What Is Schizophrenia?
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves.
It is often misunderstood and surrounded by stigma, but it’s a medical illness involving complex brain changes. People with schizophrenia may:
- Appear disconnected from reality
- Experience hallucinations or delusions
- Struggle with social or occupational functioning
Worldwide, schizophrenia affects about 1% of the population and usually appears in late adolescence or early adulthood.
Common Symptoms of Schizophrenia
Symptoms are divided into three categories: positive, negative, and cognitive.
Positive Symptoms
“Positive” refers to added experiences that aren’t present in healthy individuals. These include:
- Hallucinations: Hearing, seeing, or feeling things that aren’t real (most commonly hearing voices)
- Delusions: Strong beliefs that are false (e.g., believing one is being followed or controlled)
- Disorganized thinking: Difficulty organizing thoughts, making conversation hard to follow
- Abnormal movements: Repetitive movements, agitation, or catatonia (lack of movement)
Negative Symptoms
Negative symptoms involve loss or reduction of normal functions, including:
- Reduced emotional expression (flat affect)
- Social withdrawal
- Lack of motivation (avolition)
- Diminished ability to speak (alogia)
- Decreased pleasure in everyday life (anhedonia)
These symptoms often contribute most to functional disability.
Cognitive Symptoms
Cognitive deficits can be subtle but impactful, including:
- Trouble focusing
- Poor memory
- Difficulty understanding information and using it for decisions
Cognitive symptoms often affect daily living, work, and social interactions.
Causes and Risk Factors
The exact cause of schizophrenia remains unknown, but research points to multiple contributing factors:
Genetic Factors
- Strong genetic component
- Risk is higher with a close relative diagnosed with schizophrenia
Brain Chemistry and Structure
- Imbalances in neurotransmitters like dopamine and glutamate
- Differences in brain structure (e.g., enlarged ventricles, reduced gray matter)
Environmental Factors
- Prenatal exposure to viruses or malnutrition
- Birth complications
- Childhood adversity or trauma
- Cannabis use during adolescence in genetically predisposed individuals
How Schizophrenia Is Diagnosed
Diagnosis is based on:
- Clinical interviews
- Observation of behavior
- Family and personal medical history
According to the DSM-5-TR (2022), criteria include:
- At least two or more core symptoms (delusions, hallucinations, disorganized speech, grossly disorganized behavior, or negative symptoms)
- Symptoms persist for at least six months
- Significant impact on daily functioning
- Exclusion of other medical, substance-related, or mood disorders
Early diagnosis and intervention improve outcomes significantly.
Treatment for Schizophrenia
Schizophrenia is treatable, but not curable. Most individuals require lifelong treatment.
Medications
- Antipsychotics: First-line treatment to manage symptoms
- Second-generation (atypical) antipsychotics (e.g., risperidone, olanzapine)
- First-generation antipsychotics (e.g., haloperidol)
Psychosocial Therapies
- Cognitive Behavioral Therapy (CBT): Helps manage delusions and hallucinations
- Social skills training: Improves interactions and daily functioning
- Supported employment programs: Assist with work readiness
Hospitalization
Necessary during severe episodes for safety and stabilization.
Family Support and Education
Family involvement improves medication adherence and reduces relapse rates.
Living with Schizophrenia
With proper treatment and support, many people with schizophrenia live fulfilling lives. Key strategies include:
- Adhering to medication
- Learning to recognize early warning signs
- Building a structured daily routine
- Connecting with support groups
- Maintaining physical health through exercise and healthy eating
While challenges remain, recovery and meaningful life participation are achievable goals.
