Sunday, 25th July is National Schizophrenia Awareness Day.

So, what is schizophrenia? It’s a condition that alters the way your brain processes information. Your emotions, thoughts, behaviours, experiences and desires are altered by the condition, and this can result in hallucinations, delusions, paranoia, depression, social impairment and disorganised thoughts and behaviour. Schizophrenia tends to be a chronic condition. Often people with schizophrenia have reduced insight: this means they are unaware that they have the symptoms and condition and are opposed to receiving help.

Schizophrenia is classed as a psychosis disorder. Psychosis, to quote Mind, the mental health charity, “is when you perceive or interpret reality in a very different way from people around you”.

The causes of schizophrenia are multi-factorial, i.e. there are many aspects which come together and can lead a person to develop schizophrenia, such as (but not limited to) genetics, traumatic childhood, environment, stress, and illicit substance use.

Many of us will have heard of the ‘typical’ symptoms of schizophrenia, such as delusions and hallucinations, but there is more to it. For example, extreme apathy and social withdrawal are common symptoms of schizophrenia. In fact, it is the social impairment that is the hallmark of schizophrenia, as delusions and hallucinations can occur in many other mental health conditions.

The symptoms of schizophrenia can be divided into Positive and Negative symptoms. This does not mean the symptoms are either good or bad.

Positive Symptoms are something which is added to your experience of life. For example, hearing voices (auditory hallucinations), experiences of being controlled, a fixed and unshakeable belief in something (which is usually highly unlikely) such as being persecuted.

Negative Symptoms are when you lose an aspect of your life experience, such as your desire to interact with others, your sex drive, or perhaps moving less or having less motivation.

As with the nature of much mental illness, each case is unique so there are no hard-and-fast ‘this is schizophrenia’ rules. Each person will have their own unique presentation, difficulties and strengths.

What isn’t schizophrenia?

Schizophrenia does not mean having multiple personalities. This is more frequently associated with something much rarer called a Dissociative Identity Disorder. The name ‘schizophrenia’ actually comes from the Greek words for ‘split mind’, which may be the source of that confusion.

People suffering from schizophrenia are not dangerous. Those with schizophrenia really are a much greater risk to themselves than to others. To quote Rethink Mental Illness:

“Research shows that only a small number of people with the illness may become violent. The same way as a small minority of the general public may become violent. People with schizophrenia are far more likely to be harmed by other people than other people are to be harmed by them. But as these incidents can be shocking, the media often report them in a way which emphasises the mental health diagnosis. This can create fear and stigma in the general public.”

Stigma against people with schizophrenia is very commonplace in the world and, according to the World Health Organisation: “More than 69% of people with schizophrenia are not receiving appropriate care.”  This is due, in part, to a lack of mental health services in many countries, but also because of the stigma around schizophrenia preventing people from seeking suitable treatment.

Treatments for schizophrenia

If properly diagnosed, people with schizophrenia can be treated. The NICE guidelines recommend a combination of medication and psychological and social interventions to treat schizophrenia. However, while these measures can help to reduce symptoms, some people with schizophrenia will need long-term treatment to manage their symptoms and some may still have symptoms for life.

It has also been identified that early treatment of a first episode of psychosis reduces the risk of developing schizophrenia and improves long-term outcomes.  Therefore, throughout the country there are ‘early intervention in psychosis’ services which provide intensive assessment and treatment over 3-5 years. If you believe you (or a family member) are developing psychosis, your GP can refer you to such a service. Other mental health teams will help people who already have the condition and need further input.

You can find more information here:

https://www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-conditions/schizophrenia/

https://www.mind.org.uk/information-support/types-of-mental-health-problems/schizophrenia/about-schizophrenia/

If you’re worried that you or someone you know might be suffering from schizophrenia, please contact your GP for a referral to a local mental health service. You can contact Psychiatry-UK directly for help and opinion also.

Reviewed By Dr Adam Joiner MBBS, BSc (Hons), MMEd, MRCPsych

July 2022