Schizophrenia

As with most mental illnesses, recognizing the signs of schizophrenia isn't always easy. But one thing is clear: Schizophrenia does not mean having split or multiple personalities. Hallucinations and delusions are classic signs of schizophrenia, but there are others too.
By Lambeth Hochwald
Updated July 27, 2021

Like most mental illnesses, it's not always easy to recognize the signs of schizophrenia. But one thing is clear: Schizophrenia, which affects one in 200 Americans, does not mean having split or multiple personalities. And, while hallucinations and delusions are classic signs of schizophrenia, there are others, too.

divider

What is it?

Schizophrenia is a serious mental illness that alters how a person feels, what they see, how they process thoughts, and how they behave. It's a chronic condition that is usually diagnosed in the late teens to early thirties, and there's no cure for it. However, many people with schizophrenia are able to become fully or partially free from its symptoms and live full lives with the condition.

Schizophrenia, which can involve hallucinations, delusions and difficulty with social relationships, is not as common as some other mental health issues. In fact, it's estimated that less than 1% of Americans have schizophrenia, according to the National Institute of Mental Health (NIMH).

divider

Types

While mental health experts once classified schizophrenia into five main subtypes: paranoid, catatonic, disorganized, undifferentiated, and residual, experts now identify schizophrenia as a spectrum of symptoms.

With this designation of a schizophrenia spectrum—rather than different types of schizophrenia—experts can best diagnosis schizophrenia as an entity made up of several subtypes.

It's important to note that while there are related conditions to schizophrenia such as schizophreniform disorder (two or more schizophrenia symptoms that last more than one month but less than six months) and schizoaffective disorder, which is diagnosed like schizophrenia but adds a mood element such as major depression or mania, the basics are still the same: Schizophrenia causes psychosis, which means people who have the disorder have trouble making the distinction between what's real and what isn't.

Related Content

divider

Symptoms

When you have schizophrenia, different symptoms tend to occur together in different combinations. For instance, you may have delusions and hallucinations, or you might have disorganized thinking and speech.

To arrive at a diagnosis, most experts agree that you have to experience symptoms for more than six months.

As with most mental illnesses, recognizing the signs of schizophrenia isn't always easy. Schizophrenia does not mean having split or multiple personalities, despite commonly held stereotypes. Instead, schizophrenia symptoms often reflect difficulty sorting out reality from fantasy. Schizophrenia symptoms can affect all aspects of a person—thoughts, emotions, and behavior—which can filter down into difficulty negotiating many aspects of life.

Here are some of the common symptoms of schizophrenia:

* Hallucinations. These can be auditory or visual.
* Delusions. Stories you create to make sense of your state of mind.
* Disorganized thinking and speech. This can also include talking off topic, switching topics or creating words.
* Cognitive symptoms. Difficulty with memory, focus, planning, or organization.
* Agitation. Flailing with extra, unnecessary movements; clumsiness.
* Appearing withdrawn. Speaking in monotones, not making eye contact.
* Suicidal thoughts and feelings.

divider

Causes

While the exact cause of schizophrenia hasn't been discovered yet, there are certain risk factors that make people more likely to develop it.

Genetics

Schizophrenia can sometimes run in families. If you have a family history of the mental disorder, such as a close relative who had it, you're at a higher risk of developing it yourself. Scientists haven't, however, been able to identify the particular genes linked to it.

Environment

Certain environmental factors like malnutrition in the womb, complications during a person's birth, and being exposed to certain viruses are thought to contribute to a person's risk of developing schizophrenia. Research suggests that some psychosocial factors, such as childhood abuse and growing up in a stressful home, may also increase a person's risk of schizophrenia.

Brain changes

Certain imbalances in chemicals in the brain may play a role in developing schizophrenia. Experts think the neurotransmitter dopamine in particular is likely involved and medications that block this brain chemical are often used to reduced schizophrenia symptoms.

Related Content

divider

Diagnosis

Doctors and mental health experts diagnose schizophrenia by performing physical examinations and medical tests to rule out other causes of a person's symptoms (like a brain tumor) first. If there is no physical reason a person is experiencing these schizophrenia-like symptoms, a psychiatric or psychological evaluation, including an interview and specific assessment tools, is the next step in delving into the cause of a person's thoughts and behaviors.

If you notice any of the symptoms of schizophrenia in yourself or a loved one, talk to a doctor or mental health professional.

divider

Treatment

Without a cure, schizophrenia treatment remains focused on managing symptoms. This usually involves antipsychotic medications that can help with the psychotic symptoms of schizophrenia. These prescription meds are usually taken orally every day, but they can also sometimes be administered as injections. Doctors may also prescribe antidepressants or anti-anxiety medications to manage schizophrenia symptoms.

Psychosocial treatments are also often helpful and include psychotherapy and social skills and vocational training.

During times when symptoms are severe, a person with schizophrenia may need to be hospitalized for their own safety and well-being. Learning psychosocial coping skills can help keep people out of the hospital and prevent relapse.

divider

Prevention

While there's no way to prevent schizophrenia, which is believed to be caused by an interplay of genetic and environmental factors, the family ties are ones that up your risk the most.

For example, researchers estimate that about 80% of the risk for developing schizophrenia is hereditary. Still, this doesn't mean that people with faulty genes will actually develop the disorder.

However, if you have a genetic predisposition to schizophrenia, experts urge an avoidance of substance use as that can trigger schizophrenia. For example, drugs such as marijuana, amphetamines and cocaine have been shown to prompt an increase in schizophrenia-like symptoms.

In addition, it's important to focus on stress management, work hard to forge strong social ties, and avoid unhealthy relationships that can negatively affect your mental health.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter