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Disability and Schizophrenia

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.


Schizophrenia can be crippling, but it is not always so. With effective treatment, including good access to proper medications and supportive counseling, those affected with the disorder can live reasonably normal lives. The key phrase here is 'reasonably normal'. Very few chronic people with schizophrenia can pass for 'normal' people when looked at very closely. It is likely that some odd behaviors and mannerisms will be noticeable during social interactions, even during periods of relative health. People with milder forms of schizophrenia are frequently able to work and live independently. They will likely need some special accommodations to do so. They will also show a level of functioning that is lower than their pre-illness condition. Some people experience only mild symptoms during their illness. However, an unfortunately large percentage of people with schizophrenia will experience severe to moderate symptoms, which can only partially be helped with medical treatment. Lifelong disability of varying levels can result. These challenges affect both people with schizophrenia and their families.

People with schizophrenia have problems in their ability to care for themselves and to meet other's expectations. These challenges are the ones that lead to disability. It is necessary for people to clean and feed themselves before they can function in society. If a person cannot do these basic tasks, they will find it difficult to deal with people at work or school. Hallucinations, delusions and other symptoms associated with schizophrenia can last into periods of relative recovery. This makes it difficult for them to lead regularly responsible, orderly lives. It is hard to remember to brush your teeth, for instance, when you are hearing a voice talking about your thoughts, and telling you what a horrible person you are. It is also difficult to show up for work on time when you are concerned that the FBI is out to get you, or that space aliens are broadcasting your thoughts by directly inserting them into other people's heads.

People with schizophrenia's difficulty maintaining a job causes them to have to rely on others for money and support. In addition, they often depend on others for help in getting and taking medication. Many also end up abusing drugs and/or alcohol, and smoking heavily. These issues contribute to their disability and health issues. Their relationships suffer heavily. Many lose contact with family members and friends who become burned out trying to prevent them from acting out in bizarre ways. As a group, their life expectancy is reduced due to suicide, accidents, and because of preventable diseases (that were not stopped due to poor self-care, unhealthy lifestyles, and poor medical care).