Schizophrenia affects fewer than 1% of Americans, according to the American Psychiatric Association. According to the World Health Organization, it affects 20 million people worldwide and is not as common as many other mental disorders.
Schizophrenia can occur in men and women of all ages. Males tend to show symptoms earlier than females; men typically begin to show symptoms in their late teens or early twenties, while females tend to show symptoms in their late twenties and early thirties.
Schizophrenia Symptoms and Behaviors
People with schizophrenia can have intense behavioural symptoms, most often confusion and disorientation, making it difficult for them to distinguish between reality and their delusions or hallucinations. It’s important to note that the symptoms of schizophrenia vary dramatically from person to person, both in pattern and severity. Some might have their symptoms worsen or improve unpredictably, and others might have consistent symptoms.
Schizophrenia symptoms are considered to be either positive or negative, not because they are good or bad, but based on whether or not they mark the presence or absence of symptoms. Positive symptoms, such as hallucinations, delusions, and disordered thoughts and speech represent increased activation of certain areas of the brain. The positive symptoms tend to respond well to drug therapy. Negative symptoms, on the other hand, include symptoms that halt normal functioning and don’t respond as well to drug therapy, such as a lack of desire for any social connections and lack of emotional affect.
There are five main types of schizophrenia symptoms: delusions, hallucinations, disorganised speech, disorganised behaviour, and the aforementioned “negative” symptoms.
Delusions: Broadly, a delusion is a firmly-held belief that a person has despite clear and obvious evidence to the contrary.
Hallucinations: Hallucinations are sensations experienced as real even though they only exist in the mind. These can involve any of the five senses, but auditory hallucinations (hearing voices or other sounds in your head) are the most common for those with schizophrenia.
Disorganized speech: Schizophrenia can cause issues with concentrating, which can someone’s speech skills. Disorganized speech may look like someone giving partially or completely unrelated answers to questions, using made-up words or phrases that only have meaning to themselves, repeating words or statements, and/or rhyming words meaninglessly (also referred to as “clang”).
Disorganized behaviour: Typically, people’s activities are goal-oriented, but those suffering with schizophrenia may not have goals connected to their actions. These individuals become unable to take care of themselves, work or interact like they used to with others. Disorganized behaviour can be hard to identify, but it typically results in a lack of normal daily functioning, useless and excessive movement, lack of inhibition and impulse control, and behaviours that appear bizarre.
A lack of emotional expression, enthusiasm, social withdrawal, and awareness of one’s surroundings are examples of “negative” symptoms.
These symptoms are sometimes categorised in three buckets: psychotic symptoms (altered perceptions, abnormal thinking, and odd behaviours), negative symptoms (mentioned above) and cognitive symptoms (problems in attention, concentration and memory) (problems in attention, concentration and memory).
Regardless of symptoms, most people with schizophrenia experience them either continuously or intermittently throughout their entire life after onset and are often severely stigmatised by people who do not understand the disorder.
Schizophrenia Causes and Risk Factors
Schizophrenia appears to have a strong genetic component, but the exact cause of schizophrenia in some individuals remains a mystery. So far, research suggests that a person’s risk of developing the disease is increased by a combination of genetic, psychological, physical, and environmental factors.
The diagnosis of schizophrenia by a psychiatrist can only be made after a full psychiatric evaluation has been completed to rule out other possible causes, such as substance abuse or other neurological or medical conditions that mimic schizophrenia’s symptoms. However, understanding the possible causes and risk factors for schizophrenia can help clarify who might be at risk.
Genetics: There is strong evidence of a genetic predisposition to schizophrenia. Researchers have not pinpointed one single gene that leads to schizophrenia developing, but many genes are thought to play a role. According to one research study, if a sibling or parent has the illness, your chances of having schizophrenia is around 10 percent . The presence of schizophrenia in one member of your family does not automatically imply the presence of the disorder in the rest of your family.
Environment: As with many other health conditions, there are certain environmental factors that can contribute to the development of schizophrenia. Viral infections acquired before or after conception, as well as prenatal or postnatal exposure to toxins like lead, are all possibilities.
Societal factors: There has been a lot of research devoted to investigating societal issues that could potentially contribute to the onset of schizophrenia. Many aspects are being studied, but one finding is that people who grew up in urban areas are more likely than those who did not than to be diagnosed with schizophrenia.
A person is more likely to develop schizophrenia if they have a few risk factors in their daily lives, but these are more indicative than causal. Stress of any kind, homelessness, drug abuse, loss of a loved one, divorce, the end of a romantic relationship, or abuse are all examples of this type of situation.
Despite the fact that they haven’t been linked to the development of schizophrenia, these events may serve as catalysts for someone who is already predisposed to it.
Schizophrenia is associated with subtle structural changes in the brain, according to research on people with and without the illness. A lack of grey matter in the brain, for example, has been linked to schizophrenia and has been shown to affect cognitive functions like memory and the ability to weigh benefits versus costs.
Schizophrenia is associated with abnormalities in brain chemicals that allow brain cells to communicate with one another, according to research. People with schizophrenia, for example, have dopamine levels in their brains that are out of balance. While the exact mechanism of how this happens is still being studied, it may account for certain schizophrenia symptoms.
Pregnancy or birth complications: Complications before and during birth may increase the likelihood that a person will develop schizophrenia. These complications include: infection during pregnancy, low birth weight, premature labour, maternal obesity diagnosis during pregnancy, and infection during pregnancy.
Teenagers and adults are also more likely to develop schizophrenia if they experience the death or permanent separation of one or both parents as children.
While these are a few identified causes and risks, there is no single precipitating event identified that leads to the onset of schizophrenia.
Treatments for Schizophrenia
Being diagnosed with schizophrenia doesn’t mean you can’t live a full and meaningful life. Antipsychotic medications for schizophrenia and supportive counselling can be used to treat schizophrenia, but there is no cure.
Schizophrenia requires lifelong treatment through medication, therapy, or a combination of both. Even if your symptoms have subsided, don’t stop your treatment. An in-person or online psychiatrist experienced in treating schizophrenia will be able to best guide individualised treatment plans. If you or someone you know is experiencing symptoms of schizophrenia, make sure you look into treatment options as soon as symptoms start showing, as early detection can reduce the severity of symptoms.
There are a variety of treatment options for schizophrenia, including several types of therapy and medication.
While psychotherapeutic interventions can be helpful in managing symptoms of schizophrenia that persist despite medication, it’s important to note there’s more than one kind of therapy to help treat this type of disorder. Therapy options for people with schizophrenia include:
- Individual psychotherapy: Individual psychotherapy for schizophrenia patients involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or nurse. The sessions (most effective if held on a regular basis) may focus on current or past problems, experiences, thoughts, feelings, or relationships. By sharing experiences with a trained, licenced mental health professional, individuals with schizophrenia may gradually come to understand more about themselves and their problems. They can also learn to sort out the real from the unreal and distorted world that their disorder fosters.
- Cognitive behaviour therapy (CBT): In CBT, a psychotherapist helps a person change potentially harmful or destructive beliefs and behaviours — actions and thoughts that may have developed as early as childhood and early adolescence. Cognition refers to thought patterns, and a therapist can help people with schizophrenia transform their harmful or negative cognitive patterns into healthier and more positive beliefs. For CBT to work, patients must first set goals, achieve those goals, and gain a sense of self-awareness and self-confidence. Using cognitive behavioural therapy (CBT), we can learn how our thoughts and feelings influence our actions. So, if we can alter our perceptions, we will be able to alter our behaviour.
- The goal of cognitive enhancement therapy (CET) is to help people with schizophrenia better organise their thoughts and learn to recognise the triggers and social cues that cause their symptoms to appear.
- In psychosocial therapy, a person learns how to be at ease in a group setting. This method of therapy can include social skills training, rehabilitation, family education, and self-help groups. These methods can help individuals manage their symptoms, develop the support they need, and create a satisfying, purpose-driven life.
- People with schizophrenia and their families can feel less alone when they join a support group. Members of the group offer each other emotional support, acceptance, and advice. Some groups also get involved in advocacy efforts that fight stigma and work to improve the lives of all people who have mental illness. By speaking to other people with schizophrenia about one’s symptoms, and participating in dialogue about mental illness aids, one can see their own problems in the experience of others — and perhaps gain further understanding and perspective on their illness.
Further, self-help in other forms is important. Pursuing self-help strategies such as changing your diet, relieving stress, and seeking social support may not seem like effective tools against such a challenging disorder as schizophrenia, but they can have a profound effect on the frequency and severity of symptoms, as well as improve your mood and increase your self-esteem.
- Communication, assertiveness, and other disease management and self-sufficiency skills are all part of SST’s focus on social skills training. Skills are broken down into several discrete steps. Once the steps have been thoroughly reviewed, the therapist then acts out the skill. When two co-therapists lead a small group of SST clients through role-playing exercises, they are putting their newly acquired skills into practise. After each role play, therapists and group members offer helpful feedback to the participant, and each participant has the chance to practise the skill several times. Repeated practise and over-learning of skills are important aspects of SST.
Antipsychotic medications are among the most commonly prescribed medications in the treatment of schizophrenia.
Antipsychotics help reduce psychotic symptoms such as hallucinations, delusions, paranoia and disordered thinking. Treatments for behavioural symptoms like social withdrawal, low motivation, and a lack of emotional expression may be less effective with these drugs. There are a wide variety of medications that can be used to treat schizophrenia symptoms, but a doctor will be able to help select the one that works best for each person.
If someone is in crisis or experiencing severe schizophrenia symptoms, hospitalisation may be necessary to ensure their safety. They will be able to leave the hospital with a treatment plan in place once they have been stabilised. According to research, the most effective method of treatment includes a combination of therapy, medication, and other types of support services. But, it can vary case by case, and a treatment plan should only be created by a licenced professional.
It is also possible to reduce the frequency and severity of symptoms by combining conventional treatment with self-help strategies such as diet monitoring, stress relief, and social support seeking. The most important thing for someone experiencing schizophrenia is to get professional help to monitor and manage their symptoms.