Schizophrenia

What is schizophrenia?

Schizophrenia is a long-term mental health condition, often referred to by doctors as a type of psychosis. This means you have difficulty separating your thoughts and beliefs from reality.

You may have heard that schizophrenia can make people violent or means they have a 'split personality', but these are both misconceptions that aren't true.

What are the symptoms of schizophrenia?

Doctors classify schizophrenia symptoms into positive and negative symptoms. This doesn't mean they make you feel positive or negative. Instead, the negative symptoms take something away from life, like losing interest in activities. The positive symptoms add something to your life, like believing something is real when it isn't.

Early signs of schizophrenia 

The early stage of schizophrenia (also known as the 'prodromal' phase) can build up quite slowly and usually involves negative symptoms. 

These include:

• Withdrawing from socialising

• Losing interest in your appearance and personal hygiene

• Lack of motivation and losing interest in normal activities

• Lack of concentration

• Sleeping problems

• Relationship problems with friends and family

It can be hard to recognise that these symptoms could be related to something more serious during this early stage. Schizophrenia often starts during adolescence, and symptoms can be confused simply with the teenage phase.

Later symptoms of schizophrenia

The symptoms of schizophrenia change your behaviour and thoughts and can also be described as a 'psychotic experience'. 

This may involve:

• Hallucinations – seeing, hearing or feeling things that others don't. This can include hearing voices, which might be friendly or critical. The voices feel very real. You may also see people or shapes, feel someone touching you when no one is there or even smell or taste things that don't exist.

• Delusions – firmly believing things that aren't true. For example, you may be convinced that someone is following you or trying to hurt you, that you have unique superpowers or that people are communicating with you through the TV.

• Confusing thoughts – you might process thoughts in a disorganised way, making you talk rapidly, quickly change subjects and lose your train of thought. It might feel like someone else is controlling or removing thoughts from your mind.

What causes schizophrenia?

The exact causes of schizophrenia aren’t clear. But experts believe that a combination of different factors can make you more likely to develop the condition.

These include:

• Genetics – people with a family history of schizophrenia have an increased risk of developing the condition themselves, but genes aren't the only factor.

• Chemical makeup in the brain – there's some evidence to support a link between schizophrenia and an imbalance of dopamine and serotonin (two chemicals that carry messages between brain cells).

• Stressful life events – like being abused, suffering a bereavement, ending a relationship or becoming homeless.

• Drug and alcohol abuse – there is a link between schizophrenia and people who use cannabis or other recreational drugs. It's also likely that using recreational drugs can make symptoms worse if you already have the condition.

How is schizophrenia diagnosed?

A doctor will take an initial assessment to look at any medication or recreational drugs you're taking and your family's mental health history.

If they think it could be schizophrenia, they'll refer you to a team of mental health professionals called the community mental health team (CMHT). They will give you a full assessment and check that all other possible causes for the symptoms, like recreational drug use, have been ruled out.

You may be diagnosed with schizophrenia if you've been experiencing some of the main symptoms above, most of the time for a month, and they have a significant impact on your daily life.

How is schizophrenia treated?

Schizophrenia is usually treated with a combination of the following:

• Medication – antipsychotic medication is often used to reduce symptoms of psychotic episodes by causing changes in your brain chemistry. It can be beneficial, but it isn't suitable for everyone.

• Therapy – Cognitive behavioural therapy (CBT) can help you understand your experiences and develop ways to change negative thoughts and behaviour. Other useful forms of treatment include family therapy, where you discuss your experiences as a family and find practical ways to cope together. Art therapy encourages you to express your feelings in a non-verbal way.

Other support

You're usually supported by your CMHT, who will provide day-to-day help and treatment, but other forms of support can also be helpful.

Psychotic experiences can be disorientating, confusing and frightening, and talking to others who understand what you're going through can be a huge help. Self-help groups are a safe, private place where you can share your thoughts and feelings without judgement. Talk to a doctor or CMHT to find out what's available in your area.

Hospital

When schizophrenic episodes are severe, especially if doctors are concerned about yourself or others' safety, you may need treatment in a psychiatric hospital.

Can you recover from schizophrenia?

Unfortunately, there's no cure for schizophrenia, although the treatments available help improve symptoms for many people. This often means they have long periods without symptoms or that the symptoms never return.

But, this isn't always the case, and some people must learn to live with their symptoms.

When should I speak to a doctor?

If you’re experiencing any of the above symptoms and it’s having an impact on your daily life, seek medical help as soon as you can. A doctor will be able to talk through your symptoms, how you’re feeling and refer you to the best support.