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What is schizophrenia?

Schizophrenia is a serious mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. They 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.

Schizophrenia symptoms can make it hard for a person to interact with other people, go to school, keep a job, or take care of day-to-day tasks. The symptoms can be very disabling, but with effective treatment many people with schizophrenia experience recovery.

When does schizophrenia start and who gets it?

Schizophrenia occurs in slightly more men than women and affects all ethnic groups. Symptoms usually start between the ages of 16 and 30. In rare cases, children have schizophrenia too.

What are the symptoms of schizophrenia?

Schizophrenia symptoms fall into three categories: positive, negative, and cognitive.

  1. “Positive” symptoms are psychotic experiences that are not generally seen in healthy people. People with these symptoms are sometimes unable to tell what’s real from what is imagined. These symptoms can be severe, and at other times, hardly noticeable. 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 believe that they are in danger and 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 has may appear as agitated body movements. A person may repeat certain motions over and over. In the other extreme, a person may stop moving or talking for a while, which is a rare condition called catatonia.
  2. “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
  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. Often, these symptoms are detected only when specific tests are performed. Cognitive symptoms include:
    1. Difficulty using information to make decisions
    2. Problems using information immediately after learning it
    3. Trouble paying attention

    What causes schizophrenia?

    Many factors may cause schizophrenia, including:

    • Genes, because schizophrenia sometimes runs in families. However, it is important to know that just because someone in a family has schizophrenia, it does not mean other members of the family will have it as well.
    • The environment, such as exposure to viruses or nutrition problems before birth
    • Brain structures and brain chemistry

    Scientists have learned a lot about schizophrenia, but more research is needed to help explain its causes.

    How is schizophrenia treated?

    Two main types of treatment can help with symptoms: antipsychotic medications and psychosocial treatments.

    1.  Antipsychotic medications help patients with the psychotic symptoms of schizophrenia. Some people have side effects when they start taking medications, but most side effects go away after a few days. Side effects include:
      • Blurry vision
      • Body movements a person can’t control, such as shaking
      • Dizziness
      • Drowsiness
      • Fast heartbeat
      • Feeling restless
      • Menstrual problems
      • Sensitivity to the sun
      • Skin rashes
      • Stiffness in the body

    Some types of antipsychotic medications can cause a lot of weight gain and other health concerns, which can lead to diabetes, high cholesterol, or other conditions. Other types of antipsychotic medications can cause side effects related to physical movement where a person cannot control muscle movements, especially around the mouth.

    People respond to antipsychotic medications differently, so it is important to report any of these side effects to a doctor. Sometimes a person needs to try several medications before finding the right one. People should not stop taking a medication without first talking to a doctor. Stopping medication suddenly can be dangerous, and it can make schizophrenia symptoms worse.

    1. Psychosocial treatments help patients deal with everyday challenges of schizophrenia. These treatments are often most helpful after patients find a medication that works. Treatments include:
      • Family education: teaches the whole family how to cope with the illness and help their loved one
      • Illness management skills: helps the patient learn about schizophrenia and manage it from day-to-day
      • Cognitive behavioral therapy (CBT): helps the patient identify current problems and how to solve them. A CBT therapist focuses on changing unhelpful patterns of thinking and behavior.
      • Rehabilitation:helps with getting a job or going to school and everyday living skills
      • Self-help groups: provide support from other people with the illness and their families
      • Treatment for drug and alcohol misuse:is often combined with other treatments for schizophrenia

    Are people with schizophrenia violent?

    Most people with schizophrenia are not violent; however, the risk of violence is greatest when schizophrenia is untreated. It is important to help a person with schizophrenia symptoms get treatment as quickly as possible. People with schizophrenia are much more likely to harm themselves than others.

    What about drugs and alcohol?

    It is common for people with schizophrenia to have problems with drugs and alcohol. A treatment program that includes treatment for both illnesses is critical for recovery because drug and alcohol abuse can interfere with treatment for schizophrenia.

    Drug abuse can increase the risk of suicide, trauma, and homelessness in people with schizophrenia as well as the risk of developing other mental illnesses.

    How can I help someone I know with schizophrenia?

    Family and friends can help their loved ones with schizophrenia by helping them get treatment and encouraging them to stay in treatment.

    Supporting a loved one with schizophrenia can be hard. Being respectful, supportive, and kind without tolerating dangerous behavior is the best way to help someone with schizophrenia. Check to see if there are any support groups in your area. Talking with others who support people with schizophrenia may help your whole family.

    The outlook for people with schizophrenia continues to improve. Treatments that work well are available, and new ones are being developed. Many people with schizophrenia experience recovery and lead independent, satisfying lives.

    Contact us to find out more about schizophrenia.

    National Institute of Mental Health
     Office of Science Policy, Planning, and Communications
     Science Writing, Press, and Dissemination Branch
    6001 Executive Boulevard
    Room 6200, MSC 9663
    Bethesda, MD 20892-9663
    Phone: 301–443–4513 or 1–866–615–NIMH (6464) toll–free
    TTY: 301–443–8431 or 1–866–415–8051 toll–free
    Fax: 301–443–4279

    U.S. Department of Health & Human Services
    National Institutes of Health

    NIH Publication No. TR 15-3517