What is Schizophrenia?

Please note this section is currently under review.

Schizophrenia is a chronic brain disorder that affects more than 1% of the population (i.e. more than 1 out of every 100 people develop schizophrenia at some point in their lives). It is a psychotic disorder, in that people who suffer from it can lose touch with reality at times through experiencing false beliefs, muddled or jumbled thinking, or false perceptions (such as hearing things which aren’t actually there).

Anyone can get schizophrenia. In men, psychotic symptoms often begin in the teens or 20s. In women, psychotic symptoms often begin in the 20s and 30s.

Symptoms of the illness can include delusions, hallucinations, trouble with thinking and concentration and lack of motivation. Often, people with schizophrenia may not recognize that they are unwell and this can make treatment difficult on occasions.

However, with treatment, a large number of people with schizophrenia will greatly improve over time and can recover.

Symptoms of schizophrenia differ from person to person and, as with any illness, the severity, duration and number of symptoms can vary over time.

The symptoms of schizophrenia fall into 3 main groups:

  • Positive Symptoms:
    • Hallucinations : These are false experiences that nevertheless seem very real to the person experiencing them. They can include the experience of hearing things which others do not hear, or seeing things which others do not see. Hallucinations can involve any of the 5 senses – sight, sound, smell, touch or taste.
    • Delusions: These are false beliefs which seem very real to the person holding them but which are not based on reality or on rational thinking.
  • Negative Symptoms:
    • These include a loss or decrease in the ability to make plans, to motivate oneself or to express emotion or find pleasure in things.
  • Cognitive Symptoms:
    • These can include confused or disordered speech, problems with memory and in sustaining attention.

Symptoms of schizophrenia usually appear in early adulthood but can occur at any age.

Insight

Lack of insight (lack of awareness of being ill) can occur frequently in schizophrenia, especially in the active phase (during acute episodes). Although one’s behaviour may seem very unusual to other people, it can be possible for a person with schizophrenia to believe there is nothing wrong with them at times. This denial may lead to a refusal of treatment, and can cause family and friends to become very distressed.

Sometimes one may need to trust the judgment of others, such as family and health care professionals, when considering whether to accept treatment or not. Treatment can then restore insight. In some circumstances, treatment may need to be given against the will of the person, such as if there is a significant risk of harm or of further deterioration if treatment is not instigated.

Schizophrenia is probably caused by a combination of significant life stress and problems with particular brain chemicals called neurotransmitters. Neurotransmitters are substances that allow brain cells to communicate with one another. In schizophrenia, these chemicals in the brain are not balanced properly, which then results in the symptoms of delusions, hallucinations and thinking difficulties.

At present, it is still not known for definite what causes the brain chemicals to become unbalanced, but it is probably a mixture of genetic influences, early brain development, and stress.

Abusing illegal drugs such as cannabis can also play a part in causing the illness.

While there is no cure for schizophrenia presently, treatments are available which can reduce the intensity and frequency of the symptoms, and many people are able to recover from the illness to lead fulfilling and productive lives.

Because schizophrenia involves an imbalance in brain chemicals, medications are very important in order to manage the illness and enable recovery. These medications are known as ‘antipsychotics’ and there are a wide variety of them available which are effective in reducing symptoms in the acute phase of the illness. They also help to reduce the potential for relapse.

It is vital for people with schizophrenia to take their medication consistently and for as long as is recommended by their psychiatrist. Most people with schizophrenia need to take some type of medication for the rest of their lives.

After the symptoms of schizophrenia are controlled through medication, other therapies can help people learn social skills, cope with stress and identify early warning signs of relapse, all of which will help in managing the illness and recovering from it.

These psychosocial therapies can include:

  • Rehabilitation programmes – This includes social and vocational training to help people with schizophrenia function better in their day-to-day lives. It can include job training and help with development in social and workplace communication skills.
  • Psychological therapy – This can help a person to develop coping strategies for psychotic symptoms and other features of the illness and to help in adjusting to living with a serious medical illness.
  • Family Education – In order to help family members to develop positive coping strategies and to be able to offer the most appropriate support for their ill relative to aid in their recovery.

Further useful links for learning more about schizophrenia and its treatment:

For more resources on psychiatry and mental illness, click here.