What is schizophrenia?

Do you know what schizophrenia is? The following are some of the things you might have heard about the term or about a person who suffers from this mental illness:

This is what schizophrenia looks like
No multiple personalities here — Image by PxHere.com
  • is just hearing voices
  • it’s a split personality or multiple personalities
  • they’re delusional
  • they’re volatile, at risk, all dangerous and paranoid
  • it can’t be treated
  • they can’t go to uni or hold down a job
  • they can be alright one minute and change into a different person the next

Most of the above are wrong. Some are mere myths—not the facts—and heavily influence how many people view schizophrenia.

What causes schizophrenia?

The exact causes are, as yet, unknown but research has suggested that a combination of

  • hereditary
  • psychological
  • physical
  • social and
  • environmental factors might play a role in the development of this disorder. While cannabis does not cause schizophrenia in itself, studies have shown it increases the risk of developing schizophrenia.

Definition of Schizophrenia

Schizophrenia is a mental illness that affects the brain and causes delusions

According to the Diagnostic and Statistical Manual (DSM-5), schizophrenia is a severe and chronic mental disorder. It’s characterized by disturbances in thought, perception and behavior.

The NHS agrees; schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms.

And finally, it is a serious mental illness in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behaviour that impairs daily functioning, and can be disabling, Mayo Clinic, 2020.

Schizophrenia statistics

Skip to symptoms if facts and figures make your eyes glaze over, otherwise stay here to find out more about stats:

Coloured image drawing of male face, half of which is coloured in, with brain on top of the head sliced open
Image by NetClipArt
  • schizophrenia affects less than 1 in 100 people during their lifetime and occurs in all countries, cultures, societies or class
  • it runs in families, and if you have a parent or sibling with the illness you are more likely to suffer from it yourself
  • men have a higher risk of developing schizophrenia during their lifetime
  • psychosis usually first occurs in young people between the ages of 15 and 30 and the age of onset is lower in men
  • 38% of people recover after a first episode of psychosis, and symptoms improve for 58% of people
  • 25% recovers completely from their first episode
  • early intervention and treatment methods, and newer medicines, mean better recovery rates for psychosis and schizophrenia. 10 years after diagnosis:
    • 25% improves with treatment, recovery of (almost) all previous functioning and has very few relapse events
    • 15% leads a chronic course with little or no improvement and repeated hospital stays over a prolonged part of adult life
    • 25% improves, needs significant support to function normally and to get through relapse events
    • 10% dies, as a result of suicide
  • recovery is more likely if psychotic episodes are treated early
  • psychotherapy on its own can’t treat schizophrenia effectively but it can be very useful, together with medication .

Although there’s currently no cure, the treatment success rate with antipsychotic medications and psycho-social therapies can be high. I trained as a Thorn Nurse using psychosocial interventions, and CBT for schizophrenia in Early Intervention and Family Work. The results were often remarkable.

Symptoms of schizophrenia

Patients diagnosed with schizophrenia may experience hallucinations.
Visual hallucinations

Schizophrenia has positive and negative symptoms.

Positive symptoms are thinking or behaviour that the person with schizophrenia did not have before they became ill. These can be thought of as being added to their psyche and include:

  • hallucinations occur in the five senses, i.e. hearing things that others can’t, seeing, tasting, smelling, feeling/touch
  • delusions – unusual beliefs not based on reality for example grandiose, persecutory, somatic, jealous or a mixture
  • thought disorder; for example feeling like someone’s putting words into their mind.

Negative symptoms describe thoughts or behaviour that the person used to have before they became ill, but now no longer have or have to a lesser extent. They can be thought of as being lost or taken away from a person’s psyche and can include:

  • flat affect; the inability to show emotions
  • apathy, lacks motivation, lethargy losing interest in everyday activities
  • difficulties talking
  • and withdrawing from social situations, friends and relationships.

Everyone is different and not everyone with schizophrenia will get all of the above positive and negative symptoms.

Paranoid schizophrenia

Men suffering from paranoid schizophrenia
Hearing persecutory voices

Involves hallucinations and beliefs where the individual feels they’re being watched, harassed or persecuted. The beliefs fall into two categories:

Unusual – they believe for example that the CIA, Local Authority government or police are watching them.

Everyday – the individual may start believing that their mother is being unfaithful. They reached that conclusion because of “evidence” that has nothing to do with cheating (like their mum bought a particular newspaper ). Others around them can see there’s no evidence at all to suggest that their beliefs are true.

These delusions will obviously distressing for the individual and also for those seen as the ‘persecutors’ especially if they are friends or family members.

Paranoid schizophrenia is a common form of schizophrenia. The media often writes wild stories about people with this disease. Note that a schizophrenic is less likely to be dangerous compared to your average member of the public.

What treats schizophrenia?

What is schizophrenia and will antipsychotics treat is?
Image by Pxfuel.com

Specific medications called antipsychotics reduce the symptoms of schizophrenia. The most common antipsychotic drugs include medicine such as Haldol (holaperidol) and Seroquel and(quetiapine) and Zyprexa (Olanzapine). The individual will most likely have to take such medication for the rest of their life. This is true even if symptoms improve. Medication can come in the form of a tablet, liquid, or as an injection.

Other treatments might include Cognitive Behavioural Therapy (CBT), specifically for schizophrenia, social skills training and family interventions. However, it’s important for families to educate themselves about schizophrenia, in the first instance, so that they’re able to support their family member with schizophrenia.

Prognosis

Prognoses differ very much from individual to individual. Treating schizophrenia should be done at at an early stage and will show a substantial deduction in symptoms when medication is used.

Many people with schizophrenia respond well to treatment and can live normal, fulfilling and productive lives in their community. Whereas, others can experience a chronic course with episodes of illness.

Over to you

What do you think?
Clipart.com

Of course, the above information is not exhaustive and you might find different sources supply different material. What are your thoughts? Do you or someone you know have a diagnosis of schizophrenia and want to refute any of the above? Would you be able to explain what it means now? I look forward to reading your comments and I’m happy to answer any questions.

Related blog post: How my life was changed with these schizophrenia symptoms (1)

Author: mentalhealth360.uk

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

20 thoughts on “What is schizophrenia?”

      1. Aa I have mentioned on my blog, when it came to my mum, I remember the certain conversations she does when unwell from the age of 9,except at 9, I thought I was learning something from mum. But there was a very small feeling that something may not be right. But I wasn’t concerned.

        It started from age 11 when I have always been worried about mum since, up to present day. Even when she had good stable years as it could get for my mum.
        But at 11 was when mum first disappeared. Dad learnt 24 hours later she signed herself in the mental health unit. The mental health unit I know well, because of then and trips last year there and before that. Whether as a voluntary patient, outpatient, or as now, before nursing home she’s now officially in permanently while things are, as they are, sectioned.

        From 13, when it was just me and mum, after dad died, then I became her unofficial carer.

        Dad, growing up, fearful of. There were odd good times, but rare. Better with other kids than his own.
        And his behaviour would not have helped mum. But mum had her issues before he came along in her life, which soon they had me.

      2. Ah, that’s right, I remember some of it cos I only started blogging about 6-7 months ago.

        Wow, that must have been tough for you and yes, kids can pick up when things are not quite right.

        At least your mum checked herself into a hospital, it’s not what a lot of people would do, is it? She obviously had good insight.

        13 is certainly young to become a carer Liz and particularly as your dad wasn’t around to help. Still, you don’t think he could cope with that. So, you’ve had years of being a carer. Wow, I take my hat off to you Liz.

        You take care x

      3. It wasn’t something I felt forced to do. I just did it. But yes unrecognised. No support, until after mum took an overdose last year. Although the support was mum’s support, I felt supported because if something was wrong with mum, I could tell them and they would act on whatever was needed.

        When mum went missing when I was 11, dad, was a dad in that space of time. Which was weird for me and still unnerving. But also he collapsed with stress of it. I witnessed a few times his blackouts. So that was scary.

  1. Really informative post. I’ve learnt about schizophrenia in my psychology classes and one thing that stood out for me was how difficult it was to find alternative to medication. Medication is very necessary in a lot of cases and although other treatments are available they are often not as effective. However, I also learnt that a lot of patients have a hard time finding medications that work for them and don’t have really bad side effects. I was really sad when I learnt that.

    1. Unfortunately Pooja, the best thing for schizophrenia is medication/drugs. And yes, patients had to try various and many meds to find out what worked best for them. And most drugs have side effects, which was painful to observe i.e. massive weight gain.

      Like everyone else, people with schizophrenia stop taking their medication because “they feel better”, then they tend to relapse back into psychosis.

      Talking therapies i.e. CBT and Psychosocial Interventions work really well in schizophrenia, but you can only engage in that when you’re well. So, back to medication, I’m afraid.

  2. Positive versus negative symptoms…what interesting terminology. It does seem like the experience of the symptoms would fit those concepts. When thoughts or images intrude, it can feel like a weight added. When feelings or abilities diminish, it can feel empty.

  3. I have schizoaffective disorder and went on to earn my masters degree in psychology post diagnosis. School is easy; working is hard. Studied much about the negative symptoms and blogged about it (been blogging since 2013 about my personal ongoing recovery). Have never heard or read about negative symptoms being present prior to having schizophrenia. Do you have a source for that? Thanks 😊 super interested

    1. Hi Victoria, I’m delighted to hear that you went on to earn your masters, as did many of our patients. One or two ‘relapsed’ once or twice but with a treatment team in place, this was often ‘captured’ quickly and no in-patient stays were necessary.

      I worked a lot with patients who had schizophrenia and schizoaffective, together with their families. Some reported the negative symptoms were more obvious before the onset of positive symptoms like hearing voices. Once I was a mental health nurse, I went on to study for 5-6 more years and trained in CBT for Schizophrenia, early intervention and family work for patients with schizophrenia.
      Here’s one abstract you might want to read:
      https://link.springer.com/chapter/10.1007/978-3-642-76841-5_10

      However, while this article argues that the negative symptoms were secondary to other conditions; “it was recognized early that they might originate secondary to a lot of conditions, some related directly and others indirectly to the disease under study.

      Still the same article says, “the current conceptualizations indicate that primary negative symptoms may predate the positive symptoms by years in an undiagnosed state.”

      And out NHS write in this article: ” The negative symptoms of schizophrenia can often appear several years before somebody experiences their first acute schizophrenic episode.

      These initial negative symptoms are often referred to as the prodromal period of schizophrenia.

      Symptoms during the prodromal period usually appear gradually and slowly get worse. “https://www.nhs.uk/conditions/schizophrenia/symptoms/#:~:text=The%20negative%20symptoms%20of%20schizophrenia,gradually%20and%20slowly%20get%20worse.

      1. Sorry Victoria, I pressed send too quickly. Thank you for asking about the source. I hope you find these articles of interest and I have many more I could suggest.

        Because I had my own psychotic depression I read a lot about the subject prior to my training to be a nurse 🙂 It’s fascinating.

      2. Just came across this again and wanted to ask you if you think 20 years is possible? I was a rebellious teenager and ran away to New York City on drugs. Then met my husband and raised 3 kids. At 36 I started having positive symptoms. Thanks ahead

  4. Hi Victoria, sorry I don’t quite understand what you’re asking? “If I think 20 years (what) is possible?

    Do you mean to have a relapse? If so, the sooner you get treatment, the better the outcome in the long-term. It is possible to get better and maintain a positive, worthwhile life.

    Please let me know if I got this wrong and you need a different response. Caz 🙂

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