What is schizophrenia?
Schizophrenia is a severe mental health condition that affects about 1 in 100 people. It's often described as a type of psychosis, which means you have difficulty separating your thoughts and beliefs from reality.
You may have heard that schizophrenia makes people violent or means they have a 'split personality', but these are both misconceptions that aren't true.
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 – negative symptoms
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. It often starts during adolescence, and symptoms can be confused with a teenage phase.
Positive symptoms of schizophrenia
The positive symptoms of schizophrenia change 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, and research shows that the brain mistakes thoughts for real voices. 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 your thoughts or removing thoughts from your mind.
The exact causes of schizophrenia are not clear. But experts believe that a combination of different factors can make you more likely to develop the condition.
- 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 of a link between schizophrenia and an imbalance between 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.
Diagnosis for schizophrenia
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 most of the time for a month, and they have a significant impact on your daily life.
Schizophrenia is usually treated with a combination of:
- Medication – antipsychotic medication is often recommended 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.
You're usually treated by your CMHT, who will provide day-to-day support and treatment, but other avenues 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 your doctor or CMHT to find out what's available in your area.
When schizophrenic episodes are severe, especially if doctors are concerned about yourself or others' safety, you may need treatment in a psychiatric hospital.
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. Unfortunately, this isn't always the case, and some people must learn to live with their symptoms.
- Reviewed by:
Dr Rhianna McClymont
Lead GP at Livi
- Last updated: