Emotional Well-Being|Mental Health|Prevention and Wellness
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Schizophrenia

Last Updated June 2023 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

What is schizophrenia?

Schizophrenia is a serious mental illness that interferes with the way you think, feel, and act. It makes it hard for you to think clearly and make decisions. It is also hard for you to relate to people and act appropriately in social situations. People with schizophrenia can have trouble telling the difference between what’s real and what’s not. For example, they may hear voices that aren’t there or think that someone is out to get them.

Schizophrenia occurs in both women and men. Symptoms usually start between the ages of 16 and 30. It is a lifelong condition. It can be disabling to work and school life as well as relationships if not treated and regularly managed.

Symptoms of schizophrenia

Symptoms of schizophrenia usually develop slowly over time. They fall into multiple categories.

Psychotic symptoms

These are symptoms that often appear during psychotic episodes.

  • Hallucinations – Sensing something that isn’t there. Hearing and seeing things are the most common. Many people with schizophrenia hear voices. Others may smell strange odors or feel something on the skin that isn’t there.
  • Delusions – When a person believes something that isn’t true. These are often strange or extreme beliefs. They may believe that someone is trying to hurt them or is putting thoughts into their head.

Negative symptoms

These reflect the absence of or reduction in certain appropriate behaviors. They can sometimes be confused with symptoms of depression.

  • Limited range of emotions
  • Speaking in a flat, disconnected way
  • Withdrawal from family, friends, and social activities
  • Low energy
  • Lack of motivation
  • Loss of pleasure or interest in life
  • Poor hygiene and grooming habits

Disorganization symptoms

  • Confused, disordered thinking or speech
  • Trouble organizing thoughts
  • Speaking in words or sentences that don’t make sense
  • Repetitive body movements, such as pacing
  • Catatonia, when a person stops moving or talking for a period of time

Cognitive symptoms

  • Difficulty in understanding information and using it to make decisions
  • Problems with focusing or paying attention
  • Trouble with using information immediately after learning it

There is a misperception that people who have schizophrenia are violent. This is not true. In fact, most people who have the disorder are more likely to be harmed by someone else. They are at a higher risk of being taken advantage of by others, as well.

What causes schizophrenia?

There isn’t one known cause of schizophrenia. Researchers have found that your risk of developing the illness could be higher if:

  • You have a family history of psychosis
  • You were exposed to viruses or malnutrition before you were born
  • You have brain chemistry issues, especially with some neurotransmitters
  • You took mind-altering drugs when you were a teenager or young adult
  • Psychosocial factors (poverty, stressful or dangerous living environment, loneliness, job issues, relationship status, etc.)

How is schizophrenia diagnosed?

If you or a family member have symptoms of schizophrenia, see your family doctor. They will review your medical history and ask you about your symptoms. Your doctor may order tests, such as blood tests or brain scans. These can help rule out physical conditions that have similar symptoms.

Your doctor may refer you to a psychologist or a psychiatrist. They will assess your symptoms, talk to your family, and observe your behavior over time. To be diagnosed with schizophrenia, a person must experience at least 2 symptoms regularly for at least 6 months.

Schizophrenia can be hard to diagnose and it can mimic other mental illnesses. There aren’t any tests for it. Substance abuse, medicines, or other medical conditions can produce some of the same symptoms. Many people diagnosed with schizophrenia don’t believe they have it. In those cases, friends and family members must make sure the person gets help.

Can schizophrenia be prevented or avoided?

Schizophrenia can’t be prevented or avoided. Symptoms may be avoided by taking medicines as prescribed by your doctor.

Schizophrenia treatment

There is no cure for schizophrenia. However, treatments can help people manage their symptoms and improve their daily lives, especially in achieve personal life goals, such as completing education, pursuing a career, and having fulfilling relationships.

Schizophrenia requires lifelong treatment, even when you don’t have symptoms. Treatment should reduce the number of times you relapse, and improve your quality of life. Medicine and support therapy are the most common forms of treatment.

People with schizophrenia commonly take antipsychotic medicines. These change the balance of chemicals in your brain and help manage symptoms. Some can cause side effects. You might need to try different medicines to find one that works for you.

Support therapy helps people with schizophrenia manage their illness. This can include one-on-one counseling, training in social skills, family therapy, and job support.

When symptoms are severe, people with schizophrenia may need to stay in the hospital. This will make sure they stay safe and are taken care of.

Living with schizophrenia

Schizophrenia doesn’t ever go away, but it can be managed. Many people can control their symptoms with medicine. Therapy, case management, job, and social support help people with their recovery. In the early stages of the illness, relapses and recurring episodes are common. Symptoms and relapses tend to decrease over time if a person continues to take their medicine and receives support. Some people with schizophrenia can live on their own. Others may live with family members or a group home for extra support.

Questions to ask your doctor

  • Is there any other medical condition that could be causing my symptoms?
  • Will my symptoms get worse?
  • After I start taking medicine, how long will it take until I start feeling better?
  • What are common side effects for this medicine?
  • What will happen if I stop taking the medicine?
  • What kinds of social support are available in my community?
  • What should I do if I relapse or have severe symptoms?
  • Will there be any warning signs that a relapse is coming?
  • Is it safe for me to work or drive?

Resources

National Institutes of Health, MedlinePlus: Schizophrenia

National Institute of Mental Health: Schizophrenia

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