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The Daily Struggle

© Ian Chovil

Not so long ago schizophrenia was a catchall diagnosis for many people who didn't really have anything as disabling as schizophrenia, and they recovered with and without medication. These days you can almost define schizophrenia by the need for medication and by what happens when someone stops taking medication. In a world where people work and raise families people with schizophrenia generally are in solitary early retirement. We'll have to wait and see what impact optimum treatment strategies have on long-term disability. The optimum treatment strategy is within the first six months with continuous prevention of psychotic symptoms thereafter. It's a very difficult strategy to achieve for a wide variety of reasons. My history of untreated psychosis for ten years indicates just how far from treating people in the first six months we really are. More people developing schizophrenia are treated optimally these days, but it is still more the exception then the rule.

Almost everyone tries to de-emphasize that schizophrenia is a very disabling disease. Without optimum treatment, you get substantial, more or less, permanent disability. The degree and quality of disability varies a lot from person to person. We generally live on long term disability benefits, from the government, or from private insurance plans. They are not usually very generous so you have to struggle to make ends meet. And then there are some very strange regulations, like the one here in Ontario that makes it very difficult for anyone receiving disability benefits to live with someone of the opposite sex, whether that person is also collecting disability benefits or not. As if it was somehow unnatural or undesirable for someone with schizophrenia to live with someone of the opposite sex.

You can feel very disconnected with the real world even with what would be called a good response to medication. You don't have to get up at 7 AM to be at work by 9 AM. You don't have an hour just for lunch at noon. You don't come home to making dinner for the family. Even housework is optional. You live alone. Some people would say that is early retirement and might envy living on disability benefits. And for some people that early retirement might be preferable to the life they are living. I doubt that that is true for many people though. My friends would all love to get off these disability benefits, which tend to become very demoralizing. For someone with schizophrenia this early retirement can also be a really challenging daily struggle. Few people understand that though.