What is Schizophrenia? 

Schizophrenia is a severe mental illness that disrupts brain functioning and results in an altered experience of reality. Schizophrenia causes psychosis, often coupled with long periods of reduced expression, motivation and functioning. It affects men and women equally, and interrupts their ability to manage emotions, concentrate, make decisions and relate to others.

Causes

The causes of schizophrenia are only partly understood at the moment. Some identified contributing factors include:

  • Family history
  • Environmental factors such as prenatal infection, foetal hypoxia, and the use of cannabis in genetically predisposed individuals
  • Maternal depression during pregnancy, where one of the parents had psychosis

Signs and Symptoms

Generally, schizophrenia develops slowly, with gradual decline in functioning. Common warning signs of schizophrenia include depression, social withdrawal, hostility/suspiciousness, deterioration of personal hygiene, an expressionless gaze, inability to cry or express joy, oversleeping/insomnia, forgetfulness, difficulty concentrating as well as odd/irrational statements.

Symptoms of schizophrenia vary dramatically from person to person and may change in type and severity over time. Individuals may have different combinations of symptoms. Symptoms can be divided into three main categories; positive, negative and disorganised symptoms.

Positive symptoms add to an individual’s experience of life:

  • Hallucinations, most commonly auditory hallucinations
  • Delusions, including:
    - Delusion of persecution: the belief that other people are out to get the individual.
    - Delusion of reference: the belief that an innocuous environmental event is directed at the individual, for example that a billboard has a message that is specifically directed at the individual.
    - Delusion of grandeur: the individual believes they are a famous or important figure, or have unusual god-like powers.
    - Delusions of control: the belief that the individual's thoughts or actions are being controlled by external forces.


Negative symptoms are abilities that an individual loses: 

  • Lack of pleasure in previously enjoyed activities, socialising or relationships
  • Lack of, or inappropriate, emotional expression
  • Self neglect, such as decrease in personal hygiene
  • Lack of interest or enthusiasm in daily life


Disorganised symptoms affect an individual’s ability to think and respond clearly: 

  • Rapidly shifting from topic to topic with no connection between one thought and the next.
  • Made up words that only have meaning to the individual
  • Repetition of words and statements
  • Behaviours that appear bizarre and have no purpose
  • Lack of inhibition and impulse control

Treatment and Support  

Schizophrenia often requires long-term treatment, even once symptoms are gone,  in order to avoid regression. Successful treatment takes a holistic approach, and includes:

  • Psychological treatment: A common form of therapy used in individuals with schizophrenia is cognitive behavioural therapy (CBT), which aims to support better coping skills and helpful ways of thinking.
  • Medication: Antipsychotic medication can help to reduce symptoms while an individual is undergoing psychological treatment. 
  • Support networks: Friends and family can help by providing emotional support and a stable environment. As individuals experiencing schizophrenia have a higher risk of suicide, it is important for those around them to be well aware of signs of suicidal ideation.
  • Lifestyle changes: Regular exercise may help reduce symptoms. Avoiding alcohol, drugs and nicotine can also help as substance use may complicate treatment and worsen symptoms.