What Is Schizophrenia?
Schizophrenia is a complex and chronic mental illness that can severely affect a person's behavior and understanding of reality. Schizophrenia interferes with a person's ability to think, make decisions and manage emotions, with many other symptoms that can be significantly disabling .
A wide variety of symptoms are possible and vary by case. Symptoms can be defined by difficulties discerning reality, a decline or disruption in a person's behavior or ability to express emotions, as well as dysfunctions in memory or thinking.
Treatments also vary by case, but include a combination of medications, psychotherapy, and a need for life-long support or as long as symptoms are present.
You should make an appointment with your primary care physician to discuss these symptoms. It is likely a referral to a psychiatrist is necessary and anti-psychotic medication will be prescribed.
How common is Schizophrenia?
Symptoms that always occur with Schizophrenia:
- Hearing voices or seeing things that aren't there
- Impaired social or occupational functioning
The first signs of schizophrenia can be very subtle, especially in the teenage population. They can include sleep problems, irritability, a drop in grades, and sometimes slow isolation or withdrawal from others.
Established symptoms of schizophrenia can be divided into three groups: positive symptoms, negative symptoms, and cognitive symptoms [1,2].
These are psychotic behaviors that involve difficulties in discerning reality. People with positive symptoms often "lose touch" with what is really happening in the world and life.
- Hallucinations: These are false perceptions that appear to be real. For example, a man dying of thirst in a desert may think that he sees a lake.
- Delusions: These are fixed false beliefs that are resistant to reason or confrontation with actual facts. For example, a person who believes they are being followed or watched by aliens.
- Movement disorders: These symptoms are agitated body movements that do not involve thoughts or perceptions but are considered positive symptoms since they are not generally seen in healthy people.
Negative symptoms are associated with declines or disruptions to a person's abilities, emotions, or behaviors. These symptoms include:
- Flat affect: This refers to reduced facial expression, tone of voice or little emotion.
- Reduced feelings of pleasure
- Reduced speaking
These symptoms are related to dysfunction in memory or thinking. Symptoms include:
- Difficulty focusing or paying attention
- Difficulty with executive functioning: This is struggling to understand information and using it to make decisions.
- Difficulty with working memory: This is struggling to use or remember information immediately after learning it.
Schizophrenia is a complex disease and fully understanding its causes has been a difficult task for medical professionals thus far. Schizophrenia affects just one percent of the population, as diagnoses of mood disorders are often more prevalent . Research suggests that schizophrenia has several possible causes that may all interact with each other, such as genetics, environmental factors, brain chemistry, and substance use.
Though many genes are known to be involved in schizophrenia, no specific genetic variations have been found to definitively cause the disorder. Nevertheless, familial patterns observed over time strongly suggest that schizophrenia has a genetic component.
- Schizophrenia in first-degree relatives: Ten percent of people who have a first-degree relative with the disorder (for example, a parent or sibling) also develop the disease .
- Schizophrenia in identical twins: When an identical twin is diagnosed with schizophrenia, the other twin has about a 50 percent chance of also developing the condition .
- Overall inheritance pattern: Trends are not clear-cut, and it is not yet possible to use genetic information to predict who will develop schizophrenia.
In relation to stressors that occur during a child's development, environmental factors may increase the risk of schizophrenia.
- Pre-natal stressors: These include inflammation, exposure to viruses, or malnutrition before birth, and have often occurred in people who develop schizophrenia .
- Social isolation: The child may struggle to form healthy relationships and constructs of the world.
- Adversities: This includes those related to racial discrimination, family dysfunction, unemployment, and poor housing conditions.
Research suggests that dysfunction in brain substances called neurotransmitters may contribute to schizophrenia . Neurotransmitters such as dopamine and glutamate are key in allowing brain cells to communicate with each other, and people with schizophrenia often have imbalances in these substances.
Certain substances can affect development or aging, depending on how old the individual is, possibly leading to the onset of schizophrenia.
- Mind-altering drug use in young people: According to the National Institutes of Health (NIH), research suggests that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia .
- Marijuana use: A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences.
- Marijuana use in young people: The younger and more frequent the use, the greater the risk. Another study has found that smoking marijuana led to earlier onset of schizophrenia and often preceded the manifestation of the illness.
Treatment Options and Prevention for Schizophrenia
There is no cure for schizophrenia, but there are a few treatment options  available that help alleviate symptoms of the condition. Antipsychotic medications and psychotherapy are often used in conjunction.
These medications can help treat many of the positive symptoms associated with schizophrenia.
- Types: They are usually taken daily in pill or liquid form, but some are injections that are given once or twice a month.
- Side effects: Some people have side effects when they start taking medications, but most side effects go away after a few days.
Psychotherapy is often used in combination with medications to help you cope and address the everyday challenges that schizophrenia can cause. People with schizophrenia who utilize psychotherapy are:
- Less likely to have relapses
- Less likely to be hospitalized
- Have more success attending work and school
- Have more success pursuing other life goals
Schizophrenia can significantly affect your life. The average life expectancy of people with schizophrenia is 15 to 25 years less than that for the general population due to increased physical health problems and high suicide rates . In 2015, an estimated 17,000 people worldwide died from behavior related to or caused by, schizophrenia. Furthermore, people with schizophrenia often experience social problems such as unemployment, poverty and homelessness.
Despite the debilitating nature of the condition, it is possible to live a fulfilling life especially with consistent medication, psychotherapy, and follow-up. About 20 percent of people adjust well eventually, and a few even recover from the condition completely.
When to Seek Further Consultation for Schizophrenia
You do not have to have a full-on hallucination in order to see a healthcare professional about schizophrenia. If you begin to notice subtle signs such as irritability, mood changes, or cognitive difficulties, make an appointment with your physician especially if you have a family history of schizophrenia in your family.
Questions Your Doctor May Ask to Determine Schizophrenia
To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.
- Did you faint?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Are you sick enough to consider going to the emergency room right now?
- How long has your current headache been going on?
- How severe is your headache?
The above questions are also covered by our A.I. Health Assistant.
- Schultz SH, Shields CG. Schizophrenia: A Review. American Family Physician. 2007;75(12):1821-1829. American Family Physician Link
- Schizophrenia. National Institute of Mental Health. Published February 2016. NIMH Link
- Mattejat F, Remschmidt H. The Children of Mentally Ill Parents. Deutsches rzteblatt International. 2008;105(23):413-418. PubMed Link
- Narayan CL, Shikha D, Shekhar S. Schizophrenia in Identical Twins. Indian Journal of Psychiatry. 2015;57(3):323-324. PubMed Link
- Morgan C, Fisher H. Environment and Schizophrenia: Environmental Factors in Schizophrenia: Childhood Trauma - A Critical Review. Schizophrenia Bulletin. 2007;33(1):3-10. PubMed Link
- Scientists Discover Neurochemical Imbalance in Schizophrenia. UC San Diego Health. Published Sept. 11, 2014. UCSD Health Link
- Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G. Substance Abuse in Patients with Schizophrenia. Dialogues in Clinical Neuroscience. 2006;8(1):37-43. PubMed Link
- Wildgust HJ, Hodgson R, Beary M. The Paradox of Premature Mortality in Schizophrenia: New Research Questions. Journal of Psychopharmacology (Oxford, England). 2010;24(4):9-15. PubMed Link