What is Schizophrenia

Schizophrenia is a mental illness. It may cause disturbed or disorganized thinking, speech, or behavior. People with schizophrenia have problems functioning in one or more areas of life.

People with schizophrenia are at increased risk for suicide, certain long-term (chronic) physical illnesses, and unhealthy behaviors, such as smoking and drug use.

People who have family members with schizophrenia are at higher risk of developing the illness. Schizophrenia affects men and women equally, but it usually appears at an earlier age (teenage or early adult years) in men.

What are the causes?

The cause of this condition is not known.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Having a family member who has schizophrenia. Some gene combinations may increase the risk, but there is no single gene that causes schizophrenia.
• Impaired brain or neurotransmitter development or chemistry. Neurotransmitters are chemicals in the brain.

What are the signs or symptoms?

The earliest symptoms are often subtle and may go unnoticed until the illness becomes more severe (first-break psychosis). Symptoms of schizophrenia may be ongoing (continuous) or may come and go in severity. Episodes are often triggered by major life events, such as:

• Family stress.
• College.
• Military service.
• Marriage.
• Pregnancy or childbirth.
• Divorce.
• Loss of a loved one.

Symptoms may include:

• Seeing, hearing, or feeling things that do not exist (hallucinations).
• Having false beliefs (delusions). Delusions often involve beliefs that you are being attacked, harassed, cheated, persecuted, or conspired against (persecutory delusions).
• Speech that does not make sense to others or is hard to understand (incoherent).
• Behavior that is odd, confused, unfocused, withdrawn, or disorganized.
• Extremely overactive or underactive motor activity (catatonia). Motor activity is any action that involves the muscles.
• Bland or blunted emotions (flat affect).
• Loss of will power (avolition).
• Withdrawal from social contacts (social isolation).

Symptoms may affect the level of functioning in one or more major areas of life, such as work, school, relationships, or self-care.

How is this diagnosed?

Schizophrenia is diagnosed through an assessment by a mental health care provider.

• Your mental health care provider may ask questions about:
  • Your thoughts, behavior, and mood.
  • Your ability to function in daily life.
  • Your medical history.
  • Any use of alcohol or drugs, including prescription medicines.
• You may have blood tests and imaging exams.

How is this treated?

Schizophrenia is a chronic illness that is best controlled with continuous treatment rather than treatment only when symptoms occur. The following treatments are used to manage schizophrenia:

• Medicine. This is the most effective and important form of treatment for schizophrenia. Antipsychotic medicines are usually prescribed to help manage schizophrenia. Other types of medicine may be added to relieve any symptoms that may occur despite the use of antipsychotic medicines.
• Counseling or talk therapy. Individual, group, or family counseling may be helpful in providing education, support, and guidance. Many people also benefit from social skills and job skills (vocational) training.

A combination of medicine and counseling is best for managing the disorder over time. A procedure in which electricity is applied to the brain through the scalp (electroconvulsive therapy) may be used to treat catatonic schizophrenia or schizophrenia in people who cannot take medicine or do not respond to medicine and counseling.

Follow these instructions at home:

• Keep stress under control. Stress may trigger psychosis and make symptoms worse.
• Try to get as much sleep as you can.
• Avoid alcohol and drugs. They can affect how medicine works and make symptoms worse.
• Surround yourself with people who care about you and can help you manage your condition.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider and counselor. This is important.

Contact a health care provider if:

• You have a bad response to changes in medicines or to your treatment plan.
• You have trouble falling sleep.
• You have a low mood that will not go away.
• You are using:
  • Drugs.
  • Too much caffeine.
  • Tobacco products.
  • Alcohol.

Get help right away if:

• You feel out of control.
• You or others notice warning signs of suicide such as:
  • Increased use of drugs or alcohol
  • Expressing feelings of not having a purpose in life, being trapped, guilty, anxious and agitated, or hopeless.
  • Withdrawing from friends and family.
  • Showing uncontrolled anger, recklessness, and dramatic mood changes.
  • Talking about suicide, discussing or searching for methods.

You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Schizophrenia is a mental illness that causes disturbed or disorganized thinking, speech, or behavior.
• Symptoms of schizophrenia may be ongoing or may come and go. They are often triggered by major life events.
• Keep stress under control. Stress may trigger psychosis and make symptoms worse.
• Avoid alcohol and drugs. They can affect how medicine works and make symptoms worse.
• Get help right away if you feel out of control.