Fear and paranoia

Many people are afflicted with mental diseases like schizophrenia. They are unable to distinguish between fact and delusion. May 24 is World Schizophrenia Day

By Shevlin Sebastian

One morning, Ramesh Menon (name changed), a schizophrenia patient, set out to do a cartoon. But there was nothing funny in it. He drew an agonised man, with open mouth and shut eyes. Inside the head, where the brain is located, there are several questions marks. Just outside, above the temple, there is another series of question marks, ending in a large one near the forehead.

“I view everything suspiciously,” says Ramesh, describing the cartoon. “I told my mother about the disturbances caused by such thoughts. I get peculiar ideas often. At the same time, I believe I am blessed. I have a divine nature within me. But no one believes me.”

In another cartoon, Ramesh drew a coiled wire entering the ears of a person. All over the chest Ramesh has drawn ragged mountain-like peaks. The face, with a straggly beard, with a long nose and fleshy lips seems to be a self-portrait. Two drops of perspiration can be be seen at one side of the forehead.


“This drawing is about my experience," he says, "Something is piercing my ears. It is causing an unbearable sound and pain. I feel an intense burning inside the body and have to drink a lot of water to cool down.”

Dr. Dr. M. Chandrasekharan Nair, Director, Head of Psychiatry, Nair’s Hospital, Kochi, encouraged Ramesh to do drawings to capture what he was going through during a full-blown psychotic breakdown because of schizophrenia. The end result was several cartoons, which showed Ramesh's deep sense of paranoia and distrust of people.

“When he is sick, Ramesh is not in touch with reality,” says Dr. Nair. “But during other times, he talks sense. He is on a daily course of medicines.”

In the past, patients would suffer a visible impact when they took drugs. “They would have a catatonic look, shivering hands, and walk slowly but stiffly, almost like a statue, says Dr. Nair. “But that is no longer the case, thanks to new-generation drugs.” One of the most popular is Clozapine. “It is a wonderful medicine,” says Dr. Nair. “There are no visible side-effects and has a good impact in controlling the disease.”


Ramesh is now 35 years old and for the past several years he has managed to avoid having a breakdown by taking tablets regularly. He works as an accountant in a company and does cartoons in his spare time.


Apart from drugs, counselling helps to discover the factors that is causing stress in the patient. “In Ramesh’s case, he was under the delusion that everybody was teasing him,” says Dr. Nair. “But the family actually treated him well. I tried to tell him that.”


May 24, is World Schizophrenia Day. It is defined as a mental disorder which results in a breakdown of thought processes, emotions, reasoning, and an inability to distinguish between reality and fantasy. In India, around 25 million people suffer from the disease. In Kerala, there is also a significant number of victims.


“Schizophrenia occurs because of hereditary and genetic factors, the influence of the environment, and diseases like meningitis, which affect the brain,” says Dr. Nair. Some signs include the sudden withdrawal from the public. Or a person becomes incoherently garrulous. There is a lack of logic in his talk. Some believe that they are possessed of a divine or demonic spirit. There is also a paranoia that people are attempting to harm them.


“I know of a 17-year-old girl who has not gone to school for the past two years,” says Dr. Nair. “She told me that her parents have been attempting to poison her.”


Sadly, to watch a son or daughter fall prey to a mental disease is one of the most agonising experiences for a parent. “Because of the stigma of a mental illness, parents cannot confide in anybody,” says Dr. Nair. “Hence, they have to face an unbearable situation on their own.”


Interestingly, all normal people have schizophrenia-like experiences often. “When you have a dream at night, you go through incidents which seem to appear very real. You are being beaten, or chasing somebody, or flying in the sky. But the only difference is that, unlike the schizophrenic, you can awaken and realize that it is a dream, while the schizophrenic patient is unable to distinguish between fantasy and reality.”


(The New Indian Express, Kochi and Thiruvananthapuram)