Grief and Mourning in Schizophrenia

Grief Schiz

Precautions and Procedures for the Prevention of Suicide and the Treatment of Depression in Recently Diagnosed Schizophrenics

Any major chronic medical diagnosis can have psychological and emotional reverberations for the patient, as chronic conditions can often be perceived as a "life sentence" of sorts. The inescapability of symptoms and the long-term prognosis of many chronic disorders can cause patients to seriously question their future quality of life, the impact that their condition will have on personal relationships and other interactions with the outside world, and the purpose or meaning of continuing a life that they may perceive to consist largely of pain or other problems. In such scenarios, it is not unusual for depression and even suicidal tendencies to be observed, and for patients' problems and quality of life issues to be ultimately compounded and exacerbated as a result of this depression.

It is not only the diagnosis of chronic physical disorders that have the potential to cause these depressive reactions in patients, but diagnoses of many chronic mental disorders can have depressive impacts that are similarly profound if not even more so. Schizophrenia is one mental disorder the diagnosis of which has been empirically examined and shown to lead quite frequently to depression and suicidal thoughts in patients (Wittman & Keshava, 2007). The following pages will explore the issue of grief, depression, and suicidal tendency in patients diagnosed with schizophrenia. A safety plan to mitigate the effects of these tendencies and to assist patients in overcoming them is developed as a result.

Depression and Suicide in Recently Diagnosed Schizophrenics

In a series of three case studies involving patients recently diagnosed with schizophrenia, Wittman & Keshava (2007) not only observed that depression and suicidal thoughts were common among these patients, but they also developed a clear explanation for this trend. Depression and even suicidal thoughts can be a part of grief and mourning -- depression almost always is, according to most models -- and it is as a result of fairly traditional grief and mourning processes that these trends and tendencies arise in recently diagnosed schizophrenics (Wittman & Keshava, 2007). According to these researchers, what is essentially grief for the loss of oneself or one's future takes hold after a diagnosis of schizophrenia, and the pattern of depression that follows is similar to what would be expected in a typical, if somewhat extreme, case of grief for the loss of a loved one (Wittman & Keshava, 2007).

This research paints a particular picture of the progression of depression and suicidal tendencies in patients recently diagnosed with schizophrenia that is quite concrete and actionable. By identifying the grieving and mourning process not only as a common but even as a necessary aspect of dealing with a schizophrenia diagnosis, the practitioner and the patient can be equipped with a set of tools, perspectives, and practices that will enable them to handle the depression in a proactive manner that does not negate the grieving process, but works through it (Wittman & Keshava, 2007). Through this, suicidal tendencies can be diminished and quality of life can be largely restored over time (Wittman & Keshava, 2007).

Safety Plan

Safety plans to assist physicians and other medical practitioners in the prevention of suicide have been the subject of ongoing study and development, with the recognition of and respect for the underlying issues in such cases undergoing significant growth in recent decades (Beck & Alford, 2009). As depression itself has become better understood, so have its effects -- such as the potential for suicidal thoughts and actions -- and its mechanisms, and thus more effective ways of handling depression at all ages and for a variety of causes have also been developed (Beck & Alford, 2009; Bhatia & Bhatia, 2007). As many schizophrenics are diagnosed in adolescence, a focus on research in handling depression and suicidal tendencies in the adolescent age group was employed, along with specific information regarding depression in schizophrenics (Beck & Alford, 2009; Bhatia & Bhatia, 2007; Wittman & Keshava, 2007). In this way, a comprehensive safety plan was established.

First and foremost, cognitive behavioral therapy is recommended for the treatment of depression in children and adolescents prior to any pharmaceutical treatment (Bhatia & Bhatia, 2007). Especially as a recently diagnosed schizophrenic might be prescribed various medications including psychotropic pharmaceuticals, eliminating anti-depressants from a first-line response to depression in these cases is ideal (Wittman & Keshava, 2007; Bhatia & Bhatia, 2007). Anti-depressants can actually increase suicidal thoughts in some users, especially in adolescents, so these should be avoided as much as possible (Beck & Alford, 2009; Bhatia & Bhatia, 2007).