What is schizophrenia?

Schizophrenia is a mental illness that affects brain function. Specifically, it affects thoughts, behaviour, language, and perception. A person with schizophrenia has an altered perception of reality, meaning they may have trouble distinguishing between what is real and what is not.

Schizophrenia may cause intense delusions and hallucinations as well as long periods of reduced expression, motivation and general functioning.

Schizophrenia is present in all countries, cultures and genders. It affects more than 21 million people worldwide[1] and about 1 in every 100 people in Australia[2]. It usually develops in teenage years or early adulthood but it can also start later in life. In some rare cases, it can develop in childhood.

Schizophrenia is thought to affect men and women in equal measure, although it may have an earlier onset in males.

Symptoms of schizophrenia

There is no reliable way to predict exactly how schizophrenia will affect someone’s life. The symptoms, severity and effects of the illness can be different between individuals and the effectiveness of any treatment and support can significantly influence their wellbeing.

About 20 to 30 per cent of people with schizophrenia experience it in the form of a few, brief episodes.[3] For others, it’s an ongoing condition. Sometimes it’s a short, single event with an obvious cause, such as a traumatic experiences or substance abuse, and at other times it’s a longer lasting condition with no obvious trigger or cause.

Schizophrenia tends to initially develop as changes in someone’s thought patterns, emotional responses and behaviour. These symptoms may be inconsistent or erratic – they ‘come and go’, but if left untreated can get worse over time.

People with schizophrenia may experience two or more of the following symptoms:

• Thinking difficulties – Concentration, memory, and planning and organisational ability are affected, making it difficult to make decisions, reason, communicate or complete simple daily activities.
• Delusions – There is a fixation on beliefs that are implausible or not true, such as false beliefs of being persecuted or targeted, or being under external control.
• Hallucinations – Things are experienced that no one else can hear, see, taste, touch or smell. These most commonly involve hearing voices. These experiences are very real to the person affected, but are not actually present.
• Abnormal movement – Catatonia and reduced facial expressions are experienced.
• Lack of drive – difficulty engaging in common daily activities, such as basic domestic tasks. It should be noted that this is not laziness, but is an aspect of the mental illness.
• Blunted emotional expression – The capacity to express emotion is reduced, often accompanied by inappropriate reactions to events that may be considered happy or sad.
• Social withdrawal – The capacity to interpret other people’s emotions and motives may be affected, resulting in social withdrawal. This may be motivated by the fear that someone is going to harm them or shame them due to the loss of social skills.
• Lack of awareness – It is common for people with schizophrenia to be unaware that something is wrong. This can be a cause behind the common reluctance to accept treatment.

Early signs of schizophrenia

A person experiencing the onset of schizophrenia is likely to withdraw from others. They may also feel depressed, anxious, or develop unusual ideas or extreme fears. Addressing these early signs is important for early access to treatment.

Subtler signs may present earlier. They may include turbulent relationships, poor performance in studies or work and reduced motivation.

Some common early signs include[4]:

• Preoccupation or obsession with a particular subject.
• Speech or writing that is very fast, muddled, irrational or hard to understand.
• Loss of concentration, memory and/or attention.
• Increased sensitivity to light, noise and/or other sensory inputs.
• Increased anger, aggression or suspiciousness.
• Inactivity and/or hyperactivity, including behaviour that is reckless, strange or out of character.
• An inability to feel or express emotion.

Other complications

People with schizophrenia tend to have a shorter lifespan than the general population. One reason is that they are at greater risk of experiencing health problems such as heart disease, high blood pressure, diabetes or weight gain.[5] The fact that one in two people living with schizophrenia do not receive care for the condition[6] is also a likely contributing factor.

Functional decline

People with schizophrenia can find working, keeping up social contact and organising daily activities a challenge. The risk of unemployment or even being able to live independently increases with the severity of the illness.

Stigma and social isolation

Schizophrenia is a highly complex condition that has spawned numerous stereotypes and misconceptions. Consequently, people with schizophrenia are among the most highly stigmatised and socially marginalised people in our community.

More information: here are some of the more damaging myths about people living with schizophrenia, including the myths that they are violent or have multiple personalities.

Suicide risk

People with schizophrenia are 12 times more likely to die from suicide compared to the rest of the population[7]. Unsurprisingly, suicide is one of the main causes of death for people with schizophrenia, as severe depression often accompanies the illness.

Schizophrenia treatment

There is no cure for schizophrenia. However, it can be treated and managed.

A person with schizophrenia is better able to think and act like themselves again when they receive appropriate treatment. In fact, research indicates that the earlier that treatment take place, the better the outcome, including reduced overall impact of the illness.

Treatment can help people live productive and positive lives. However, similar to other illnesses, some people respond better to treatment than others.

A person concerned about schizophrenia can see their GP for an initial assessment. The GP may then refer them to a specialist (usually a psychiatrist) for an in-depth diagnosis and treatment plans. Psychiatrists make their diagnosis based on a person’s individual symptoms and behaviour, usually over a period of time to ensure that other causes are not to blame for what is being experienced.

Treatments may include medication, specialist therapies like cognitive behavioural therapy (CBT), mindfulness-based treatments, psycho-education and community support programs to help with navigating friendships, health, work, study and living arrangements.

Treatment for schizophrenia can last from two to five years, or sometimes longer. Some people need to continue treatment throughout their lives. Treatment may also change over time, to improve results or reduce side-effects.

After the symptoms of schizophrenia are controlled, various types of therapy can continue to help people manage the illness and improve their lives, including help with study or work. These therapies can also help people improve social skills, deal with stress and manage their symptoms.

Helping someone with schizophrenia

If you think you or someone you know might be experiencing schizophrenia, see your GP as soon as possible.

Informed support and understanding from loved ones is an important part of treatment. It helps to encourage the person with this illness to stay connected to social networks and continue hobbies and pursuits they enjoy.

Family and friends of people with schizophrenia can often feel confused and upset, as the illness can affect those connected to the person with the illness. Support and education may be recommended for the support networks of someone with schizophrenia, to help them cope with the effects of the illness and provide better support to their loved one.

More help

SuicideLine Victoria counsellors can help if you, or someone you know and care about is experiencing some of the symptoms of schizophrenia. SuicideLine Victoria is available 24/7. Call us on 1300 651 251.

If it is an emergency, call 000.

References

[1] https://www.who.int/mental_health/management/schizophrenia/en/

[2] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/schizophrenia

[3] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/schizophrenia

[4] https://www.sane.org/information-stories/facts-and-guides/schizophrenia

[5] https://www.sane.org/information-stories/facts-and-guides/schizophrenia

[6] https://www.who.int/mental_health/management/schizophrenia/en/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC498022/