7 > Case study Zachariah keeps worrying about his future – he worries that he may not be able to earn enough for his family. School fees keep going up and the cost of living is putting a strain on him. He lies awake at night wondering: ‘What if I don’t earn enough?’ Zachariah has always been a person who worries, and even when he was still at school he kept worrying: ‘What if I fail my exams?’ Psychosis (Mini lecture and discussion) This is a disorder with severe mental, emotional and behavioural problems. A person can be badly affected by this and have trouble keeping in touch with reality. Schizophrenia is the most common form of psychosis and patients in psychiatric wards often suffer from this illness. > Case study Chipo is a 32-year-old woman who, in the last few months, has begun manifesting different behaviour. She complains of hearing voices when no one else hears them and she thinks everyone is out to cause her harm. Sometimes, she believes the voices come to her through the radio. At times, Chipo feels she has special powers given to her by God to change objects into people or animals. She wanders around mumbling to herself and it is impossible to make sense of what she says. Chipo no longer cares about her appearance and personal cleanliness. Some people think that Chipo may have been possessed by spirits. However, her brother takes her to Harare Psychiatric Hospital and she is diagnosed with schizophrenia and put on medication, which helps. Signs of psychosis Some questions, such as the following, can help determine whether a person may have psychosis: • • • • Do you at times hear voices that no one else hears? Do you have strange feelings in your body? Do you smell things that other people do not smell? Have you seen things or had visions that no one else has seen? The signs are as follows: • The person may move from topic to topic or put words together that do not make any sense. The person’s thinking has thus become disorganised; • The person may move around without a purpose or may make strange movements; • Sometimes, a person will sit or stand in a strange position for a long time without moving; • Strange, inappropriate emotional responses, such as laughing when they hear sad news; • An inability to do everyday tasks; • Appearance and hygiene become poor; and • An inability to fit in socially and at work. Module 7: Dealing with trauma, psychological healing and support 115