Schizophrenia

Schizophrenia is a brain disease that affects approximately three million people in the United States alone. It is a highly treatable disease, and there are many new treatments for schizophrenia that can help improve people’s lives.

What Is Schizophrenia?

There are three types of schizophrenia, which are divided by the types of symptoms: positive, negative, and disorganized.

Positive/Psychotic Symptoms

People suffering from schizophrenia that presents with positive symptoms may have delusions or unusual thoughts, or feel extremely suspicious. They may be out of touch with reality and think that other people are plotting against them. They can suffer from audio or visual hallucinations. Normally, these hallucinations are negative or frightening.

People with schizophrenia may have a distorted view of the things around them. The things they see or smell may not represent real life, and this can make normal objects scary or unusual. People with schizophrenia may also be more sensitive to light, color, and other distractions.

Negative Symptoms

Negative symptoms of schizophrenia can include a lack of emotions and energy. People might have difficulty experiencing or expressing their emotions, empathizing with others, or relating to people. This can lead to isolation. People with negative symptoms may also have trouble concentrating and finishing projects. They could have to be reminded to do simple things such as bathing. Some symptoms are similar to those of depression. Schizophrenics may find the world uninteresting and flat, feeling that there is no point going out and doing things. They may also say little to nothing unless spoken to.

Disorganized Symptoms

Symptoms of schizophrenia can also be disorganized. These symptoms are similar to those of severe ADHD or autism. Confused thinking and speech is common, so patients are unable to carry on conversations or solve problems. They may repeat rhythmic gestures or completely stop moving for long periods of time.

How Will a Family Member with Schizophrenia Act?

You may notice schizophrenia developing between adolescence and the age of 40, which is the most common time that it first appears. However, children and older adults can also develop schizophrenia. If your loved one had been ill for a long period of time, this can be a precursor to schizophrenia. You may notice the first episode if the patient seeks help when delusions or hallucinations trigger unusual behavior. Patients who seek help have a good chance of recovering from the episode within a few months.

What Can I Expect from Schizophrenia?

If you have schizophrenia, you should know that the course of this brain disease varies greatly. Medication can often control your symptoms. If you take your medication exactly as directed, you will likely have a mild type of the disease. In that case, you will have only one or two relapses in total by the age of 45 and will show only minor symptoms. If you have moderate schizophrenia, you will likely have several major relapses by the age of 45, plus symptoms during stressful times, and you will have persistent symptoms between relapses. This often results from taking your medication most, but not all, of the time. Not taking medication at all or dropping out of treatment often causes a severe and unstable course of the disease. If you have this type, you will only be stable for a short period of time between relapses. You may have serious symptoms and need help with your day-to-day life.

How Does a Patient Recover?

Patients can recover from acute episodes. They will begin to stabilize when they take medications that control their symptoms. After that, they may still have some trouble with symptoms, but these will be much less severe. Between episodes, maintenance is important to prevent mild and persistent symptoms. During this phase, many patients continue to improve.

Is Diagnosis Important?

Diagnosis is important, especially because it’s important for doctors to treat schizophrenia as soon as possible. Early diagnosis can help stabilize and prevent many symptoms and help in a variety of other ways. Medical professionals’ top priority is to eliminate psychotic symptoms. They can usually do this within six weeks. Next, they will provide antipsychotic medications to help patients prevent relapse and hospitalization.

After patients are treated with antipsychotics, doctors reevaluate their treatment. A patient can sometimes be misdiagnosed, since some other disorders are similar to schizophrenia. If patients drink alcohol, they will need to decrease their intake or stop drinking entirely. Abusing alcohol or other substances can make schizophrenia much worse. Doctors and other hospital staff also want to reduce a patients’ risk of suicide, which is highest in the early years of schizophrenia. Such suicidal thoughts are treatable, and patients can take antipsychotics such as:

• Haloperidol
• Thioridazine
• Fluphenazine
• Chlorpromazine

There are also additional drugs available besides these conventional antipsychotics. Atypical antipsychotics like risperidone, quetiapine, and olanzapine can also be used and may have fewer side effects than conventional antipsychotics.

Should Patients Take Medication during Recovery?

Researchers have not found a cure for schizophrenia, so it is important to take any medications prescribed as they are given. The symptoms of schizophrenia can be controlled in most people as long as they take their medications. After the first episode, doctors recommend that patients stay on medication for 12 to 24 months before reducing the dose. Patients who have had more than one episode or those who have not fully recovered may need to be treated for a longer period of time, and some people may need treatment indefinitely.

Patients need to be careful and recognize side effects of medications, since some can cause fairly large problems. Extrapyramidal side effects can cause people to feel rigid or stiff, or they may feel like they need to keep moving all the time. Doctors may prescribe an anticholinergic in some cases to help treat this side effect. People can also develop tardive dyskinesia when they take antipsychotics for a long period of time. This results in the uncontrolled movement of the mouth. If this develops, simply switching the type of antipsychotic can help.

For more on the topic of Schizophrenia , we’ve included the following expert consensus documents as reference materials:

• Full reprint in PDF: Treatment of Schizophrenia 1999
• Guide for Patients and Families in PDF
• Selected Results from the 1996 Schizophrenia Policy Survey in PDF

View Resources

• MedlinePlus – general information about Schizophrenia
• Guidelines – treatment of patients with schizophrenia
• NIMH – recovery after schizophrenia
• NIMH – rethinking schizophrenia
• PubMed – general information about Schizophrenia