Illness & Conditions - Special Health Issues
What is schizophrenia?
Schizophrenia is an illness that can affect your ability to think clearly, manage your emotions, and interact with others. It affects each person differently.
The way other people react to schizophrenia can make a difference in how schizophrenia affects you. It can make it easier or harder for you to cope with the illness.
Most people who have schizophrenia:
With treatment, they may come to understand that these experiences aren't real but are a problem with how their brains work.
There are several types of schizophrenia. The most common is paranoid schizophrenia, which causes people to have frightening thoughts, believe that people or forces are trying to harm them, and hear voices. Some people think that schizophrenia is the same as a "split personality" ( dissociative identity disorder ), but that is a different mental health problem.
Living with schizophrenia can cause many challenges. It's a difficult disease. It changes your life and the lives of your family. But you can live a full and meaningful life if:
What causes schizophrenia?
Experts don't know what causes schizophrenia. It may have different causes for different people.
It is not caused by anything you did, by personal weakness, or by the way your parents raised you.
What are the symptoms?
Symptoms of schizophrenia include:
Symptoms usually start when you are a teen or a young adult, but they may start later in life. They may appear suddenly or may develop slowly. You may not be aware of your symptoms.
Negative symptoms usually appear first. They may be hard to recognize as schizophrenia, because they are similar to symptoms of other problems, such as depression . Positive symptoms can start days, months, or years after the negative symptoms.
Early signs of schizophrenia may include doing worse in school, thinking that people are trying to harm you, or having changes in your personality, such as not wanting to see people.
These signs don't mean you have schizophrenia. But if you notice these signs, see a doctor.
How is schizophrenia diagnosed?
Your doctor will ask you questions about your health and about any odd experiences you may have had, such as hearing voices or having confusing thoughts. You will have a physical exam. Your doctor also may suggest tests, such as blood tests or imaging tests , to see if your symptoms may be caused by another health problem.
How is it treated?
Medicines help your symptoms, and counseling and therapy help you change how you think about things and deal with the illness. Treatment may last a long time.
When you have your symptoms under control, you are in recovery. Recovery usually is a lifelong process. In the recovery process, you learn to cope with your symptoms and challenges, find and meet your goals, and get the support you need. Your recovery depends upon a partnership between you, your doctors, and others who are important in your life.
People who have schizophrenia often stop treatment. This may be because they don't understand that they have an illness or because the medicines cause side effects. When treatment stops, symptoms usually come back (relapse) or get worse. A relapse might happen right after treatment is stopped or months later. A later relapse makes it hard to see that stopping the medicine was the cause. During a relapse, some people who have schizophrenia may need to spend time in a hospital.
How can family and friends help?
Having schizophrenia can be a scary experience, and knowing that someone you love has this illness changes your life. Show love, and learn as much as you can about the illness. Understand that the behavior you may see is caused by the illness and is not the person you love.
If you think that someone you love has schizophrenia, help that person get to a doctor. The sooner the illness is diagnosed and the person begins treatment, the more successful treatment and recovery may be.
You can help by talking to your loved one and helping him or her continue treatment. You also can help your loved one deal with fear and other feelings about the illness and with the negative attitudes that some people have toward schizophrenia.
Frequently Asked Questions
Experts don't know what causes schizophrenia. It may have different causes for different people.
Schizophrenia is not caused by anything you did, by personal weakness or bad choices, or by the way your parents raised you.
The symptoms of schizophrenia can be negative, positive, or cognitive.
"Negative" doesn't mean "bad." Negative symptoms are things that are "lost" from your personality or how you experience life. You may:
"Positive" doesn't mean "good." Positive symptoms are things "added" or "new" to your personality or how you experience life because of schizophrenia. You may:
Cognitive and other symptoms
Other symptoms include:
Symptoms of schizophrenia usually start in the late teens to mid-20s for men and the late 20s to 30s for women. The symptoms may start suddenly or happen gradually.
Childhood schizophrenia is rare.
There are four stages of schizophrenia: prodromal phase, active or acute phase, remission, and relapse.
Schizophrenia usually starts with this phase, when symptoms are vague and easy to miss. They are often the same as symptoms of other mental health problems, such as depression or other anxiety disorders. They may not seem unusual for teens or young adults. In fact, schizophrenia is rarely diagnosed at this time.
Symptoms are sometimes triggered by stress or changes, such as going away to school, starting to use drugs or alcohol, or going through a severe illness or a death in the family.
These first symptoms often include being withdrawn, outbursts of anger, or odd behavior. For more information, see Symptoms.
This phase can last for days, months, or years.
Active, or acute, phase
At some point you start to have symptoms such as hallucinations, delusions, or confusing thoughts and speech.
These symptoms may appear suddenly or slowly over time. They can be severe and can cause a psychotic episode , which means you can't tell the difference between what is real and what isn't real.
You may need to go to the hospital. You probably won't be able to make many decisions about your care.
This phase usually lasts 4 to 8 weeks. This is when schizophrenia usually is diagnosed.
Remission and relapse
After an active phase, symptoms get better, especially with treatment, and life may be more "normal." This is called remission. But symptoms may get worse again, which is called a relapse. You may have this cycle of symptoms that get severe and then improve.
In each cycle, symptoms such as hallucinations and delusions may become less intense, but other symptoms, such as feeling less interested in caring for yourself, may get worse. You may have few or many cycles before you are able to stay in remission.
Within 5 to 10 years, you may develop a unique pattern of illness that often stays the same throughout your life. It also is possible that you will have fewer relapses as you get older and may even not have symptoms.
Tips for avoiding relapse
Watch these areas for problems:
What Increases Your Risk
Schizophrenia is a complex illness. Experts don't know what causes it or why some people get it and others don't. But some things increase your chances of getting it. These are called risk factors.
You may be at risk for schizophrenia if:
When to Call a Doctor
Call 911 or other emergency services if you (or a loved one with schizophrenia):
Call a doctor if you (or a loved one with schizophrenia):
If you are worried that you or a loved one may have schizophrenia but need help deciding whether to see your doctor, read about some of the reasons people don't get help and how to overcome them.
Who can treat schizophrenia?
Health professionals who can help diagnose schizophrenia or who may work together with other health professionals to treat schizophrenia include:
Exams and Tests
Your doctor will ask you questions about your medical history and your mental health and about any odd experiences you may have had, such as hearing voices or having confusing thoughts. You also will have a physical exam.
Your doctor also may suggest tests to rule out other conditions with similar symptoms or to diagnose other schizophrenia disorders. These tests may include blood tests and a CT scan or MRI . The CT scan or MRI will check the size, structure, and function of your brain.
If your doctor thinks you are depressed or are thinking about suicide, a suicide assessment also may be done.
Schizophrenia is diagnosed when: 1
Finding out that you have schizophrenia can be scary and hard to deal with. But you can treat it.
The goals of treatment and recovery are to:
Medicines help your symptoms. And counseling and therapy help you change how you think about things and deal with the illness.
If medicine and therapy aren't helping you, your doctor may suggest electroconvulsive therapy (ECT). In this procedure, your doctor uses electricity to create a brief and mild seizure. This may change your brain chemistry and help your symptoms.
If you struggle with alcohol, drugs, or tobacco or have other mental health problems, such as depression, you need to treat these problems too.
Treatment may last a long time, and the need to follow a recovery plan usually lasts for your lifetime. Your treatment and recovery plan may change as your experience of schizophrenia and your life change.
Most people with schizophrenia qualify for health care programs such as Medicare or Medicaid. To find out whether you qualify, check with your local health and welfare agency.
Medicines are the treatment that works best for schizophrenia, and you may be taking more than one at a time. They may be used for positive or negative symptoms, but they don't work as well for negative symptoms as they do for positive symptoms.
It may take time to find which medicines are best for you. This may be frustrating. Getting support from your family, your friends, and a community-based rehabilitation program is helpful, especially while you and your doctor are trying to find the best medicines. It also may help to speak with and get support from others who have had trouble finding the right medicines.
If you stop taking your medicines, you may have a relapse. Don't stop taking your medicines until you talk with your doctor. If you and your health care team decide you should stop using medicine, you will need to be checked on a regular basis.
Medicines used most often to treat schizophrenia include:
These medicines often are used along with the medicines listed above:
Because of side effects or the risk of side effects, you may be tempted to stop using your medicine. But if you stop using medicine, the symptoms of schizophrenia may come back or get worse.
If you have any concerns about side effects, talk to your doctor. He or she will work with you. Your doctor may give you a smaller dose of the antipsychotic medicine, have you try another antipsychotic medicine, or give you another medicine to treat the side effect.
Some side effects of antipsychotic medicines can be serious.
You may need regular blood tests to check for side effects. Children, teens, and older adults may need to have blood tests more often than other people.
Counseling and Therapy
Counseling and therapy are important parts of treatment. You will work with a mental health professional such as a psychologist, a licensed professional counselor, a clinical social worker, or a psychiatrist.
Find a therapist you trust and feel comfortable with. A good therapist not only provides help but gives you support and encouragement. If you don't feel good about working with one doctor or therapist, try another one.
Here are some types of therapy that may help:
When you have schizophrenia, you need more than medicines and counseling to move forward with your life. You need to partner with your health care team to find and meet your personal goals. This life-long partnering is known as recovery.
Recovery isn't the same as being cured, and it doesn't mean that you will be symptom-free. It is being able to live a full life and enjoy favorite activities with as little trouble as possible from your symptoms. Recovery may help you manage your symptoms so that you can be an active member of your community.
Education, support, and training in social and job skills all are important parts of your treatment and recovery. For example:
There are 10 principles of recovery (What is a PDF document?) that can guide you as you work toward your goals and learn new things to help yourself. They help you gain self-confidence and respect for yourself. They make it clear that you make your own decisions with the help of your doctor, counselor, and family. And they encourage you to be as independent as possible while living with schizophrenia.
It may be hard to understand and accept that you have an illness, and it's easy to become discouraged. You can help yourself by focusing on your recovery goals and learning to see schizophrenia as one part of your life, not your entire life. Make managing schizophrenia well one of the many successes in your life.
You have schizophrenia, but like other people, you have wishes and goals for your life. You most likely want healthy relationships with your partner, family, and friends. You may want a job that gives you a sense of self-worth.
Your family and community can support you and help you meet your goals.
If your symptoms come back, it's called a relapse. Anyone with schizophrenia can have a relapse, but it may happen much more often when you don't take your medicine.
You can help prevent a relapse by taking your medicine, going to your counseling sessions, being active in your own recovery, and not drinking alcohol or using illegal drugs.
If you are having trouble taking your medicine or feel that you don't need to, talk to your doctor or another trusted person. Your doctor may be able to change the medicine or how much you take. A partner or spouse may help you find ways to remember to take the medicine.
A healthy lifestyle
The symptoms of schizophrenia can make it easy to forget some of the basics of good health. But it's important to try to have a healthy lifestyle.
Here are some things to do:
For Family and Friends
Schizophrenia affects everyone around the person who has the illness. It can be hard to watch a family member or friend develop symptoms and perhaps act in very different ways.
You may feel helpless, but you play an important role in the life and treatment of a loved one who has schizophrenia.
What you can do
You can also help the person with good health habits, like getting enough sleep and avoiding alcohol and drugs.
Sometimes people who have schizophrenia are too sick to seek treatment on their own. If the symptoms are severe, you may have to force the person to get treatment. Talk with your health care providers and/or local law enforcement officials about the laws and procedures in your area for getting treatment in this situation. If you have this information before you need it, it will reduce your fears and concerns and may make it easier for you.
Some people who have schizophrenia may become aggressive or violent at times. Call 911 or other emergency help if you notice:
Supporting or caring for someone who has schizophrenia isn't easy. Finding your own support can help you deal with the illness and the sense of loss you may feel.
For more information, see the topic Caregiver Tips.
Other Places To Get Help
Last Revised: August 31, 2012
American Psychiatric Association (2000). Schizophrenia and other psychotic disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 297–343. Washington, DC: American Psychiatric Association.
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