SURVIVING mental disorder, more so avoiding sliding back into a schizophrenic relapse is almost impossible. According to the World Health Organisation (WHO) Schizophrenia affects more than 23 million people worldwide. It is more common among males (12 million), than females (9 million) and starts earlier among men.
By Kudakwashe Pembere
People with schizophrenia are 2-3 times more likely to die early than the general population. This is often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases (WHO).
For 40 year old Tobias Mudavanhu (name supplied) a Schizophrenia survivor, the journey as a mental patient requires one to be strong in-order to fight the stigma deeply embedded in society. Despite the harsh economic environment which is very stressful, its a miracle Mudavanhu had not had schizophrenic relapses for the past 25 years.
Mudavanhu testifies that hope, faith and love alongside medication adherence sailed him through the past 24 years without experiencing a schizophrenic relapse. He has been battling schizophrenia from early 1990s saying due to stigma on people with his condition, he prefers this name and does not want to be filmed or photographed.
Born the third child in a family of five in 1978 is Mudavanhu who learnt of mental impairment, Stigma and ill-treatment from his Late father. He is a rare case.
“I was born on the 18th of December 1978 third child in a family of five. There were four boys and one girl. I first noticed mental illness from my father who suffered from it. My father started exhibiting signs of mental illness when I was six years old in 1984.
“I recall my father having episodes of getting out of the window and not reporting for work due to this illness. From this, I learned of the shaming and stigma associated with mental disorders. My father’s had a mental health specialist named Dr Chikara who treated his condition. He would relapse while working for ZESA and at times would report absent at work,” he reminisces.
“For the mere fact that as a parastatal there was no stigma, he would work without any problems. In 1991, my father had a stroke which paralysed his left side where he would drag his left leg. Seeing my father’s destressing situation, I lost all hope in completing my education but God gracefully, he got a pension from the company at a time when the economy was still sound.”
A schizophrenic patient presents any of several psychotic disorders characterized by distortions of reality and disturbances of thought and language and withdrawal from social contact. Schizophrenia is a chronic and disabling illness, with the majority of patients experiencing multiple relapses during the course of the illness.
Prior to the availability of the second generation antipsychotics (SGAs) physicians were primarily concerned with the risk of motor disorders, particularly tardive dyskinesia (TD). TD causes stiff, jerky movements of your face and body that you can’t control. You might blink your eyes, stick out your tongue, or wave your arms without meaning to do so.
Not everyone who takes an antipsychotic drug will get it. But if it happens, it’s sometimes permanent.
Relapse, characterised by acute psychotic exacerbation, may have serious implications. For example, there is a risk of patients harming themselves or others, of jeopardising personal relationships, education or employment status, and of further stigmatisation of the illness.
The causes of this condition is unknown. However studies have attributed genetical and environmental triggers.
Relapses have been seen in studies to be common in schizophrenia, and seriously impacts patients’ quality of life and social functioning. Many factors have been identified that may potentially increase the risk of relapse.
A variety of risk factors has been reported to be associated with relapse, including medication nonadherence, substance abuse, criticism, hostility or emotional over-involvement, and stressful life events. Research has it that 10 to 20 percent of schizophrenia patients hardly experience relapses.
Mudavanhu started exhibiting classic symptoms of schizophrenia in 1992. The media’s roles are to inform, educate and entertain.
To Mudavanhu, the media not only educated him but informed him. Radio shows on the then Radio 2 by the late psychiatrist Dr Chikara helped him a great deal just at the nick of time.
“I could hear voices. I could hear my grandmother’s voice. But I could recognise that she is in the rural area not here in town. I felt her voice. I struggled with these symptoms until 1993. Dr Chikara had radio shows on Mental Health on Radio 2 (now Radio Zimbabwe).
“I didn’t go to school this other day eagerly waiting to listen to this show and explained to my mother that I had done so for this show. On the show, he talked of symptoms I had. These included sleeplessness, eating disorders and suicidal ideas which I developed through hopelessness. Realising that there was a professional who related with me mentioning the same things I experienced, I pleaded with my mother to go for a consultation on the condition with our General Practitioner who was called Dr Dizwane. I wanted to see Dr Chikara,” Mudavanhu recounts.
Antipsychotics are viewed by some as leading, over a prolonged period, to eventual recovery for some patients with schizophrenia.
“In the first week of August, 1994, Dr Dizwane referred me to Dr Chaodzera for a CT Scan of the brain. When we showed Dr Dizwane the results from the scan, he eventually referred me to Dr Chikara. My first visit for Dr Chikara was August 14, 1994. I vividly remember that day for it was one that I first took psychotropic drugs. I was to be reviewed after two weeks. Taking these psychotropic drugs saw me having baby sleeps, gained appetite, the voices disappeared with the suicidal thoughts gone.
“At the review, I told Dr Chikara that I was feeling better suggesting I stop the medication. Chuckling, he prescribed me further medication. This time, it was medication for a whole month. I started taking the tablets. I didn’t do well in my O Level Examinations due to my condition passing only one subject, Accounts,” Mudavanhu said.
Upon not doing well in his O Level exams, Mudavanhu started selling wares in South Africa. He had a bank account with First National Building Society which due to economic pressures was placed under curatorship.
This left Mudavanhu with no choice but to join the Zimbabwe National Association of Mental (ZNAMH) as a user in 2000. There, he was offered a job by one Mrs Matare which he gladly accepted. But as the economic crisis worsened he left the organisation and returned to the cross border business.
In 2005, he married and was to be blessed with a healthy baby boy. Mudavanhu feared the boy to be born with cerebral palsy, a neurological disorder affecting motor skills and muscle tone.
“Early 2005 is when I married my wife. She did not have any mental disorders then. We were blessed with a healthy baby boy whom I named Tinotenda for there were times I feared he would have cerebral palsy. I would like to thank God for His mercy and faithfulness. My wife was very caring. She took good care of me to an extent that I was blind to notions that men have torrid times with their wives,” says Mudavanhu.
Post-natal stress led to his wife being early diagnosed with Bipolar Affective Disoder following their second child’s death. But Mudavanhu has since been supportive to his wife ensuring that she gets her medication.
Mudavanhu has several things he wishes to be addressed. For example, he wants to see mentally impaired patients get medications without the hassles of having to fork out United States Dollars which are scarce. He also wants the alignment of provisions of Disability Act and Mental Health Act. He says this will help them in accessing funds from the social services department.
To Mudavanhu hope, faith and love have been driving forces in his life. These have seen him reach close to 25 years without a relapse. To avert stigma, he does not want to appear on TV at the moment until he gets funding to appear on billboards as a mental health champion.
With mental impairment in the African set up believed to be caused by a concoction of bewitchment and genetic factors, Mudavanhu is convinced his condition is hereditary.
“It’s also my wish to see Mental Health Prioritised. As mental health patients we have other conditions. For example I’m also asthmatic. So I believe I was not bewitched to be mentally ill but it is a hereditary condition from my forefathers, my parents like I earlier mentioned that my father had this condition,” he said.
ZNAMH clinical psychologist and national coordinator Ignatious Murambizi finds Mudavanhu’s life battle with schizophrenia equally fascinating. He said its possible for one to ward off relapses.
“There are several about things to avoid relapses. One is accepting your condition while knowing what triggers it. Second thing is psycho-social support from the family, friends and relatives. The third item is to adhere to medication. The fourth thing is that of staying away from drugs and dangerous substances. One also needs to be prayerful. The other thing is to manage your stress to avoid relapsing,” he said.
A comprehensive review from the World Psychiatric Association section on Pharmacopsychiatry notes “Antipsychotic treatment has a significant impact on the long-term course of schizophrenic illness and can significantly facilitate recovery.”