At one point, you may have seen someone in your neighbourhood wandering around aimlessly and possibly talking to themselves. You probably called them ‘mad’ or ‘bewitched’ or ‘possessed’, but what you didn’t know is that the person could’ve been struggling with a mental disorder.

For instance, it could’ve been schizophrenia, a chronic brain disorder that affects a person’s ability to think, feel and behave clearly. Schizophrenia may be characterised by hallucinations, thoughts or experiences that seem out of touch with reality, disorganised speech or behaviour and decreased participation in daily activities. Difficulty with concentration and memory may also be present.

A patient’s ordeal

Ishimwe, (not real name), a mother of one, was diagnosed with the illness almost six years ago, and started treatment. She describes going back into society as a very disheartening experience.

"I can’t tell you that I really remember what happened during my episodes, but I have heard stories and some are really bad. When I recovered, being around people who knew me while I sick was painful, they would point fingers at me, some would move away from me—scared that I would ‘infect’ them—or beat them. I had a hard time accepting myself because of that, till this day,” she says.

When she had the disorder, her family wasn’t supportive as they thought she was bewitched. Although she lived with a half-sister, often times, she wandered around almost naked, aggressive towards strangers or sometimes even friendly. Sadly, during this time, she was also raped, and got pregnant. However, a random sympathiser decided to take her for treatment at Ndera. She received treatment while pregnant, and a couple of months later, was released, as she has shown tremendous recovery. She had her son not too long after. 

"I received treatment from doctors, therapists and others I don’t recall well. Being at Ndera was comforting because I could see that I wasn’t the only one with a problem, and we were taught that we could recover and go back to society and have a normal life like others,” Ishimwe recalls.

Her family was also sensitised on the disorder, assured by doctors that Ishimwe was not bewitched and that she would have a normal life again. However, after some time, she decided to find her own place with her son for ‘a peace of mind’.

Caraes Ndera Neuropsychiatric Hospital, recorded 54.64 per cent of the people admitted to the centre with schizophrenia in 2019 alone.   

Dr Bizoza Rutakayire, a psychiatrist and psychotherapist at Ndera, says that schizophrenia is a mental disorder that is chronic.

"This mental disorder is characterised by a divided mind; the word ‘schizo’ means divided and ‘phrenia’ means mind or spirit, the evolution of this mental disorder is a crisis dominated by agitation. This chronic mental disorder is the most severe in psychiatry, and can be hereditary,” he says. This chronic disorder also commonly affects young people and adolescents.

"This disorder has various categories and has to be treated for a lifetime period, the types which are very common here are paranoid schizophrenia, hebephrenia, and schizoaffective disorder,” Dr Rutakayire says.

Common symptoms of schizophrenia

• Delusions: These are false beliefs that are not based on reality. For example, you think that you’re being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you, or a major catastrophe is about to occur. Delusions occur in most people with schizophrenia.

• Disorganised thinking (speech): Disorganised thinking is inferred from disorganised speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can’t be understood.

• Disorganised or unusual behaviour. This may show in a number of ways, from childlike silliness to unpredictable agitation. Behaviour isn’t focused on a goal, so it’s hard to do tasks. Behaviour can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.

"Suicidal attempts can also be found in schizophrenia, not only in depression, that is why the evaluation of suicidal risk is important also in schizophrenia. But in the classification of the symptoms we have criteria that we look at first, like the fact that the symptoms are not linked to consumption of cannabis, amphetamine or alcohol, otherwise if that is the case, the symptoms are classified in another disorder called drug-induced psychotic disorder,” Dr Rutakayire explains.  

Treatment

"In treating our patients, we use remedies that are assigned to the symptoms, but we also use biopsychosocial approach, psychotherapy to deal with psychological problems, family problems, relationship problems that can lead to relapses, and we also use the social approach to facilitate the reintegration of the patient into the community again,” Dr Rutakayire explains.

According to the doctor, the biopsychosocial approach is used to give stabilisation to the patients, psychoeducation is also another approach used to insist on the fact that these mental disorders are not connected to demonic possessions or witchcraft.

"People have to understand the patients are also normal, we also have patients that are schizophrenic that have successful lives and careers,” he says.

It is important to note that the disorder does not make one incapable of achieving anything in life if well treated. If you notice some of these symptoms in someone, take them to the hospital before anything else. It is always good to seek professional assistance first.