What is schizophrenia?
Schizophrenia is a serious mental illness which affects about one person in 100 in Australia. It affects the way people think, feel and behave.
Schizophrenia changes the way the brain receives and processes information. This can make it difficult for people with schizophrenia to relate to other people and to organise their thoughts. Many people with schizophrenia have trouble distinguishing between what is real and what is not. When people appear to lose touch with reality in this way, it is known as psychosis.
Schizophrenia usually first appears in the teens and twenties. It is typically a chronic (long-term) condition, requiring lifelong management.
Symptoms of schizophrenia
The symptoms of schizophrenia can vary and will not be the same for every person. Symptoms may also come and go, and be worse at some times than others.
Experts often divide the symptoms into 2 groups, called positive symptoms and negative symptoms.
These are symptoms that include changes in thoughts and behaviour, e.g. symptoms of psychosis:
- Delusions (holding beliefs that are odd or not true): These often take the form of persecution or paranoia, where the person believes that others are plotting against them, or trying to harm them. People may also have delusions of grandeur, where they believe they have special powers or importance.
- Hallucinations (false sensations): Usually these take the form of hearing voices that don’t exist. Sometimes the affected person may also believe they have seen, tasted, smelled or felt things that are not there.
- Confused thinking: People may have trouble organising thoughts and keeping track of conversations; their speech may become confused and jumbled and they may sound as though they are not making sense.
- Movement disorders: People may have agitated body movements.
Negative symptoms include reductions in normal emotion and behaviour, for example a lack of pleasure in everyday life, lack of motivation, reduced interaction with other people, lack of emotion when speaking, a flat facial expression and poor personal hygiene.
Negative symptoms can be difficult to recognise, because they are not as obvious as positive symptoms and can often appear gradually. They may appear several years before a person has their first episode of psychosis. They are also common in other disorders or problems, so it can be hard to tell if they indicate schizophrenia until some of the positive symptoms are present.
People with schizophrenia may also feel depressed, anxious or irritable. The symptoms can be frightening for the person with schizophrenia and may cause them to become agitated and afraid.
Schizophrenia symptoms in teenagers
Teenagers may have the same symptoms as adults with schizophrenia, but it can be difficult to recognise in younger people. This is because some of the early symptoms are similar to things that many teenagers experience. These include low mood, a drop in school performance, withdrawal from friends, difficulty sleeping, lack of motivation and irritability.Teenagers with schizophrenia may be less likely than adults to have delusions, but appear more likely to have visual hallucinations (adults most commonly have hallucinations involving sounds and voices).
Myths about schizophrenia
Many people think that people with schizophrenia have ‘dual’, ‘multiple’ or ‘split’ personalities. This is not correct. People with schizophrenia have one personality, just like everyone else.
What causes schizophrenia?
No one knows the exact cause of schizophrenia, but it seems to involve a combination of both genetic and environmental factors. People with a family history of schizophrenia are more likely to develop the illness. Experts think that changes in brain chemicals, exposure to viruses or environmental toxins in the womb (before birth) and complications during birth may also play a role.
Regular use of mind-altering drugs like cannabis during the teenage years may increase the risk of developing schizophrenia.
Who gets schizophrenia?
Anyone can develop schizophrenia. The illness affects men and women equally, but in men the symptoms usually start in the late teens and early twenties. The symptoms often begin a little later in women, in the late twenties and early thirties.
Diagnosis of schizophrenia
There is no one test used to diagnose schizophrenia. Early detection can be difficult before a person starts having hallucinations, delusions or other abnormal behaviours.
Doctors may consider several things, such as the type of symptoms and how long they have been present, and what the person’s life was like before the symptoms started. A person will often be referred to a psychiatrist (a doctor who specialises in mental health problems) for further assessment and diagnosis.
Treatment of schizophrenia
There is currently no cure for schizophrenia, but with appropriate and ongoing treatment, many people with the illness can live productive and rewarding lives.
It is important to start treatment as early as possible – experts have found that the sooner a person gets help for their symptoms, the better the chances are of receiving effective treatment.
Schizophrenia is a chronic (ongoing) condition that usually requires lifelong treatment, even when symptoms are controlled.
A person with schizophrenia will usually be cared for by a team of health professionals. Treatment aims to reduce or get rid of the symptoms of schizophrenia, and to help the person to function as well as they can. This usually involves a combination of medicines and psychological therapy.
Antipsychotic medicines can reduce or eliminate the symptoms of schizophrenia, and reduce the risk of relapse once symptoms are controlled. They can be taken orally (as a pill) or via injection.
Everyone responds differently to antipsychotic medication. That is why it is important for people with schizophrenia and their families to work in close partnership with their doctor to work out the best medicine for them.
Psychological therapy and support
Mental health professionals play a key role in treatment of schizophrenia. They can provide counselling and organise community support for people with schizophrenia and their families. They can help the person and their family to navigate the healthcare system and find the right services. They can also help the person to develop skills to look after themselves, interact with other people and function as well as they can in society.
How to help a person with schizophrenia
Caring for and supporting a person with schizophrenia can be challenging. It is important to:
- Find out as much as possible about schizophrenia.
- Encourage the person with schizophrenia to get treatment and follow recommendations by their treatment team.
- Learn to recognise the changes in behaviour that may indicate the person is getting worse or having an episode of psychosis.
- Stay positive and supportive without tolerating inappropriate or dangerous behaviour.
- Join a support group for families of people with schizophrenia.
Last Reviewed: 29/04/2016
Your Doctor. Dr Michael Jones, Medical Editor.
1. Schizophrenia and related psychoses [revised Feb 2013]. In: eTG complete. Melbourne: Therapeutic Guidelines Limited. (Accessed March 2016.)
2. National Institutes of Mental Health (NIMH). Schizophrenia (Feb 2016). http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. (Accessed March 2016.)
3. Mayo Clinic [website]. Schizophrenia (reviewed Jan 2014). Available at: http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/definition/con-20021077 (accessed March 2016)
4. NHS Choices. Schizophrenia (reviewed Oct 2014). http://www.nhs.uk/conditions/Schizophrenia/Pages/Introduction.aspx (accessed March 2016).
Antipsychotic medicines work by helping to restore the brain’s natural chemical balance. While these medicines cannot cure schizophrenia, they can relieve or improve symptoms.
Video: Symptoms of schizophrenia
Schizophrenia has several core symptoms including psychosis and delusions.
When someone experiences psychosis they are unable to distinguish what is real. Symptoms include confused thinking, delusions and hallucinations.
Video: Diagnosis of schizophrenia
Diagnosis of schizophrenia is quite complicated and involves taking a detailed history.
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