Double trouble:Mental illness & drugs

Tom was a very bright young man. He graduated from college top of his class. Two years after working in a bank, he developed a mental illness. It was schizophrenia. The news of having a mental illness was devastating for Tom and his family. No one in his family ever had a mental illness.

For the next few years, Tom's life took a downward course. He lost his job. He started to isolate himself from family and friends. He stopped taking care of himself and refused to bathe and would not attend to his personal hygiene. Then he started to smoke cannabis. His condition then got further out of control. His family could no longer cope.

This story is a typical one. It highlights the plight of persons who develop a mental disorder such as schizophrenia and also use drugs.

What is schizophrenia?

Schizophrenia is a mental disorder that is due to a chemical imbalance in the brain. The chemical dopamine is in excess amount in the brain.

How does someone with schizophrenia behave?

There are many types of schizophrenia. Features associated with this disorder include hallucinations where an individual hears voices or sees things that are not present. Some people may also complain of smelling poisonous gas when this is not present. The common voices people hear are voices commenting on their behaviour, cursing them or giving them commands.

Some persons who have schizophrenia may have paranoid beliefs.

Common beliefs held by persons who are paranoid are that others are trying to hurt them, plotting against them or spying on them. As a result of these beliefs, they are very suspicious and secretive. They also have a tendency to isolate themselves as they do not trust others and may become violent and aggressive.

Persons with schizophrenia may show marked change in behaviour in that they become very withdrawn and appear to lose interest in doing things. They may stop taking care of themselves and their surroundings and refuse to socialise or go anywhere.

What is the relationship with schizophrenia and drugs?

The precise relationship with schizophrenia and a drug such as marijuana is not very clear. In some patients, it appears that marijuana triggers schizophrenia . Many psychiatrists believe many people develop the mental disorder first and then they start to use marijuana because it actually makes them feel better. Although marijuana will make some individuals feel better, continued use makes the hallucinations worse and makes them even more paranoid.

How do you treat persons who have mental disorders and use marijuana?

This is a million-dollar question. Marijuana dependence, by itself, is very difficult to treat and when it occurs with a mental disorder such as schizophrenia, then it becomes double trouble. It is extremely difficult to treat.

What if I have a family member with a mental illness who uses marijuana?

Choose your battles. Focus on the treatment of the mental disorder. If you focus on the marijuana use, you are going to become frustrated.

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept. Of Community Health and Psychiatry, University of the West Indies, 977-1108; email: yourhealth@gleanerjm.com.