All About Schizophrenia

Some symptoms of schizophrenia can be easier to recognize because they stand out distinctly from a person’s usual behavior.

Schizophrenia symptoms are often classified as either positive or negative. You can think of these symptoms as those that add behaviors (positive) and those that decrease them (negative).

For instance, positive symptoms often involve hallucinations or delusions — symptoms that not everyone would experience. Negative symptoms disrupt common emotions, behaviors, and abilities, such as experiencing a lack of emotion.

According to the DSM-5, in order to be diagnosed with schizophrenia someone must experience 2 or more of the following symptoms most of the time for at least 1 month:

• delusions
• hallucinations
• incoherent speech or speech that quickly switches from topic to topic
• severely disorganized behavior such as issues with motor function or inexplicable agitation or giddiness, or catatonia
• negative symptoms (e.g., just sitting with no interest in going to work, school, or engaging in any activities)

At least one of the first three symptoms (delusions, hallucinations, and disorganized speech) must be present.

These symptoms must significantly affect one or more major areas in your life — such as your work, relationships, or just generally taking care of yourself.

There must also be continuous signs of disturbance over the course of 6 months with at least 1 month of active symptoms.

Delusions

Delusions are fixed beliefs that don’t change, even when you’re given evidence the beliefs aren’t based in reality.

People can have a variety of delusions such as:

• persecutory (“people are going to harm me”)
• referential (“people are sending me secret signals”)
• grandiose (“I am wealthy and famous and known around the world”)
• erotomanic (“I know that person is in love with me”)
• nihilistic (“the end of the world is coming!”)
• somatic (“my liver can transform any poison into a harmless substance”)

Hallucinations

Hallucinations involve “unreal” perceptions, or experiencing something that someone else doesn’t — like seeing something that isn’t really there.

Hallucinations can affect any of your senses, but they most often occur as auditory hallucinations, like hearing voices that aren’t there.

While the causes of schizophrenia aren’t entirely understood, genetic, biological, and development risk factors may all play a role.

Like many mental health conditions, the causes of schizophrenia are likely complex and multifaceted.

Earlier research has suggested that abnormalities in brain structures are a contributing cause. Imbalances of chemicals in the brain have also been thought as responsible for some symptoms of schizophrenia.

A newer study in 2020 found lower levels of a protein found in the connections between neurons in brain scans of people with schizophrenia. This affected regions of the brain involved in planning.

However, more research needs to be done to fully understand this connection. Some of their research was also done on rats.

People with a family history of schizophrenia have a higher risk of developing this condition. Research has found genetics to play a strong role in developing schizophrenia.

People are often diagnosed with schizophrenia in early adulthood, when they first experience an episode of delusions or hallucinations.

The condition is most often formally diagnosed by a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. However, you may first seek help from your primary care doctor.

Your healthcare provider will likely use a combination of evaluation and tests to diagnose you, such as:

• blood tests
• a physical exam
• imaging tests, including magnetic resonance imaging (MRI) or computed tomography (CT) scan
• questions about your medical history, mental health, and family medical history

They’ll also rule out any other potential causes for symptoms such as substance use or other mental health conditions.

While there’s no cure for schizophrenia, there are effective treatments available including:

• medications
• therapy
• social support treatment
• vocational rehabilitation
• wellness, lifestyle, and self-care tools

Each person reacts to medications in different ways, so it’s important to work closely with a doctor that has experience treating schizophrenia. The medications often used for schizophrenia are called antipsychotics.

In addition to medications, many people with schizophrenia also benefit from some form of psychotherapy or social support treatment.

There are a variety of other ways you can help manage symptoms of schizophrenia:

• follow structured daily routines
• get support from friends, family, or a schizophrenia support group
• create a plan for what to do in a crisis
• use stress-relieving techniques, as stress may exacerbate symptoms

While you can manage your schizophrenia, relapses can and do occur. Maintaining treatment will generally be done throughout your life.

Living with schizophrenia can be challenging — as with any chronic condition — but managing and living well with schizophrenia is possible.

The best way to do this is to find and follow a treatment plan that’s right for you, acknowledge your condition and educate others, and have a support system for when challenges come up.

The aim of healthcare professionals is to help keep you out of the hospital and prevent future episodes or relapses. Working closely with your healthcare team and keeping them informed of any symptoms or changes can help.

Some people may turn to using substances like drugs or alcohol to help manage or avoid symptoms of their condition. This can lead to different problems, so reach out to your doctor if you believe you’re relying on substances for relief.

You don’t need to go it alone. It’s often very helpful to have the support of family, friends, or other people with schizophrenia. Find support groups through the National Alliance on Mental Illness (NAMI).

There’s a lot that goes into managing schizophrenia — be proud of the work and effort you put into living with and managing your condition.

When left undiagnosed or untreated, schizophrenia can cause complications, like:

• depression
• anxiety
• thoughts of suicide or self-harm
• new or worsening phobias
• substance use

People living with schizophrenia can often benefit from the support and encouragement of friends and family who understand that their symptoms don’t diminish their unique personality and strengths.

But sometimes, if you don’t live with the condition, the symptoms can be difficult to understand. And when someone with schizophrenia is untreated or their treatment isn’t currently working, symptoms can worsen.

Knowledge and education can go a long way in helping you understand what someone with schizophrenia is going through.

Here are some quick tips for helping a loved one with schizophrenia:

• Research the condition to understand both the basics and learn about misconceptions and stigma.
• Help them advocate for their health with nonjudgmental support.
• Help them develop and structure a daily routine.
• Understand that they may behave or say things in unexpected ways which requires compassion and patience.
• If they’re in a crisis or you’re worried about their safety, encourage them to reach out to a crisis hotline or contact their mental health team for next steps.

The first step — seeking help — can often be the hardest part. Before you’re diagnosed, you may not even be aware that anything’s wrong.

Often, loved ones may be the first to notice symptoms and reach out to find you treatment. This can be difficult, however, since you still need to consent to treatment, and you may not feel as if you need it.

Many people find it most helpful to start the process with a mental health professional. They’re trained to recognize the symptoms of schizophrenia and make an accurate diagnosis, while ruling out other possible diagnoses or issues that may be causing your symptoms.

Once you have a diagnosis, continue to work with your treatment team to ensure you have all the tools you need to live well.

Take action: Find a local treatment provider