What is schizophrenia?
Schizophrenia is a serious and lifelong neurodevelopmental disorder that affects how a person thinks, feels, and behaves.
People with schizophrenia may experience delusions, hallucinations, disorganized speech or behavior, and impaired cognitive ability. They may hear voices or see things that aren’t there. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. These behaviors can be scary and upsetting to people with the illness and make them withdrawn or extremely agitated. It can also be scary and upsetting to the people around them.
People with schizophrenia may sometimes talk about strange or unusual ideas, which can make it difficult to carry on a conversation. They may sit for hours without moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are thinking.
Schizophrenia is not dissociative identity disorder (formerly called multiple personality disorder or split personality). While some of the signs may seem similar on the surface, people with dissociative identity disorder have two or more distinct identities that are present and alternately take control of them.
People with schizophrenia may cope with symptoms throughout their lives, but treatment helps many to recover sufficiently and pursue their life goals. Researchers are using new research tools to understand the causes of schizophrenia and develop more effective treatments.
What are the signs of schizophrenia?
It’s important to know the signs and symptoms of schizophrenia and seek help early. The signs usually appear between ages 16 and 30. In rare cases, children can have schizophrenia too. Schizophrenia symptoms fall into three categories: positive, negative, and cognitive.
“Positive” symptoms are referred to as positive because the symptoms are additional behaviors not generally seen in healthy people. For some people, these symptoms come and go. For others, the symptoms become stable over time. These symptoms can be severe— but at other times—unnoticeable. Positive symptoms include:
Hallucinations: When a person sees, hears, smells, tastes, or feels things that are not real. Hearing voices is common for people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice a problem.
Delusions: When a person believes things that are not true. For example, a person may believe that people on the radio and television are talking directly to him or her. Sometimes people who have delusions may believe that they are in danger or that others are trying to hurt them.
Thought disorders: When a person has ways of thinking that are odd or illogical. People with thought disorders may have trouble organizing their thoughts. Sometimes a person will stop talking in the middle of a thought or make up words that have no meaning.
Movement disorders: When a person exhibits abnormal body movements. A person may repeat certain motions over and over—this is called stereotypies. At the other extreme, a person may stop moving or talking for a while, which is a rare condition called catatonia.
“Negative” symptoms refer to social withdrawal, difficulty showing emotions, or difficulty functioning normally. People with negative symptoms may need help with everyday tasks. Negative symptoms include:
Talking in a dull voice
Showing no facial expression, such as a smile or frown
Having trouble experiencing happiness
Having trouble planning and sticking with an activity, such as grocery shopping
Talking very little to other people, even when it is important
These symptoms are harder to recognize as part of schizophrenia and can be mistaken for depression or other conditions.
Cognitive symptoms are not easy to see, but they can make it hard for people to have a job or take care of themselves. The level of cognitive function is one of the best predictors of a person’s ability to improve how they function overall. Often, these symptoms are detected only when specific tests are performed. Cognitive symptoms include:
Risk of violence
Most people with schizophrenia are not violent. If a person has symptoms of schizophrenia, it is important to help him or her get treatment as quickly as possible. The risk of violence is greatest when schizophrenia is untreated since the illness may get worse over time. People with schizophrenia are much more likely than those without the illness, to be harmed by others as well as harm themselves.
Drugs and alcohol
It is common for people with schizophrenia to have problems with illicit drugs and alcohol. A treatment program that includes treatment for both illnesses is critical for recovery because misuse of drugs and alcohol can interfere with treatment for schizophrenia.
Drug abuse can increase the risk of suicide, trauma, and homelessness in people with schizophrenia as well as increase the risk of developing other mental illnesses. To learn more about substance use and mental health, visit www.nimh.nih.gov (search: substance use).
What causes schizophrenia?
Many factors may cause schizophrenia, including:
Genetics. Schizophrenia sometimes runs in families. However, it is important to know that just because someone in a family has schizophrenia, it does not mean that other members of the family will have it as well.
Environment. Many environmental factors may be involved, such as living in poverty, stressful surroundings, and exposure to viruses or nutritional problems before birth.
Disruptions in brain structures, brain function, and brain chemistry. These disruptions could be the result of genetic or environmental factors and, in turn, may cause schizophrenia.
Researchers have learned a lot about schizophrenia, but more research is needed to help explain its causes.
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