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Schizophrenia is a chronic, severe mental condition that affects how people think, act, express emotions, perceive reality, and interact with others. Though schizophrenia is not as frequent as other major mental illnesses, it is the most persistent and debilitating.
People with schizophrenia frequently struggle to function properly in society, at work, at school, and in relationships. They may appear to be fearful and withdrawn, and they may appear to have lost touch with reality. This chronic disease cannot be cured, but it can be managed with correct treatment.
Schizophrenia, contrary to popular opinion, is not a split or multiple personality disorder. Schizophrenia is characterized by psychosis, a type of mental illness in which a person is unable to distinguish between what is real and what is imagined. People suffering from psychotic disorders can lose contact with reality at times. The world may appear to be a tangle of perplexing thoughts, images, and noises. Their behavior may be unusual, even alarming. A psychotic episode is a sudden change in personality and behavior that occurs when people with it lose touch with reality.
The severity of schizophrenia varies from individual to person. Some people experience only one psychotic episode throughout their lives, while others have multiple episodes over the course of their lives but have quite regular lives in between. Others may experience increased difficulty functioning over time, with little improvement between full-fledged psychotic episodes. Symptoms of schizophrenia appear to worsen and mend in cycles known as relapses and remissions.
WHAT ARE THE SYMPTOMS OF SCHIZOPHRENIA?
Schizophrenia symptoms may include the following:
Early symptoms
The illness commonly manifests itself in men in their late teens or early twenties. It primarily affects women in their early twenties and thirties. The prodromal interval is the time between the onset of symptoms and the onset of complete psychosis. It can persist for a few days, weeks, or even years. It can be difficult to detect because there is generally no clear trigger. Particularly with teenagers, you may only observe modest behavioral changes. This includes the following:
- A shift in grades
- Withdrawal from social activities
- Having difficulty concentrating
- Flares of temper
- Sleeping problems
Positive signs
The term "positive" does not indicate "good" in this context. It refers to extraneous ideas or acts that are not grounded in reality. They are sometimes referred to as psychotic symptoms and can include:
- Delusions: These are incorrect, muddled, and sometimes odd ideas that aren't grounded in reality and that the person refuses to abandon, even when confronted with evidence to the contrary. A person suffering from delusions, for example, may feel that others can hear their thoughts, that they are God or the devil, or that others are putting thoughts into their heads or scheming against them.
- Hallucinations: These involve fictitious experiences. The most prevalent delusion in patients with schizophrenia is hearing voices. The voices may make observations about the person's behavior, insult them, or issue directives. Less common varieties include seeing objects that aren't there, tasting weird aromas, experiencing a peculiar taste in your tongue, and feeling sensations on your skin despite nothing touching your body.
- Catatonia: In this state, the person may stop speaking and remain in a single position for an extended period of time.
Disorganized Symptoms
These are positive signs that indicate that the person is unable to think clearly or respond appropriately. Here are several examples:
- Talking in illogical sentences or utilizing meaningless words, making it difficult for the person to communicate or maintain a conversation
- Rapidly shifting from one thought to the next with no visible or logical link between them
- Slowly moving
- Inability to make judgments
- Excessive but meaningless writing
- Forgetting or misplacing items
- Pacing or walking in circles are examples of repetitive movements or gestures.
- Having difficulty making sense of ordinary sights, sounds, and emotions
Cognitive symptoms
These symptoms are sometimes referred to as "cognitive" symptoms since they indicate that someone is experiencing difficulty with specific cognitive or mental activities. They are as follows:
- disordered thinking or speech, such as when a person abruptly switches topics while speaking or employs made-up words or phrases
- forgetfulness
- a lack of organization in one's thinking, such as difficulty focusing or paying attention
- inadequate "executive functioning," or the ability to grasp information and use it to make decisions
- issues in learning and applying information
- Schizophrenia symptoms can vary in degree and type, and can be exacerbated if a person is under stress, using substances, or not taking their prescription meds correctly.
WHAT ARE THE CAUSES OF SCHIZOPHRENIA?
The precise cause of schizophrenia is unknown. However, schizophrenia, like cancer and diabetes, is a real illness with a biological basis. Researchers have discovered a variety of factors that appear to increase one's risk of developing schizophrenia, including:
Genetics (heredity): Schizophrenia can run in families, which indicates that a higher risk of schizophrenia may be handed down from parents to children.
Brain chemistry and circuits: People suffering from schizophrenia may be unable to control brain chemicals known as neurotransmitters, which control specific routes, or "circuits," of nerve cells that affect thinking and behavior.
Abnormalities in the brain: People with schizophrenia have aberrant brain anatomy, according to research. This, however, does not apply to all people suffering from schizophrenia. It can affect persons who do not have the condition.
Environment: Viral infections, poisons like marijuana, or highly stressful events can all precipitate schizophrenia in persons whose genes predispose them to the disorder. Schizophrenia is more likely to manifest when the body is undergoing hormonal and physical changes, such as those experienced during adolescence and early adulthood.
WHAT ARE THE RISK FACTORS OF SCHIZOPHRENIA?
Despite the fact that no one knows what causes schizophrenia, researchers believe genetics may play a role. People with a family history of schizophrenia are more likely to develop the condition.
Other potential risk factors for schizophrenia include:
- Toxins, a virus, or starvation before or during birth or infancy
- using mind-altering substances
- being in a high-stress situation
- experimenting with mind-altering substances throughout adolescent or early adulthood
HOW IS SCHIZOPHRENIA DIAGNOSED?
If symptoms of schizophrenia are evident, the doctor will take a thorough medical history and, in some cases, do a physical exam. While no laboratory tests exist to explicitly diagnose schizophrenia, the doctor may employ a variety of procedures, including blood tests and brain imaging scans, to rule out another physical illness or intoxication (substance-induced psychosis) as the origin of the symptoms.
If the doctor discovers no other medical cause for the schizophrenia symptoms, he or she may send the patient to a psychiatrist or psychologist, who are mental health experts who are trained to diagnose and treat mental illnesses. To examine a person for a psychotic condition, psychiatrists and psychologists employ specifically prepared interviews and diagnostic tools. The therapist bases his or her diagnosis on the person's and family's reports of symptoms, as well as their observations of the person's attitude and conduct.
If a person has at least two of the following symptoms for at least 6 months, they are diagnosed with schizophrenia:
- Delusions
- Hallucinations
- Speech that is disorganized
- Behavior that is disorganized or catatonic
- Negative signs and symptoms
- At least one of the symptoms must be
- Delusions
- Hallucinations
- Speech that is disorganized
During the 6-month period, the participant must have at least one month of active symptoms. (It may be reduced if treatment is successful.) Symptoms should have a detrimental impact on them socially or at work, and they cannot be caused by another condition.
WHAT ARE THE TREATMENTS FOR SCHIZOPHRENIA?
Schizophrenia has no known cure. Current treatments are aimed at managing or lessening the severity of symptoms.
It is critical to seek treatment from a psychiatrist or other mental health professional who has treated people with this disorder in the past. You may also be able to work with a social worker or a case manager.
Treatment options include the following:
Medications
The most common treatment for schizophrenia is antipsychotic medication. Medication can help with:
hallucinations
delusions
Vocational rehabilitation
Vocational rehabilitation can teach you the skills you need to get back to work. It may make it easier to keep a steady job.
Psychosocial intervention
Psychosocial intervention is another treatment option for schizophrenia. Individual therapy is included to help you cope with stress and your illness.
Social training can help you improve your interpersonal and communication skills.
Family assistance and education
If you or someone you care about has been diagnosed with schizophrenia, having the support of family and friends can help reduce stress and create a sense of belonging. There are educational programs for family members that can help everyone spot the symptoms and provide support when necessary.
The National Alliance on Mental Illness' support and education page is a good place to start.
HOW CAN SCHIZOPHRENIA BE PREVENTED?
There is no way to truly prevent schizophrenia. Identifying who is at risk and how to prevent the disorder from occurring in at-risk people has remained a major focus of researchers in recent years.
Schizophrenia symptoms may disappear for a time and then reappear, but it is possible to live a healthy, symptom-free life. Following your doctor's advice will help your prognosis.
According to the Royal College of Psychiatrists, three out of every five people with schizophrenia will improve with treatment. To get started on the path to success, it's critical to:
- discover more about your condition
- understand the risks
- adhere to your doctor's treatment plan
If you are looking for information on programs that offer services for the assessment and treatment of early signs of psychosis or schizophrenia, you can use the Substance Abuse and Mental Health Services Administration's Early Serious Mental Illness Treatment Locator and the Early Psychosis Intervention Network (EPINET) Clinics locator to find a facility near you.