Mental Illness

Mental Illness

One in every hundred people will develop schizophrenia in their lifetime. At the beginning of the 21st century, three hundred thousand Canadians aged sixteen to thirty have been diagnosed with schizophrenia. The average time between onset of symptoms and fist effective treatment is one to two years, but be much longer.

Males and females are equally likely to be diagnosed with schizophrenia. But males tend to have an earlier age of onset, in the teens or early twenties for men, and in the twenties or early thirties for women. Nearly 80 per cent of people with schizophrenia experience a major depressive episode at some point in their lives.

Approximately four out of every ten people with a diagnosis of schizophrenia attempts suicide, and approximately one in ten people diagnosed with schizophrenia die of suicide, making it the leading cause of premature death for people with with schizophrenia. Besides, suicide in this population is rarely attributable to florid psychotic symptoms (hallucinations, delusions); it is more likely to occur in periods of remission or improved functioning. Depression and hopelessness are important factors in suicide by people with schizophrenia.

Tom Ko has worked with 160 families in his job as therapy supervisor at the Calgary Early Psychosis Treatment and Prevention Program. Many – but not all – of his clients are young enough to be living at home with parents and siblings. Ko, who has a master's degree in social work, encourages the whole family to attend psychoeducation sessions with him. “Not all siblings have strong emotional reactions to the illness,” says Ko, a social worker. “But all have some reaction to a psychotic illness in the family.”

How Siblings Are Affected

Here are some of the common emotions and issues raised by the siblings:

1. Anger of parents (“Why don't they take control and fix this?”) and at the unwell sibling (“Why doesn't he just get better?”) “They get angry a lot because things have changed, “Ko says. “They want their brother or sister back.”
2. Grief and sadness: “Because the family isn't the same, and they can sense that.” Ko says that children go through a grieving process just as parents do. “When things change and everything's up in the air, they do get depressed.”
3. Fear that they'll become mentally ill. “Not the seven-year-old but the fourteen-year-old says, “Will I get it?” And we are always upfront.” (Research shows that if you have a first-degree relative with schizophrenia, you in turn have a 10-per-cent chance of winding up with the disorder; this compares to a 1-per-cent chance for someone with no diagnosed relatives.)
4. Guilt that they contributed to their sibling's disorder, or made it worse. For example, two brothers may have been fighting just before one is diagnosed (which is not uncommon because the sibling relationship changes with the onset of symptoms). “We try to tell them, “ You didn't know; of course you got into fights; everybody does, but it didn't cause the illness.
5. Loss of normal family relationship: When parents are tied up with hospitals and meds and caring for their unwell child, says Ko, “It's easy to forget there are other kids involved... Often they (the siblings) will say “we used to have family dinners together, do this and that together.” We try to get them back to those family routines so that everything goes back to normal as much as possible.”
6. Confusion because they know something is wrong but no one is explaining what or why. “They find it very difficult to understand sometimes. They can tell their brother or sister is different, they can tell their family is different, and they wonder. But it just becomes a family secret that no one talks about. They want to know what's going on.”

People can recover. Most of the people who have recovered have been at the depths of depression or the depths of some other illness, and they have made it back to find a life worth living with meaning and purpose. Illustration by Elena.