Frequently Asked Questions about Schizophrenia
Schizophrenia is a severe and debilitating brain and behavior disorder affecting how one thinks, feels and acts. People with schizophrenia can have trouble distinguishing reality from fantasy, expressing and managing normal emotions and making decisions. Thought processes may also be disorganized and the motivation to engage in life’s activities may be blunted. Those with the condition may hear imaginary voices and believe others are reading their minds, controlling their thoughts or plotting to harm them.
Most people with schizophrenia suffer from symptoms either continuously or intermittently throughout life and are often severely stigmatized by people who do not understand the disease. Contrary to popular perception, people with schizophrenia do not have “split” or multiple personalities and most pose no danger to others. However, the symptoms are terrifying to those afflicted and can make them unresponsive, agitated or withdrawn. People with schizophrenia attempt suicide more often than people in the general population, and estimates are that up to 10 percent of people with schizophrenia will complete a suicide in the first 10 years of the illness — particularly young men with schizophrenia.
While schizophrenia is a chronic disorder, it can be treated with medication, psychological and social treatments, substantially improving the lives of people with the condition.
Schizophrenia can have very different symptoms in different people. The way the disease manifests itself and progresses in a person depends on the time of onset, severity and duration of symptoms, which are categorized as positive, negative and cognitive. All three kinds of symptoms reflect problems in brain function. Relapse and remission cycles often occur; a person can get better, worse and better again repeatedly over time.
Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30.
Men tend to experience symptoms earlier than women. Most of the time, people do not get schizophrenia after age 45. Schizophrenia rarely occurs in children, but awareness of childhood onset schizophrenia is increasing.
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems and irritability — behaviors that are common among teens.
A combination of factors can predict schizophrenia in up to 80 percent of youth who are at high risk of developing the illness. These factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop the disease, this stage of the disorder is called the “prodromal” period.
Currently, schizophrenia is diagnosed by the presence of symptoms or their precursors for a period of six months. Two or more symptoms, such as hallucinations, delusions, disorganized speech, and grossly disorganized or catatonic behavior, must be significant and last for at least one month. Only one symptom is required for diagnosis if delusions are bizarre enough or if hallucinations consist either of a voice constantly commenting on the person’s behavior/thoughts, or two or more voices “conversing.” Social or occupational problems can also be part of the diagnosis during the six-month period.
Foundation-funded research to find markers, such as abnormal brain scans or blood chemicals that can help detect early disease and allow for quicker interventions is now being done. Scientists are also working to understand the genetic and environmental mechanisms that combine to cause schizophrenia. As more is discovered about chemical circuitry and structure of the brains of people with the disease, better diagnostic tools and early intervention techniques can be developed. This is crucial for schizophrenia as it is believed that with every psychotic episode, increased damage is done to the brain.
While no cure exists for schizophrenia, it is treatable and manageable with medication and behavioral therapy, especially if diagnosed early and treated continuously. Those with acute symptoms, such as severe delusions or hallucinations, suicidal thoughts or the inability to care for oneself, may require hospitalization. Antipsychotic drugs are the primary medications to reduce the symptoms of schizophrenia. They relieve the positive symptoms through their impact on the brain’s neurotransmitter systems. Cognitive and behavioral therapy can then help “retrain” the brain once symptoms are reduced.
These approaches improve communication, motivation and self-care and teach coping mechanisms so that individuals with schizophrenia may attend school, go to work and socialize. Patients undergoing regular psychosocial treatment comply better with medication, and have fewer relapses and hospitalizations. A positive relationship with a therapist or a case manager gives a patient a reliable source of information about schizophrenia, as well as empathy, encouragement and hope. Social networks and family member support have also been shown to be helpful.
A method called transcranial direct current stimulation, or tDCS, has already been used to help stroke victims recover, and has been studied in patients with Alzheimer's and Parkinson's diseases. tDCS is a non-invasive technique in which a very weak direct electrical current is passed through the cerebral cortex via electrodes placed on the scalp. Donel M. Martin, Ph.D., of the University of New South Wales, who used a 2010 NARSAD Young Investigator Grant to conduct studies with tDCS, says the method "can potentially help the brain activity and inhibiting competing brain regions." More studies are needed to determine if cognition related to psychiatric illness can be imporved beyond the treatment sessions themselves.