancient tradition that we should never worry alone," says Ken Duckworth, MD, medical director for NAMI and an assistant professor at Harvard University Medical School in Boston. "Self-help groups are important because they reduce isolation, and reduce this idea that God has picked only on you. People get information, they learn about medications and other schizophrenia treatments, they learn about good doctors from others, and who will take insurance. It's problem-solving, support, and networking."
NAMI provides one of the nation's largest networks of support groups. Group leaders such as Booda make sure the meetings run on time and that no one dominates the sessions. Facilitators also help participants navigate potential crisis situations, since group leaders may have dealt with these issues in their own lives.
"Family members go to groups to do the same thing," says Dr. Duckworth. "They get support and [tips on] troubleshooting. If you share your problems, you're a little less burdened."
Schizophrenia Support Groups: Additional Help Is Out There
In addition to NAMI's network of support groups, here are other resources to help you locate a local support group or get involved in chat rooms and discussion groups online:
A state-by-state guide. The U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration has a state-by-state guide to mental health services, including support groups.
Find a friend. Compeer, a non-profit organization, helps people who have schizophrenia and other mental illnesses reach out and support each other.
If you prefer chat and discussion groups, consider these options:
- Schizophrenia.com, a non-profit group managed by volunteers.
- Schiz456, a support and discussion forum for people who have schizophrenia, their families, and friends.
- Caregiver.com hosts chat rooms for those who provide care to people with mental illness. It includes one exclusively for schizophrenia.
A Positive Step in Schizophrenia Treatment
So do people who participate in support groups manage their illnesses better than those who do not? Few studies have fully explored this question, but "NAMI is now studying the family-to-family support group," Duckworth says. "They have shown that the burden of illness is reduced and that people's stress levels are reduced. The study is in process to see if it really impacts patient outcomes."
Nevertheless, Duckworth warns that the study will be difficult to complete because not everyone attends their support group as faithfully as Booda — this will make it tough to conduct surveys over a long period of time.
Despite that, Duckworth and Booda are both convinced that connecting with others represents a positive and important aspect of schizophrenia treatment.
New drug-like molecules could improve schizophrenia treatment
Researchers at Vanderbilt University have identified chemical compounds that could lead to a major advance in the treatment of schizophrenia.
In a transaction announced this week, Vanderbilt has licensed the compounds to Karuna Pharmaceuticals in Boston, Mass., for further development leading to human testing.
All current anti-psychotic medications act by binding to serotonin and dopamine receptors in the brain to help control hallucinations and delusions, but they provide little relief of other serious symptoms, including social withdrawal and the inability to pay attention or make decisions. As a result, many patients have difficulty holding a job or living independently. In addition, current drugs have serious side effects.
The new Vanderbilt compounds work in a fundamentally different way than existing medications, by inhibiting glycine transporter one (GlyT1), an action that allows for more normal function of brain cells involved in schizophrenia.
“The potential of these new compounds to ameliorate the devastating social and cognitive deficits of schizophrenia, which do not respond to currently available medications, is very exciting,” said National Institute of Mental Health Director Thomas R. Insel.
The novel compounds were developed by Jeffrey Conn and Craig Lindsley, co-directors of theVanderbilt Center for Neuroscience Drug Discovery(VCNDD), and their colleagues in the VCNDD, part of Vanderbilt University Medical Center.
“We are delighted to have the opportunity to partner with VCNDD to help these drugs realize their full potential, to bring a valuable new treatment to patients and families suffering with this disabling disease,” commented Karuna CEO Edmund Harrigan, former executive vice president ofWorldwide Business Development at Pfizer.
Schizophrenia is a chronic disabling mental illness that affects more than 3 million Americans according to the NIMH, and 24 million people worldwide, according to the World Health Organization. The worldwide market for antipsychotic drugs exceeds $20 billion a year.
The Vanderbilt GlyT1 inhibitors were discovered and developed with support from the NIMH, which in 2010 awarded Vanderbilt a five-year, $10 million grant to establish a National Cooperative Drug Discovery and Development Group, targeting new schizophrenia therapies.
Bringing drugs to market
The work is now sufficiently far enough along to hand off to Karuna Pharmaceuticals, a Boston- based company focused on developing breakthrough therapies for schizophrenia.
That’s where academic medical centers can help. Vanderbilt is uniquely positioned to undertake early stage drug discovery, in part because of its strength in clinical pharmacology, its investment in research infrastructure including high-throughput screening, its ability to attract government, foundation and corporate support and its recruitment of top-notch scientists.It can cost over a billion dollars to bring a drug to market. Cuts in health care reimbursement for medications could make it even more difficult for pharmaceutical companies to recoup that investment. Some firms already are downsizing their research operations as patent protection ends for some of their best-selling brand name products.
“This work shows how publicly funded basic research can foster the identification of novel medication targets and promising candidate compounds that industry can then take forward,” Insel said. “It is a wonderful example of translational research with the potential to change lives.”
Conn and Lindsley’s colleagues in the Vanderbilt Center For Neuroscience Drug Discovery on the schizophrenia program include Carrie Jones, the center’s director of in vivo pharmacology; Colleen Niswender, director of molecular pharmacology; and J. Scott Daniels, director of drug metabolism and pharmacokinetics.
Self-Care for Schizophrenia
It is important for everyone, especially those with a mental illness such as schizophrenia, to exercise and eat a healthy diet, because a sedentary lifestyle and obesity can lead to a host of medical problems including heart disease, diabetes, and high blood pressure.
However, people with schizophrenia can have a difficult time with self-care, often neglecting to practice healthy behaviors such as exercise and weight control. One of the symptoms of schizophrenia, a lack of motivation, is part of the problem. “Diminished motivation leads some people to being less active,” says Thomas E. Smith, MD, associate professor of clinical psychiatry at Columbia University Medical Center and medical director of the New York City Mental Health Care Monitoring Initiative.
Another problem is the substantial weight gain that can be a side effect of drugs to control the illness. “The medications that schizophrenics often are prescribed are notorious for stimulating appetite,” Dr. Smith says, adding that putting on 100 pounds is not unusual.
Schizophrenia Self-Care Strategies
Here are healthy habits that people with schizophrenia should follow to improve quality of life:
- Be an advocate for your own health care. Unfortunately, health care providers may tend to take concerns voiced by people with a mental disorder less seriously. You must not only communicate your concerns regarding your schizophrenia, but also talk to your doctor about your body and what you should be doing to keep it healthy. If you don’t understand your doctor’s directions, ask follow-up questions. Write down instructions about when to take your medication and when your prescriptions need to be refilled.
- Quit smoking. People with mental illnesses are twice as likely to smoke compared with others.Smoking increases your risk for heart disease, lung cancer, and other illnesses, and it can also interfere with the absorption of your medications. Studies show that quitting smoking does not make symptoms of mental illness worse. In fact, if you stop smoking, you may be able to lower your dose and have fewer side effects such as weight gain or trouble sleeping. Ask your medical team about aids to help you stop smoking.
- Maintain a healthy weight. When you’re overweight, your heart has to work harder. This means you’re more likely to develop high blood pressure, which could lead to a stroke. The best way to maintain a healthy weight is to eat a diet rich in fruits and vegetables, lean meats, and whole grains, and low in fat, salt, and sugar. Eating healthy foods also helps you have more energy and feel better — it’s one of the most important things you can do for yourself. If your antipsychotic drugs are causing you to gain weight, discuss the problem with your health care provider, Smith says, but do not stop taking your medication on your own.
- Be active. An active lifestyle can help prevent diabetes, heart conditions, and weight gain. “If illness-related factors such as depression or negative symptoms limit your motivation to be active and get out, try to address those symptoms with psychological treatment,” Smith says. Talk to your mental health professional about therapy options.
- Get enough sleep. People with a mental illness often have sleep-related problems. You may have trouble sleeping or may sleep too much. To improve your sleep quality, don’t drink alcohol or caffeinated beverages or smoke before bed — these are all stimulants. Have a small bedtime snack of foods such as milk or turkey that contain L-tryptophan, a natural sleep inducer. Go to bed at the same time each night. However, don’t try to fall asleep if you’re wide awake. Relax before bed by taking a bath, reading a book or magazine, or listening to soothing music.
People with schizophrenia must take care of body and mind. The healthier your body, the better you will feel physically and mentally. The key is to follow a healthy lifestyle by eating properly, exercising, and sleeping well. If you need motivation to adopt healthier habits, be sure to talk to your doctors.
Schizophrenia and the Workplace
Of the roughly 2 million Americans with schizophrenia, it is estimated that only 10 to 27 percent are in the workforce. But a 2008 survey of those living with schizophrenia found that 76 percent of respondents said they thought having a job would improve their lives. For those people, significant barriers stand in the way.
Schizophrenia and Work: Is It Possible?
Whether a person with schizophrenia can work depends upon the severity of the illness and the nature of the symptoms. Studies have found that positive symptoms, such as hallucinations and delusions, are less of a barrier to employment than negative symptoms and cognitive deficits. Negative symptoms are the absence, or reduced level, of mental processes that should occur normally, such as the ability to make plans, enjoy pleasurable activities, and interact with other people socially. Cognitive deficits are problems with planning and organizing, remembering things, and paying attention.
Frank Baron, who lives with schizophrenia, has not returned to regular employment since his diagnosis, although he is active. "In my case, medications stop the delusions but they do not manage the cognitive deficits," he says. Baron says the cognitive issues prevent him from working: "Before, I was a civil engineer, but now I don't have the concentration." Baron serves on the Institutional Review Board for the Los Angeles County Mental Health Commission and does public speaking on mental illness issues.
Schizophrenia and Work: Which Jobs Are Best?
Schizophrenia does not predispose people to a specific type of work. The right job for a person with schizophrenia depends upon the severity of the illness and on a person's skills and interests. A few people with schizophrenia have been very successful professionally: Fred Frese earned his doctorate in psychology after a diagnosis of schizophrenia, and Elyn Saks earned a law degree after her diagnosis and is a professor of law at the University of Southern California.
But Baron notes, "Like they say on TV, 'results not typical.' " Most people with schizophrenia work in entry-level and part-time positions, and only about 30 percent of working people with psychiatric disorders such as schizophrenia have been promoted from entry-level positions.
Schizophrenia and Work: Health Benefits
Health insurance and other benefits are an important issue for people with schizophrenia to consider when choosing a job, and even when deciding how many hours to work. While increasing one's income seems appealing, the reality for people with schizophrenia is a bit more complicated. The entry-level positions that people with schizophrenia most often obtain rarely include benefits.
People who rely on Medicaid may have to limit paid work hours so as not to jeopardize their health benefits. A benefits counselor can help sort out the regulations that surround Medicaid and Social Security benefits, and help people make the right decision about how many hours they can work.
Schizophrenia and Work: Other Challenges and Solutions
A person with schizophrenia faces several challenges when seeking employment. It can be difficult to explain gaps in a resume to a potential employer without revealing your mental illness status, anddiscrimination against people with mental illness still exists.
On an individual level, Baron says that supported employment programs help some people with their quest for meaningful work. Supported employment programs help people with psychiatric disabilities prepare for, find, and maintain competitive employment.
This is especially important because schizophrenia tends to appear around young adulthood just as people are entering the workforce; people with schizophrenia may not have much work or job-search experience before diagnosis. Supported employment programs help with job searches and pre-employment training, and continue to provide services to help people with schizophrenia succeed in their jobs.