Doctor SAYS: FRIENDLESS

Dear Counsellor,

My daughter is 28 years old and has been diagnosed with a schizoaffective disorder. She has become withdrawn, quiet and does not have any friends. She stays in her room and refuses to bathe or comb her hair. She is on medication but it does not seem to be working. She resigned her work and it is financially stressful for me.

- Maxine

Dear Maxine,

Schizophrenia tends to have its onset in the late teen years and early 20s. Her behaviour is typical of patients who are not responding to the medication. Your daughter needs to be under the care of a psychiatrist. There are varieties of medications which can be used. If she is not responding to the medication we need to look at the dosage and duration of treatment. We usually start at the lower doses so that side-effects are minimized. However, we usually increase the dose of the medication to a higher dose to get the desired response. The medication has to be given for sometime at the higher dose before we say that the patient is non-responsive. The medication is changed to another more effective one. We cannot predict which medication will work and at what dosage. Patients who are non-responsive to medication should be referred to a psychiatrist.

Medication is not the only thing that she needs. She seems to need hospitalization to stabilize her symptoms and get her to the stage of recovery. She will benefit to be in a group home for rehabilitation and reintegration back into the workforce.

The group home will get her back into the work routine and rebuild her confidence. After a bout of illness many patients lack confidence and have low self-esteem. Counselling by a psychologist will be helpful in dealing with daily life issues. Currently, the cheaper, older medications are off the market but the newer medications are effective but with different side-effect profiles.

Don't give up hope as many people are dealing with the same issues. In Jamaica many family members are involved in the care of their relatives. As a caregiver it can be distressing and frustrating. PERSEVERANCE conquers difficulties.

COPING

Dear Counsellor,

I am a professional and I find it difficult to cope at times. I get fatigued and worn out at times. I take supplements and do exercise.

- Margaret

Dear Margaret,

Stress is a part of life and we have to adjust to life's challenges. You seem to be on the right track, as you are taking supplements and doing exercise. Have a look at your diet and sleep patterns. Sleep is essential to recovery of the body. Are you getting enough sleep? Each day you need to get rest and respite care.

Go to your general practitioner for a check-up as you may be anaemic. Organise yourself each day and manage your time well.