Schizophrenia is a devastating mental illness that is common. It affects 1% of people around the world. “Schizo” means divided or split, and it reflects the fact that people with schizophrenia live in an altered sense of reality. It is not the same as split or Multiple Personality Disorder, but schizophrenia is often confused with this. People with schizophrenia are psychotic, meaning that they interpret the way events are happening around them abnormally because of disordered brain function. It happens most commonly in young men in their early 20’s. Women usually develop schizophrenia in their mid- to late-20’s. For this reason, women tend to do better than men as they have built up their support networks further by the time they are diagnosed with this mental illness.

There are certain symptoms that are characteristic of schizophrenia including seeing things or hearing voices that aren’t actually present (hallucinations), having fixed beliefs that are often absurd and untrue (delusions), displaying little to no emotion, feeling paranoid that people are out to get them, being socially isolated, having poor social skills and personal hygiene, and sometimes having difficulty with coordinated movements. Unfortunately the natural course in disease progression with schizophrenia is a slow worsening of symptoms.

There are some misconceptions about schizophrenia. One of them is that people with the disorder are violent. This is usually not the case as most people with schizophrenia tend to withdraw into themselves, although some do become violent. Not everyone who hears voices has schizophrenia, and not everyone who is paranoid has the disorder either.

The cause of schizophrenia is unknown, but studies are being done looking at levels of certain brain chemicals (neurotransmitters) involved in signaling within the brain. There seems to be a pattern common to people with schizophrenia in the size of certain brain structures, and the amounts and distribution of the neurotransmitters among other things. Schizophrenia does tend to run in families, with about 10% of people with the disorder having a family member with it as well.

People with schizophrenia will often think that nothing is wrong with them as their delusions, hallucinations, and paranoia are all real to them. It takes family members or friends to notice that something is wrong and to bring the person to see a doctor who can recognize the symptoms and diagnose schizophrenia.

Diagnosis of schizophrenia is made after a careful history and physical exam are done to rule out any other possible causes of the symptoms. Blood and urine tests are usually done to make sure that the symptoms are not being caused by drugs or alcohol. Certain infections, thyroid problems, cancers, and immune system disorders can mimic schizophrenia. Other mental illnesses may cause hallucinations, delusions, and paranoia as well, like Bipolar Disorder and Depression.

Treatment for schizophrenia has improved a lot in the past few years, with fewer side effects. In the past anti-psychotic medications tended to cause involuntary movements in a person being treated with them called “tardive dyskinesia,” but this is not a problem with the newer medications. With proper taking of the medications for schizophrenia it can be quite well controlled, with few relapses and few symptoms. The problem with schizophrenic people is that they often don’t take their medications properly making the treatment less than optimal.

Non-medication treatments like cognitive therapy with a psychiatrist can help a person with schizophrenia learn to deal with their distressing thoughts. Training can be done in personal hygiene and how to cope in social situations. People with schizophrenia can even sometimes be employed at a regular job and can live independently, but often they live in group homes where there is constant support.

In summary, schizophrenia is a hard illness to deal with, both for the individual and for their friends and family. There are support groups available and with proper compliance in taking the newer anti-psychotic medications the diagnosis of schizophrenia is not as devastating as it once was.