7.3 Emerging themes and subthemes
7.3.3 Theme 3: The symptomatology of a mental illness
The findings of this study seem to suggest that mental illness manifests in several symptoms that can be classified as either physical or emotional symptoms. Based on the two cases under investigation, the results have shown that both depression and schizophrenia may manifest themselves through emotional and behavioural symptoms.
74
Subtheme 1: Emotional symptoms of mental illness
It appears from the findings of the study that both depression and schizophrenia may manifest through emotional symptoms. These emotional symptoms have much to do with the subjects‟ feelings as opposed to physical symptoms.
a). Depression: Most participants have shown that depression may present itself in the form of emotional and behavioural symptoms which may range from diminished interest, feelings of hopelessness and helplessness, guilt, agitation, difficulty in concentration to suicidality. The extracts below demonstrate that.
“There may sometimes be markedly diminished interest or pleasure in all or almost all activities that one used to enjoy.
Sometimes they may present with a inappropriate guilt, diminished ability to think or concentrate and many others.” (Participant CP5)
“Yes, sometimes the patient may present with hopelessness, helplessness and feeling guilty.” (Participant CP3)
“Sometimes they even present with a diminished ability to think or concentrate, or indecisiveness, nearly every day. These symptoms should not be due to the effect of a substance. They should have affected functioning in at least one area and they should have at least lasted for two weeks.” (Participant CP6).
This finding seems to suggest that the presence of emotional symptoms that range from diminished interest, feelings of hopelessness and helplessness, guilt, agitation, difficulty in concentration to suicidality are a confirmation of the presence of depression.
b). Schizophrenia: Patients with schizophrenia may also present with emotional symptoms which, according to the participants, may include the following, lack of emotional expression and motivation, avolition and catatonia. This is shown in the extracts below.
75
“..sometimes people with schizophrenia may present with a diminished emotional expression or avolition, or they can sometimes become catatonic.” (Participant CP5).
“Yes, they can be paranoid and they can lack, you know, emotional expression and lack motivation generally. Those are some of the things they can present with.” (Participant CP2).
“Okay. They may present with many symptoms that may range from emotional withdrawal, lack of emotional expression, at times, so much excitement that may not be associated with anything tangible, unprovoked crying spells and so on.” (Participant CP1)
For the participants, an inability to express emotions and lack of motivation, avolition and catatonia is a confirmation of the presence of schizophrenia.
Subtheme 2: Physical symptoms of mental illness
The findings of the study seem to suggest that in addition to emotional symptoms, mental illness may manifest through physical symptoms. This seems to also apply in both depression and schizophrenia as the centre of the investigation in the present study.
a). Depression: Depression may present with physical symptoms that include weight loss or gain, loss of energy, tiredness and psychomotor retardation. These are perceived as the symptoms that can be observed by others, as opposed to subjective reports of the individual having the symptoms. This is shown in the extracts below.
“...the other symptoms of depression include significant weight loss or sometimes weight gain, loss of energy, tiredness most of the day.” (Participant CP1)
“... a significant weight loss when not dieting or weight gain. At times, it can be a slowing down of thought and a reduction of physical movement as observed by others.” (Participant CP6).
76
“Individuals with schizophrenia, they can lack, you know, emotional expression and lack motivation generally. Those are some of the things they can present with.” (Participant CP2)
One participant has further asserted that depressive symptoms may sometimes co- occur with symptoms of other conditions which may also differ from one patient to another.
“Okay, the other symptoms that can be associated with such a condition; you can also have your anxiety symptoms as well as your psychotic symptoms which appear with the condition.”
(Participant CP4)
This assertion suggests that there is a possibility of coexistence of depression and other types of mental illness with some patients.
b). Schizophrenia: Individuals with schizophrenia, on the other hand, may present with physical symptoms that include paranoia, social withdrawal, speech and behaviour disorganisation, aggression towards people and property, and hallucinations. This is shown by the following extracts.
“The other symptoms that we can find include some disorganized speech and disorganized behaviour. You can also find aggression with such people where they can be violent towards others and destruct property.” (Participant CP4)
“You may at times find a disorganized speech such as a frequent derailment or incoherence, catatonic behaviour or even visual hallucinations.” (Participant CP6).
“At other times, they may present with aggression towards people, animals or property, collection of garbage, the neglect of their personal hygiene and the tidiness of their environment, roaming around, talking to self, high levels of energy, eating nonsense and
77
so on. They often present with many symptoms and the symptoms may differ from one individual to another.” (Participant CP1).
The information shared above seems to suggest that both depression and schizophrenia may be manifested in both emotional and physical symptoms. The symptoms may also differ from one individual to another.