What Is Schizophrenia?

Schizophrenia is a serious mental health condition that affects how the brain works and impacts an individual's thoughts, emotions, and behaviors—schizophrenia can affect all areas of life. It can run in one’s family, but there are other factors that influence its development as well. While there is no cure for schizophrenia, people with mental illnesses like schizophrenia can take steps to help manage their symptoms and live fulfilling lives. In this article, we will discuss the symptoms of schizophrenia as well as how to receive appropriate support and treatment.

Symptoms of schizophrenia

According to the National Alliance on Mental Illness, schizophrenia is "a serious mental illness that interferes with a person's ability to think, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness, affecting about 1% of Americans."

Due to its potentially life-altering symptoms, this disorder can be one of the most challenging mental health conditions to manage. Symptoms typically fall into two categories: positive and negative. Positive symptoms include behaviors that would not typically be present in someone without the disorder —for example, if you hear voices that others don’t—while negative symptoms include a notable absence of behaviors considered typical, such as a lack of emotional expression or interest in social interactions.

The following symptoms are some possible signs of schizophrenia:

• Auditory or visual hallucinations, such as hearing voices or seeing things that are not there
• Delusions or beliefs that are not based in reality. For example, someone with schizophrenia may feel frightened because they believe that someone is “out to get them,” that the government is targeting them, or that they have magical powers, even when there is no evidence to support these beliefs, or there is discounting evidence
• Difficulty communicating clearly or expressing emotions
• Unusual movements such as repeatedly waving your arms or holding a pose for a long period
• Disorganized or incoherent speech
• Social withdrawal, even from those you were previously close to
• Loss of interest in activities that you once enjoyed
• Challenges with processing information and making decisions
• Difficulties with sustaining focus and concentration

In addition to these symptoms, people with this disorder are at an increased risk of developing complications with their physical health, such as obesity, diabetes, and heart disease. Symptoms of schizophrenia can make it difficult for someone to function and carry out daily tasks. Any of these symptoms can hinder the ability to handle responsibilities at work or school, maintain relationships, complete household tasks, and maintain proper hygiene.

Early signs to look for

Signs of this disorder can be subtle in the early stages and may develop over months. Early warning signs of schizophrenia may include:

• Changes in mood, like increasing irritability and depressed mood
• Unusual behavior, like laughing for no apparent reason
• Excessive sleeping
• Social withdrawal
• Problems with speech or logical thought, like trouble organizing their thoughts and speech
• Noticeable decline in personal care and hygiene
• An unusual drop in functioning in academics, sports, and other activities

Early signs typically start in young people, in their late teens through their mid to late twenties. 

It is important to note that this is not a comprehensive list of the signs and symptoms of this illness. As with any mental health problem, schizophrenia affects all people differently. Some people experience all these symptoms, while others may experience only some of them. Most people with schizophrenia experience symptoms intermittently or continuously throughout the duration of their life. 

If you believe you or your child are experiencing symptoms, make an appointment with your doctor. While only a healthcare provider can diagnose schizophrenia, if you’d like to investigate your symptoms before seeing a doctor, the Revive Research Institute created a simple quiz to test if you have schizophrenia, with simple questions that may indicate whether it is likely or not that your symptoms are consistent with schizophrenia. Bring the results of your quiz to your doctor’s appointment as a reference for your symptoms. 

Diagnosis

People are typically diagnosed with schizophrenia in their early adult years. According to the National Alliance on Mental Illness, early diagnosis improves a person’s likelihood of managing symptoms and reducing psychotic episodes. Individuals who develop schizophrenia can learn to manage their symptoms and have productive lives with early intervention and comprehensive schizophrenia therapy. Men are typically diagnosed earlier than women, although this is not always the case.

First, symptoms such as social isolation and trouble concentrating can often be dismissed as part of changing life circumstances, such as graduating from high school or ending a serious relationship. Additionally, people with schizophrenia may deny their symptoms, which can make it difficult for a medical professional to obtain a full picture.

Testing for schizophrenia

There is no one test that allows for the diagnosis of this disorder. Instead, providers must take an individual’s symptoms over a period of time into account and rule out other physical and mental illnesses. Their health care provider might want to learn more about their beliefs, past hospitalizations, any use of drugs or alcohol, and whether their symptoms have significantly interfered with their life over the past month or more. This can help them narrow down potential causes and determine if schizophrenia is a possible diagnosis.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, explains the criteria for diagnosing schizophrenia.

• Individuals must experience at least two of the five main symptoms for a significant portion of a month, or less time if the illness is being effectively managed. 

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms

A medical professional may also check for the following criteria:

• A marked decrease in functioning related to work, relationships, self-care, etc. since the onset of symptoms.
• Disturbances persisting over a six-month period
• Other mental illnesses, such as schizoaffective disorder and bipolar disorder have been ruled out, and symptoms have been shown to not be linked to the effects of a substance.

If you or someone you know is experiencing symptoms, reach out to a medical professional for help.

Ways to manage symptoms

How is schizophrenia treated? There is no one-size-fits-all approach. Effective treatment plans for schizophrenia can vary between individuals. Therefore, it is important to work with a medical provider to determine the best treatment plan and approach for you. They may suggest that you implement one or more of the following treatment methods:

Medication

Many medications can be used to help control the symptoms of schizophrenia, such as antipsychotic medications. Your doctor may also recommend medications to help manage other symptoms that are common in people with schizophrenia, such as anxiety or depression. 

If one medication alone is not enough to help manage symptoms, your doctor may recommend adding a second medication to your treatment plan. This is called combination therapy. Some of the medications prescribed for schizophrenia can have some negative side effects. It is important to discuss these side effects with your doctor to ensure that the pros continue to outweigh the cons.

Psychotherapy

Professionals may also suggest that individuals living with schizophrenia complete psychotherapy (also called talk therapy). This therapy for schizophrenia may take numerous forms, including cognitive behavioral therapy (CBT), social skills training (SST), and assertive community treatment (ACT). Family therapy has been shown to reduce the risk of relapse, because it teaches family members about how schizophrenia affect’s their loved ones daily life and offers strategies for family members to reduce stress in the environment and problem solve when their loved one is experiencing symptoms. Researchers discovered that people with schizophrenia who live in an unfavorable family environment are 2.5 times more likely to experience relapse.

Emotional support

Developing and living with schizophrenia can be difficult to process. Therefore, individuals experiencing symptoms of schizophrenia may benefit from seeking professional support in the form of a licensed counselor. Other resources, such as schizophrenia support groups, may also be beneficial.

Why see a therapist?

Regardless of an individual’s treatment plan, following up with a licensed therapist for schizophrenia can help you to process your thoughts and feelings along with both diagnosis and treatment.  It can be difficult to accept and live with a mental illness, such as schizophrenia, but there are ways to lessen the challenges and live a fulfilling and healthy life.

Research suggests that methods such as cognitive behavioral therapy may help with depression and positive symptoms those with schizophrenia may face. Additionally, other studies suggest that online CBT may be just as effective as in-person therapy.

Online therapy

Due to much of the stigma surrounding schizophrenia in teens and adults, many people diagnosed with this mental illness may feel embarrassed to seek help. However, there are many discrete ways to begin treating your symptoms and understanding how to navigate life moving forward. One such way is online therapy, which can be utilized discreetly wherever you have an internet connection, including your home.