They are enveloped in obscurity – some enjoying isolation and others enjoying a sense of being in power. Saima Bhat explores the world of schizophrenics.

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Uzma was admitted to a government hospital for abdominal cramps. Doctors advised an ultrasound, which revealed alien objects in her perforated intestine. A subsequent surgery led to the removal of those “alien objects”—polythene, pins, plastic, the handle of a shaver and needles; objects which she had consumed over a long period of time. Despite the alarming results, she feels she hasn’t done anything wrong; she has no interest in knowing what is happening around her and is seemingly lost in another world. 21-year-old Uzma, the only child of her parents, is a schizophrenic.

Uzma prefers to remain silent, and hardly shows any interest in talking to anyone—family, doctors or others. Her family says she has been stressed because her mother has been pressuring her to qualify the MSC entrance test of the University of Kashmir, which she has already failed once. The pressure lingered since she failed to qualify the MBBS entrance test.

Besides this, family members do not believe that Uzma has any other health problems. However, the doctor treating her says, “She is a case of paranoid schizophrenia (thought disorder) and has been under psychiatric treatment earlier as well, but due to family reluctance, she stopped taking medication, and finally tried to harm herself.”

Schizophrenia, a mental disorder, is characterized by a breakdown of thought processes and by poor emotional responsiveness. It most commonly includes auditory hallucinations (hearing voices); delusions (bizarre or persecutory in nature), disorganised behaviour, disorganised thought and negative feelings. According to doctors, an individual should show at least two such symptoms for six months, in order to be diagnosed with schizophrenia. But people with bizarre delusions can qualify without even waiting for six months. This disease has an onset from the age of late teens, but there have been some patients also who have been diagnosed as schizophrenic at the age of five. It is a rare condition, and worldwide it has a prevalence of one per cent.

Uzma’s family didn’t share her history of illness, but she has been advised to take anti-psychotic drugs. Schizophrenia can also be a genetic disorder, and so it can be seen in children as well as in their parents. The chances of getting this disease increases by 10 per cent in individuals who have a family history, and chances increase by 40 per cent if both parents are schizophrenic.

Abdul Hamid appears to be in his late fifties. He is homeless and is often seen wandering in a traffic police uniform. He has a shabby look, converses with himself, and spends his entire day on his feet, usually trying to direct traffic. He gets aggressive if traffic stops but when traffic starts moving again, it gives him a sense of relief and satisfaction. A group of psychiatrists believe that by controlling traffic, Abdul Hamid feels he has authority and power, the power of controlling traffic—which they term as grandiose delusion.

Wearing a green cap with long earrings, Riyaz Ahmed is familiar to every child and adult residing in the upper side of Srinagar city. He always wears a green glittering pheran and a smile. He is a regular visitor to the government psychiatric hospital, but he doesn’t take any medication.

Riyaz has anti-psychiatric behaviour, and whenever he comes to the hospital, he prefers to have a debate with his doctors rather than any treatment. He is schizophrenic but he says, “Schizophrenia is not a disease.  Only doctors say it is a disease which it is not.”No one is ready to accept that Riyaz, with his multi-coloured beaded chains and matching earrings, was once a successful electrical engineer. He must be in his fifties. He is still healthy, six feet tall and walks barefoot.

Psychiatrists say schizophrenia does not affect intelligence. It usually affects behaviour and thinking, which results in disorganised behaviour with delusions of suspicious thinking.

In the past, schizophrenic patients in Kashmir were not given any treatment till they turned violent. Dr Arshad Hussain, a psychiatrist at the Government Psychiatric Hospital says earlier schizophrenic patients were usually kept engaged in agricultural fields or some other activities to keep them absorbed in work. Such patients usually prefer to live alone and they talk to themselves, so much was not needed to do for them except for the care.

“In the US or other western countries, such patients are usually homeless, but here in the Valley our culture is best to rehabilitate such patients as they have the family support,” says Dr Arshad. “Earlier we had a spiritual model of the disease which was cultural; till violence accompanied it no one was bothered to consult a doctor to admit them in asylums,” he added.

In some places outside Kashmir, mental disorders were believed to be caused by “the devil possessing one’s body” and these were “treated” through various means varying from exposing the patient to certain types of music, to sometimes deadly means, such as drilling holes in the patient’s skull.

Today, experts believe excessive substance abuse of drugs like cannabis and cocaine also increases the chances of getting this disease. The urban and rural ratio of such patients is 50:50 and with almost equal distribution among genders.

Mohammad Aslam from Narbal area of Budgam wears torn clothes with a burnt shawl on his shoulders. He has a son, daughter in law and three grandchildren. He does embroidery but “from past five years I prefer to wander, I want to explore places.” He talks in a continuous rhythm, in a tone and says he is a poet. He visits a number of schools, government offices, Masjids, agricultural fields where he sings his poetry but he is

Mohammad Aslam

an illiterate and takes help of others to pen down his “couplets.” Someone has promised him that once he completes his poetry he will help him get it published. He writes on current issues, agriculture, education, The Holy Quran and topics, and has once broadcast a show on DD Kashir.

“I became a poet after I lost my wife. She was a noble and religious lady and it is only because of her prayers that God has come close to me,” says Aslam.

He feels God tells him to converse and he converses. He talks of an unheard voice that guides his soul what to do and what not to. He feels some power inside him which keeps him charged for hours together even if he takes food once in 24 hours.

Professor Hamid Naseem Rafiabadi, Director Shah-i-Hamadan institute of Islamic studies, University of Kashmir says that there is a problem in Kashmir society where such kind of people are treated as darwaish (seers) – people closer to God and they are not considered for treatment. Prophet (SAW) has said that if Allah has given you the disease then He has also given you the remedy. It is in Islamic religion that people should try to live till his last breath and should make every effort to live. “Disease is not intense whereas spirituality is, it can be clearly marked who is spiritual and who is pretending to be,” adds Prof Hamid.

Psychiatrists also say there is a differentiation between the spiritual and the schizophrenic. Dr Arshad believes, “Spiritual people achieve it by being focused, by being closer to God and maybe they might experience the things which are not possible for a normal human to see or feel. The most important thing is spirituals don’t lose touch with reality while as the people having psychiatric problems lose the touch of reality at the very first instance.”And to further elaborate the difference between spiritual and schizophrenic, Dr Arshad adds, “They all are not the same. All fat men are not diabetic and in the same way, all diabetic is not fat and the same applies for being spiritual and the one having a disorder.”

Zeenat, 18, has been diagnosed having schizophrenia. She was seven years old when doctors said she is suffering from the disease. Since then she is trying to get familiar with another reality that her father is in jail for life on charges of being a Hawala operator.

Her mother, Haseena, says, “Zeenat was a normal child like her other two sisters till their father was imprisoned. She keeps on crying for hours together and then when we inquire she always says, “I want my father back.”

Haseena is aware that her daughter is suffering from a disorder but at the same time, she says it has happened because of separation from her father at a young age.

Sociologist Dr Bashir Ahmad Dabla says, “Conflict has a direct effect on the mental health of Kashmir and for the past two decades it is deteriorating. Conflict is the reason behind all psychological diseases and disorders and these problems are quite alarming.”

Dr Dabla says, “The threat perception among youngsters, children, and women of getting hurt physically like torture, rapes, fear, anti-insurgency brutal killings has resulted in the psychological bend of mind.” However, Dr Arshad says that stress per se doesn’t play a role in schizophrenia but stress form psychosis.

(Some names have been changed to protect identities)

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