Do you know someone who seems like he or she has "lost touch" with reality? Does this person talk about "hearing voices" no one else can? Does he or she see or feel things no one else can? Does this person believe things that aren't true?
Sometimes people with these symptoms have schizophrenia, a serious illness. Read this brochure to find out more.
What is schizophrenia?
Schizophrenia is a serious brain illness. Many people with schizophrenia are disabled by their symptoms.
People with schizophrenia may hear voices other people don't hear. They may think other people are trying to hurt them. Sometimes they don't make any sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves.
Who gets schizophrenia?
Anyone can develop schizophrenia. It affects men and women equally in all ethnic groups. Teens can also develop schizophrenia. In rare cases, children have the illness too.
When does it start?
Symptoms of schizophrenia usually start between ages 16 and 30. Men often develop symptoms at a younger age than women. People usually do not get schizophrenia after age 45.
What causes schizophrenia?
Several factors may contribute to schizophrenia, including:
- Genes, because the illness runs in families
- The environment, such as viruses and nutrition problems before birth
- Different brain structure and brain chemistry.
Scientists have learned a lot about schizophrenia. They are identifying genes and parts of the brain that may play a role in the illness. Some experts think the illness begins before birth but doesn't show up until years later. With more study, researchers may be able to predict who will develop schizophrenia.
What are the symptoms of schizophrenia?
Schizophrenia symptoms range from mild to severe. There are three main types of symptoms.
1. Positive symptoms refer to a distortion of a person's normal thinking and functioning. They are "psychotic" behaviors. People with these symptoms are sometimes unable to tell what's real from what is imagined. Positive symptoms include:
- Hallucinations: when a person sees, hears, smells, or feels things that no one else can. "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 believe that they are in danger-that other people are trying to hurt them.
- Thought disorders: ways of thinking that are not usual or helpful. People with thought disorders may have trouble organizing their thoughts. Sometimes a person will stop talking in the middle of a thought. And some people make up words that have no meaning.
- Movement disorders: may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may stop moving or talking for a while, a rare condition called "catatonia."
2. Negative symptoms refer to difficulty showing emotions or functioning normally. When a person with schizophrenia has negative symptoms, it may look like depression. People with negative symptoms may:
- Talk in a dull voice
- Show no facial expression, like a smile or frown
- Have trouble having fun
- Have trouble planning and sticking with an activity, like grocery shopping
- Talk very little to other people, even when they need to.
3. Cognitive symptoms are not easy to see, but they can make it hard for people to have a job or take care of themselves. Cognitive symptoms include:
- Trouble using information to make decisions
- Problems using information immediately after learning it
- Trouble paying attention.
Teens can get schizophrenia, but it may be hard to see at first. This is because the symptoms may look like problems many teenagers have. A teen developing schizophrenia may:
- Start getting bad grades in school
- Change friends
- Have trouble sleeping
- Be irritable or moody.
How is schizophrenia treated?
There is no cure for schizophrenia. But two main types of treatment can help control symptoms: medication and psychosocial treatments.
1. Medication. Several types of antipsychotic medications can help, so the type of medication depends on the patient. Sometimes a person needs to try different medications to see which work best for him or her.
Medications can cause side effects. Most of the time side effects go away after a few days. Others take more time. Patients should always tell their doctor about these problems. Side effects include:
- Blurry vision
- Body movements a person can't control, like shaking
- Fast heartbeat
- Feeling restless
- Menstrual problems
- Sensitivity to the sun
- Skin rashes
- Stiffness in the body.
Some types of antipsychotics can cause a lot of weight gain and other health concerns, which can lead to diabetes, high cholesterol, or other conditions. Still other types can cause a movement disorder where a person cannot control muscle movements, especially around the mouth.
It is important to report any of these serious side effects to the doctor. Patients should not stop taking a medication without a doctor's help. Stopping medication suddenly can be dangerous, and it can make the symptoms of schizophrenia worse.
2. Psychosocial treatments. These treatments help patients deal with their illness from day to day. The treatments are helpful after patients find a medication that works. Treatments include:
- Drug and alcohol treatment: this is often combined with other treatments for schizophrenia
- Family education: ways to help the whole family learn how to cope with the illness and help their loved one
- Illness management skills: ways for the patient to learn about the illness and manage it from day to day
- Rehabilitation: help with getting a job and everyday living skills
- Self-help groups: support from other people with the illness and their families
- Therapy: talking with a therapist about living with the illness and learning how to manage symptoms, like hearing voices or having delusions.
Are people with schizophrenia violent?
Most people with schizophrenia are not violent. However, a few people have this problem. Violence usually happens at home with family members.
Suicide is a problem for some people with schizophrenia. They are more likely than other people to attempt suicide. If you know someone who talks about suicide, help him or her find help quickly.
What about drugs and alcohol?
Taking illegal drugs and drinking too much alcohol are problems for some people with schizophrenia. When a person is using drugs, they are less likely to follow a treatment plan.
Most experts believe drugs and alcohol do not cause schizophrenia, but they may make antipsychotic medications less helpful. Also, drugs like marijuana make symptoms worse.
It is very common for people with schizophrenia to smoke cigarettes. However, smoking may make the medications less useful. It is hard for people to quit smoking because it might make their schizophrenia symptoms worse for a while. Doctors need to help any patient with schizophrenia who wants to quit smoking.
How can I help someone I know with schizophrenia?
Families are usually the caregivers for people with schizophrenia. Family members can help their loved one get treatment. They can also learn how to help their loved one do his or her best in everyday life.
Caring for and supporting a family member with schizophrenia can be hard. People with the disorder may not want treatment. They may stop taking their medication. If this happens, you may need help from the police or a hospital. Doctors at the emergency room can check your loved one and decide whether he or she needs professional help.
It's important to respect a person with schizophrenia. But you do not have to allow dangerous behavior. Stay in touch with your loved one's doctors. Talk to them about how to help your family member through good and bad times.
Check to see if there are any support groups in your area. Talking to others who care for people with schizophrenia may help your whole family.
Contact us to find out more about schizophrenia.
National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 6200, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Web site: www.nimh.nih.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. TR-09-3517