Schizophrenia is an often misunderstood and mischaracterized mental illness that can affect how someone thinks, feels, and behaves. Understanding the symptoms and causes of schizophrenia can ensure people get the treatment they need.
What is schizophrenia?
Schizophrenia is a disorder that affects how someone perceives reality. It can alter how they think, feel, speak, and behave (American Psychiatric Association, 2013). It can require lifelong treatment, but early diagnosis can help in managing symptoms.
People with schizophrenia may have a difficult time staying in touch with reality. The disorder can affect everyday activities such as school, work, or communication with family members. Symptoms can include hallucinations, delusions, disorganized speech, movement disorders, or loss of interest in everyday activities. Many people who receive treatment can learn to manage their symptoms and function well in everyday life.
Possible causes of schizophrenia
The exact causes of schizophrenia remain unknown. Researchers believe a chemical imbalance in the brain combined with environmental and genetic factors can cause schizophrenia (Andreasen et al., 1999).
Problems with certain naturally occurring brain chemicals, including neurotransmitters, may contribute to the onset of schizophrenia. Neurotransmitters in people with schizophrenia can either be over- or under-active. Some research suggests it is related to the development of the frontal cortex, while other studies suggest it has to do with connections between nerves in the brain being eliminated as a brain matures (Selemon & Zecevic, 2015).
While the exact cause is still being studied, researchers have identified several risk factors:
Genes play a big role in determining susceptibility to schizophrenia. The likelihood of developing the disorder can be many times higher if there is a family history of schizophrenia, especially in a parent or sibling (Jeppesen & Benros, 2019).
A variety of external environmental components can trigger schizophrenia. Research shows that malnutrition before birth can increase risk (Selemon & Zecevic, 2015). Living in poverty, dealing with dangerous surroundings, and exposure to other health issues, such as viruses when in the womb, can also contribute to the risk. Autoimmune disorders and psychosis have also been linked to schizophrenia (Jeppesen & Benros, 2019).
Research into schizophrenia also shows that size differences in certain areas of the brain may be an indicator of the disorder (Andreasen et al., 1999). Some of these disparities may develop in the womb, but researchers are still trying to understand exactly how these relate to the disorder.
Some researchers believe the use of mind-altering drugs early in life can increase the risk of developing schizophrenia later in life, with younger heavy users at the most risk (Khokhar et al., 2018).
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Symptoms of schizophrenia
Several symptoms and signs are associated with schizophrenia. If left untreated, symptoms can worsen with age. These include:
- Delusions: believing things that aren’t true or aren’t based in reality
- Paranoia: the feeling that someone is out to get you
- Hallucinations: seeing, hearing, feeling, smelling, or otherwise perceiving things that are not real
- Disorganized speech: thinking or speaking in ways that are strange or illogical, having trouble organizing thoughts and speech to express oneself clearly
- Movement disorders: moving one’s body in an abnormal way or repetitively; or stopping movement or response altogether
- Negative symptoms: the name for symptoms that indicate a lack of emotion, motivation, or interest in daily life, or the inability to show emotions. These symptoms can seem like depression, but may point to a problem with brain chemistry that is related to schizophrenia.
- Avoiding social interactions: withdrawal from others and disinterest in social activities
How is schizophrenia diagnosed?
Schizophrenia is often caught late. While symptoms may be apparent to others, people with schizophrenia often don’t realize anything is wrong. Schizophrenia can also be difficult to diagnose in some patients. The use of mind-altering drugs can cause a person to have schizophrenia-like symptoms.
To diagnose a patient, clinicians may ask about medical history, symptoms, and family history. Lab tests may be used to rule out other conditions or diseases. Sometimes a clinician will interview family members.
Treatments for schizophrenia
There is no cure for schizophrenia, but effective treatment can help manage symptoms. Treatment is often a lifelong process that can involve more than one method of care. Therapy and medication are the most common forms of treatment.
Several forms of therapy can effectively treat schizophrenia. Cognitive behavioral therapy (CBT) can help with hallucinations by encouraging patients to adjust their thinking and behaviors. CBT can help identify triggers that cause hallucinations, delusions, or other schizophrenic episodes and reduce or prevent them.
If a patient is improving, psychosocial training can teach them how to socialize again. Often, the goal of therapy is to find solutions that allow patients to participate in school, work, and family situations.
Medication is typically a key part of treating schizophrenia, often along with therapy. Antipsychotics, the most common type of medication for schizophrenia, can make symptoms less severe and occur less often. Medications for schizophrenia are available as daily pills or liquids. Some come in the form of regular injections.
When taking medication, some symptoms can disappear within days. Other more severe symptoms, such as delusions and hallucinations, may take months to abate.
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- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Andreasen, N. C., & Others, P. B. M. and. (1999, February 25). Understanding the causes of schizophrenia: Nejm. New England Journal of Medicine. Retrieved December 9, 2022, from https://www.nejm.org/doi/pdf/10.1056/NEJM199902253400811
- Jeppesen, R., & Benros, M. E. (2019, March 20). Autoimmune diseases and psychotic disorders. Frontiers in psychiatry. Retrieved December 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435494/#:~:text=Having%20a%20first%20degree%20relative,with%2010%25%20(24).
- Khokhar, J. Y., Dwiel, L. L., Henricks, A. M., Doucette, W. T., & Green, A. I. (2018, April). The link between schizophrenia and substance use disorder: A unifying hypothesis. Schizophrenia research. Retrieved December 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094954/
- Selemon, L. D., & Zecevic, N. (2015, August 18). Schizophrenia: A tale of two critical periods for prefrontal cortical development. Translational psychiatry. Retrieved December 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564568/