Overview

Schizophrenia is a serious mental disorder characterized by abnormal interpretations of reality. It can lead to a combination of hallucinations, delusions, and disordered thinking and behavior that impairs daily functioning and can be disabling. People with schizophrenia require lifelong treatment, and early intervention may improve the long-term outlook.

Symptoms

Schizophrenia involves a range of problems with thinking, behavior, and emotions. Common symptoms include:

  • Delusions: False beliefs not based in reality.
  • Hallucinations: Seeing or hearing things that don’t exist.
  • Disorganized thinking (speech): Impaired communication with unrelated answers or word salad.
  • Extremely disorganized or abnormal motor behavior: Unpredictable agitation or resistance to instructions.
  • Negative symptoms: Reduced or lack of ability to function normally, such as neglecting personal hygiene or lack of emotion.

Symptoms can vary in type and severity over time, and some symptoms may always be present.

Symptoms in Teenagers

Schizophrenia symptoms in teenagers can be difficult to recognize, as they may overlap with typical developmental changes during adolescence. Some symptoms include withdrawal, drop in school performance, trouble sleeping, irritability, and lack of motivation. Compared to adults, teenagers with schizophrenia may be less likely to have delusions and more likely to have visual hallucinations.

When to See a Doctor

If you suspect someone may have symptoms of schizophrenia, talk to them about your concerns. Although you can’t force someone to seek help, offering encouragement and support may help them find a qualified doctor or mental health professional. If the person poses a danger to themselves or others, or is unable to provide for their basic needs, consider calling emergency responders or contacting community mental health agencies for assistance.

Causes

The exact cause of schizophrenia is unknown, but it is believed to result from a combination of genetics, brain chemistry, and environmental factors. Problems with certain brain chemicals and differences in brain structure have been observed in people with schizophrenia, indicating that it is a brain disease.

Risk Factors

Factors that may increase the risk of developing or triggering schizophrenia include a family history of the disorder, pregnancy and birth complications, and the use of mind-altering drugs during adolescence and young adulthood.

Complications

Left untreated, schizophrenia can lead to severe problems affecting various aspects of life, including suicide, anxiety disorders, depression, substance abuse, inability to work or attend school, financial problems, social isolation, health issues, victimization, and aggressive behavior.

Prevention

There is no sure way to prevent schizophrenia, but sticking to the treatment plan can help prevent relapses or worsening of symptoms. Researchers are exploring risk factors for earlier diagnosis and treatment.

From Project Semicolon to your inbox

Sign up for free and stay up to date on advancements, health tips, current health topics, and expertise on managing health.

Diagnosis

Diagnosing schizophrenia involves ruling out other mental health disorders and determining that symptoms are not due to substance abuse, medication, or a medical condition. The process may include:

  • Physical exam: To rule out other potential causes of symptoms and check for related complications.
  • Tests and screenings: To rule out conditions with similar symptoms and screen for alcohol and drug use. Imaging studies like MRI or CT scans may be requested.
  • Psychiatric evaluation: A thorough assessment of mental status, including thoughts, moods, delusions, hallucinations, substance use, and personal and family history.
  • Diagnostic criteria: The doctor may use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to confirm the diagnosis.

Treatment

Schizophrenia requires lifelong treatment, even during periods of symptom remission. Treatment involves a combination of medications and psychosocial therapy. Hospitalization may be necessary in some cases. A psychiatrist usually leads the treatment team, which may include psychologists, social workers, psychiatric nurses, and case managers.

Medications

Antipsychotic medications are the cornerstone of schizophrenia treatment, targeting brain neurotransmitters like dopamine. Second-generation antipsychotics are generally preferred due to lower risk of serious side effects. Some common antipsychotic medications include:

  • Aripiprazole (Abilify)
  • Asenapine (Saphris)
  • Brexpiprazole (Rexulti)
  • Cariprazine (Vraylar)
  • Clozapine (Clozaril, Versacloz)
  • Iloperidone (Fanapt)
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)

First-generation antipsychotics are also available, but they may have more neurological side effects.

Long-acting injectable antipsychotics are another option for some individuals.

Psychosocial Interventions

Once psychosis recedes, psychological and social interventions are important for managing schizophrenia. These may include:

  • Individual therapy
  • Social skills training
  • Family therapy
  • Vocational rehabilitation and supported employment

Most individuals with schizophrenia require some form of daily living support.

Hospitalization

In severe cases or during crisis periods, hospitalization may be necessary to ensure safety, proper nutrition, and hygiene.

Electroconvulsive Therapy

For individuals who do not respond to drug therapy, electroconvulsive therapy (ECT) may be considered, especially if there’s also depression.

Coping and Support

Coping with schizophrenia can be challenging for both the affected individual and their friends and family. Learning about the disorder, staying focused on treatment goals, avoiding alcohol and drug use, seeking social services assistance, and practicing relaxation and stress management techniques can all be helpful. Joining support groups can provide additional support and understanding.

Preparing for Your Appointment

If seeking help for someone with schizophrenia, start by seeing a family doctor or healthcare professional. In some cases, you may be referred immediately to a psychiatrist. To prepare for the appointment, make a list of symptoms, personal information, medications, and questions to ask the doctor.

Find Treatment

Your impact doubles

This month, your gift has the power to change lives. By supporting Project Semicolon, you're making sure no one ever has to struggle alone. Your gift by July 1st will be matched and have twice the impact on mental health, and suicide prevention.