Hearing things that aren't there. Disorganized behavior that doesn't fit into our society. A sense of sheer chaos just totally dictating my life. I can't even trust my social support.- These are just some of the ways people with schizophrenia feel about their complex symptoms.
Of all the mental illnesses, schizophrenia is among the least understood and the most stigmatized. Society at large tends to ostracize people with schizophrenia. People fear the symptoms, judge the behavior, and alienate themselves from those in acute distress.
But schizophrenia isn't as rare or uncommon as you think. According to the American Psychiatric Association, schizophrenia is one of the top 20 causes of disability worldwide, and it affects approximately 0.7% of the global population.
Unfortunately, people with schizophrenia often lead difficult lives and feel alone with their struggles. And while we've made great strides in advocating for mental health awareness, we still have a long way to go with increasing societal compassion for schizophrenia.
The first step is education. Learning about schizophrenia and understanding what it is- and what it isn't- can help you be a better ally.
If you want to know what life with schizophrenia symptoms feels like, keep reading:
There Aren't Always Clear Warning Signs of Schizophrenia
This can be one of the more unnerving parts of the condition, particularly for family members who want to be supportive.
The average onset of schizophrenia tends to be in the late teens to early 20s for men. For women, however, symptoms may not emerge until the late 20s or early 30s.
At first, there are early warning signs. But the following symptoms mimic symptoms of many other mental health conditions. They can include:
changes in sleeping patterns
Schizophrenia Can Look Like Many Other Mental Illnesses
Because so many symptoms of schizophrenia overlap with other mental health symptoms, recognizing the condition can be challenging. Negative symptoms like depression or sleep changes can also happen just when someone is experiencing a significant life transition.
Substance abuse also adds a significant challenge when it comes to diagnosing schizophrenia. For example, certain drugs like stimulants, hallucinogens, or marijuana can trigger psychotic symptoms.
Furthermore, many people with schizophrenia don't believe they have it. Therefore, they don't seek proper treatment. They don't necessarily realize their disorganized thinking differs from other people.
In addition, there aren't objective measurements like blood tests or imaging exams to diagnose schizophrenia. Instead, a mental health professional needs to closely evaluate symptoms over a span of time- while also ruling out other potential diagnoses (bipolar disorder, delusional disorder, schizoaffective disorder).
Self-Care Often Feels Challenging (and Isn't About Laziness)
Schizophrenia often coincides with poor personal hygiene. This can include anything from failing to shower regularly to brushing teeth to using deodorant to wearing clean clothes.
When it comes to schizophrenia, problems with grooming typically happen for two reasons:
Apathy and Anhedonia
These symptoms often pair with severe mental illness. When you lack the motivation to do much of anything, getting out of bed may seem like an enormous challenge. Brushing your teeth or washing your clothes, therefore, may sound like an impossible task.
Positive Symptoms (Hallucinations or Delusions)
The presence of positive symptoms undoubtedly affects someone's mental health. It's hard to focus on showering when you're concerned an intruder is hiding in your apartment building. Washing your face seems futile if you're concerned that your house is crawling with bugs.
Schizophrenia Doesn't Always Mean Hearing Voices
Auditory hallucinations are one of the positive symptoms of schizophrenia. But not every person experiences this type of hallucination.
Here are some of the other hallucinations associated with schizophrenia:
Visual hallucinations refer to seeing things that aren't there. People with schizophrenia may see specific types of lights, objects, people, or shadows. These hallucinations can often be frightening, particularly if the individual has some insight that the images aren't real.
Olfactory hallucinations (sometimes known as phantom smells) refer to experiencing odors that aren't there. By nature, these smells tend to be incredibly unpleasant, and they may include rotten eggs, gasoline, feces, or rotten fish.
This common hallucination tends to coincide with fear or refusal to eat. Sometimes the food tastes rotten, and the person believes they're being poisoned. Other times, the taste has nothing to do with food- the person may taste sweetness on their tongue or experience a strong metallic-like taste.
Tactile hallucinations refer to feelings and sensations. People may believe something is moving on their skin or inside their bodies. Such hallucinations may include feeling like insects are crawling on the skin, organs are shifting within the body, or something is being stretched over their head.
Schizophrenia Affects How You Organize Your Thoughts
People with schizophrenia often struggle with recognizing and organizing their thoughts. This can emerge as disorganized thinking and disorganized speech.
So, even if you're talking coherently to them, they might not be able to process the information. And when they respond, their words may seem jumbled or illogical. This isn't by choice- it's part of their brain chemistry, as schizophrenia affects parts of the brain structure associated with memory and processing.
Negative Symptoms Can Be Just as Challenging as Positive Symptoms
People often focus on the positive symptoms of schizophrenia. They consider unusual movements or severe episodes of hallucinations. But negative symptoms can create just as much emotional distress. They typically include:
lacking interest in life and activities
being unable to concentrate or focus
feeling uncomfortable or anxious around others
being unable to start things or finish what they start
As mentioned, these negative symptoms typically appear before the positive ones do. Many times, the symptoms emerge gradually, slowly affecting someone's mental health long before issues like other symptoms arise.
Delusions May Change Over Time
People often think of the classic persecutory delusion when they think of schizophrenia. Persecutory delusions are the manifestation of paranoia, where the person behaves in a way that's convinced some person, group, or organization will harm them.
But it's important to understand the other types of delusions that may occur:
Somatic delusions occur when someone believes something is fundamentally wrong with their body. This can look like a panicked health anxiety. Your loved one may believe they've been infested with parasites, or they might think their organs have been harvested (even if physical scars aren't present).
Grandiose delusions refer to false beliefs about having special powers. People with these delusions believe they're more powerful, important, or talented than they really are. These can be religious in nature (thinking God speaks directly to them), or they can be more general.
Erotomanic delusions are false beliefs that another person- often a celebrity- is in love with them. They may assume this other person speaks to them indirectly through secret messages. Over time, this delusion can lead to behaviors like stalking, harassment, infidelity, and violence.
It Can Be Hard to Trust Healthcare Professionals
Families often feel frustrated that their loved one won't get the help they need.
But take a moment to imagine this: everything in your brain is telling you that people are out to harm you. You feel scared and suspicious moving out and about during the day. You're worried something terrible is going to happen to you or your loved ones. This is your reality- it's as real as the sky being blue or the street having cars on it.
And then, you come across a doctor. You're suspicious of his intentions. He doesn't really seem to get to know you. Instead, he starts talking about medication and treatment and leaves you with several bottles of pills. He instructs you to take them, telling you that they'll make you feel better, that they'll ease your symptoms.
Trusting this doctor seems like a trap. What if he's trying to poison you? What if this is a sinister, calculated move designed to force you into submission? What if he actually isn't a healthcare professional at all? What if he's a government agent in disguise trying to hold you captive?
This is what it's sometimes like to step into someone with schizophrenia's shoes. All reality can be subjective, and serious mental illness inherently distorts reality.
Schizophrenia Does Not Mean Having Multiple Personalities
Someone with schizophrenia does not have the split personality traits associated with dissociative identity disorder (DID).
Schizophrenia isn't a distortion of personalities. Instead, people with schizophrenia experience routine losses of touch with reality. Someone with DID, on the other hand, has two or more distinct personality states. They embody completely different identities when in these states.
Schizophrenia Doesn't Always Dictate Every Moment of a Person's Life
Many people describe schizophrenia along these lines: You could be having a totally ordinary day just living your life...and then, the psychotic symptoms seemingly come out of nowhere. You start hearing voices again. Part of you wants to challenge them, but another part of you is so scared. You can't just "get over" this. So, you're trapped. It's a nonstop horror show in your mind. It's hard to trust what's real versus what's a symptom.
As mentioned, schizophrenia can develop slowly. But, in addition, symptoms often fluctuate. People don't necessarily hear voices all day long. Sometimes the hallucinations and delusions disappear for long periods of time before they emerge again.
So, Does Schizophrenia Require Lifelong Treatment?
The inconsistency of schizophrenia symptoms makes psychosocial treatments challenging. It's not uncommon for people to stop treatment once they start feeling better. Moreover, medication comes with many side effects, and some can be extremely distressing.
People With Schizophrenia Often Hide or Downplay Their Symptoms
Because schizophrenia is so highly stigmatized- and people fear hospitalization- struggling individuals may hide their symptoms from loved ones. They might also take to great lengths to conceal their feelings from mental health professionals.
Why? They don't want to be doubted, accused of acting out, or hospitalized involuntarily.
Furthermore, many people with schizophrenia come with long rap sheets of improper diagnoses. Because their symptoms may have been inconsistent, it can be hard to establish an appropriate diagnosis.
It Can Feel Like Living In Half-Reality
Imagine this: There are two worlds.
The one is the one everyone lives in. It's the 'real world.' But there's a whole other world where the hallucinations are real, and the delusions shape how you think. That world is just as real as the other one, and sometimes the two worlds intertwine.
How do you distinguish a true and authentic reality? Mental illnesses like schizophrenia and other thought disorders make it hard- and it's nobody's fault.
Schizophrenia Doesn't Necessarily Coincide with Danger or Violence
A small percentage of people with schizophrenia do behave violently. But that's the case for any mental illness- or any person in society. The vast majority (90%+) don't act this way.
For this reason, it's important to avoid making faulty assumptions or believing toxic myths about any mental health condition. Stigmas often prevent people from seeking the support they need.
Treatment Can Be Highly Effective
There isn't a cure for schizophrenia. It's a complex, pervasive condition that can ebb and flow over the lifespan. Most people won't ever be entirely symptom-free. However, the right treatment can reduce or eliminate severe psychotic episodes. In addition, having support can help people understand their triggers and live productively.
It can take time to diagnose schizophrenia, and other variables like substance abuse, health problems, or co-occurring mental illness can make this process even more challenging.
A comprehensive evaluation is imperative. This evaluation will include a detailed history of someone's physical and mental health. It will review all cognitive symptoms- both positive and negative. This evaluation helps therapists create an appropriate treatment plan.
Medication is the cornerstone of schizophrenia treatment. Antipsychotics reduce the positive symptoms by blocking dopamine responses. This helps reduce aggression and anxiety symptoms. There are two types of antipsychotic medications: typical and atypical antipsychotics.
Research shows that cognitive therapies can help people with schizophrenia.
Cognitive-behavioral therapy (CBT): CBT is the main treatment approach. This therapy focuses on challenging negative thoughts and improving behavioral responses. Studies indicate that 6-12 months of treatment can significantly decrease the presence of positive symptoms of schizophrenia.
Cognitive remediation therapy: This therapy focuses on social cognition and interaction training, both of which can improve overall functioning.
Family therapy: Family therapy focuses on skills rooted in family intervention, boundaries, and healthy communication. Research shows this can be effective in increasing the overall sense of support.
Support Group: Support groups can help people feel validated and connected to like-minded peers. These groups often blend psychoeducation with other important coping skills.
Learning how to manage stress is paramount for people with schizophrenia. Like with any mental illness, stress tends to exacerbate symptoms. For this reason, lifelong treatment typically entails a strong focus on holistic well-being, which may include focusing on nutrition, physical activity, sleep hygiene, and personal self-care.
There Isn't One Exact Cause of Schizophrenia
Despite some misconceptions, nobody really knows what causes schizophrenia symptoms. Instead, experts have examined a variety of potential risk factors that may increase the likelihood of someone's diagnosis:
Genetics: Family history may play a role in schizophrenia. The likelihood of developing schizophrenia is 6x higher when a first-degree family member also has schizophrenia.
Environmental factors: Some research suggests that prenatal exposure to viruses or malnutrition during the mother's pregnancy may increase the risk of developing schizophrenia.
Brain chemistry: People with schizophrenia may have brain structural changes with specific changes in the neurotransmitters, including dopamine and glutamate.
Substance abuse: There is growing research that suggests that taking drugs during adolescence may predispose someone to schizophrenia.
Nothing Can Specifically Prevent Schizophrenia
Just like we don't know the exact cause of this condition, there isn't any evidence showing that anyone (or anything) can stop schizophrenia from developing.
If you're a loved one struggling with guilt or self-doubt, take this to heart: you didn't cause this. It's not your fault. And even though things may feel scary, you can play an influential role by being a source of support and guidance.
Suicide is a Real Concern (And Certain Factors Increase the Risk)
The lifetime suicide rate for people with schizophrenia is around 10%, and suicide is the most significant variable associated with decreased life expectancy in this population.
Research shows people are at a greater risk for suicidal thoughts if they are:
intelligent and well-educated
aware that their life is not up to their desired standards
able to access firearms or other lethal means
In other words, the more someone is aware of their condition, the higher the risk. This highlights a common misconception people have about schizophrenia.
It's often believed that those with the lowest insight or lowest level of functioning are the most at risk. Instead, the opposite is true. Having insight coupled with feeling hopeless about things improving may cause people to feel more vulnerable.
Loved ones may find this information discouraging. But it's important to remember that compliance with a treatment plan is statistically a protective risk factor against suicide.
Treating Schizophrenia Symptoms: How We Help
Schizophrenia requires a combination of diligent attention, unwavering compassion, and an appropriate treatment plan. It's best when all family members are on board.
We know that the right treatment can reduce symptoms and dramatically improve the quality of daily life. We also know that your loved one may present as scared, resistant, or angry at the idea of getting help.
Our team of professionals prioritizes evidence-based care, and family intervention is often the first step to recovery. Contact us today to get started.