Schizophrenia is a serious mental illness. One of the biggest myths around the illness is that it isn’t treatable. With the right supports, people can work or volunteer, be active in their own care, and contribute to their communities. The exact course and impact of schizophrenia is unique for each person. Some people only experience one episode in their lifetime while others experience many episodes. Some people experience periods of wellness between episodes while others may experience episodes that last a long time. Some people experience a psychotic episode without warning while others experience many early warning signs. No matter how someone experiences schizophrenia, researchers agree that early treatment can help reduce the impact of episodes in the future.
Download and print our Schizophrenia brochure.
Schizophrenia affects the way you understand and interact with the world around you. This complex biochemical brain disorder affects a person’s ability to determine what is reality and what is not. It is as though the brain sends perceptions along the wrong path, leading to the wrong conclusion. People with schizophrenia are affected by delusions (fixed false beliefs that can be terrifying to the person experiencing them), hallucinations (sensory experiences, such as hearing voices talking about them when there is no one there), social withdrawal and disturbed thinking.
At the beginning of an episode, people may feel that things around them seem different or strange. They may start to experience problems concentrating, thinking or communicating clearly, or taking part in their usual activities. At the height of the episode, people may experience breaks from reality called psychosis. These could be hallucinations (sensations, like voices, that aren’t real) and delusions (strong beliefs that aren’t true, like the belief that they have superpowers). Some people feel ‘flat’ or numb. They may also experience changes in mood, motivation, and the ability to complete tasks. After an episode, signs can continue for some time. People may feel restless, withdraw from others, or have a hard time concentrating.
Schizophrenia can affect anyone. It usually starts to affect people in the teen years, though females often start to experience the illness a little later than males. Striking most often in the 16 to 30 year age group, affecting an estimated one person in a hundred, it is youth’s greatest disabler. No one knows exactly what causes schizophrenia or why it can affect people so differently. Genes, the way a person’s brain develops, and life events may all play a part.
Schizophrenia often starts slowly. When the symptoms first appear, usually in adolescence or early adulthood, they may seem more bewildering than serious. In the early stages, people with schizophrenia may find themselves losing the ability to relax, concentrate or sleep. They may start to shut long-time friends out of their lives. Work or school begins to suffer; so does their personal appearance. During this time, there may be one or more episodes where they talk in ways that may be difficult to understand and/or start having unusual perceptions. Once it has taken hold, schizophrenia tends to appear in cycles of remission and relapse. When in remission, a person with schizophrenia may seem relatively unaffected and can more or less function in society. During relapse, however, it is a different story. People with schizophrenia may experience one or all of these main conditions:
- Delusions and/or hallucinations;
- Lack of motivation;
- Social withdrawal;
- Thought disorders.
Delusions are false beliefs that have no basis in reality. People with schizophrenia may think, for example, that someone is spying on them, listening to their thoughts, or placing thoughts in their minds. Hallucinations most often consist of hearing voices that comment on behaviour, are insulting or give commands. Less often, people with schizophrenia may see or feel things that aren’t there. Disorganized thinking makes some people with schizophrenia feel mixed up. In conversation, they may jump randomly from one unrelated topic to another. Depression and anxiety frequently accompany these feelings. The symptoms of schizophrenia vary greatly from person to person, from mild to severe. A specialist is needed to make the diagnosis, especially because there are no diagnostic tests.
We know that schizophrenia is a biological disorder of the brain. The causes are not yet known, but there are several theories. There is strong evidence of important inherited factors. Many researchers are looking for genetic causes of schizophrenia that runs in families. Success may become more likely as genes for complex illnesses are found.
The characteristics of schizophrenia, along with its tendency to ebb and flow in cycles, makes it similar to auto-immune diseases.
New technology has provided some recent clues to the causes of schizophrenia. Computer images of brain activity show that the part of the brain that governs thought and higher mental functions behaves abnormally in persons with schizophrenia. Magnetic Resonance Imaging, or MRI, has shown that the same area in the brain of some people with schizophrenia appears either to have deteriorated or not to have developed normally.
Computed Axial Tomography (popularly known as CAT scans) show that the fluid-filled spaces within the brains of people with schizophrenia tend to be larger than those in people without the illness. Even the treatments physicians use today are giving scientists much-needed pieces to the puzzle. For example, some people with schizophrenia respond well when they are given medication that interferes with their body’s production of the brain biochemical dopamine. This fact is leading researchers to speculate that either an over-production of dopamine or an over-sensitivity to it has something to do with the illness.
While there is no cure for schizophrenia, people can and do recover. Recovery may mean learning to reduce the impact of problems, work around challenges, or maintain wellness. Most people use some combination of the following treatments and supports. Some people need to spend time in hospital if they experience a severe episode of psychosis. This is a time to figure out the best treatment for you and begin your journey to health. Before you leave the hospital, care providers should help you map out the service providers (like doctors, counsellors, and social workers) who will be involved in your care and support your recovery.
- Medication – Medication called antipsychotics may help reduce the severity of symptoms like hallucinations and delusions, and may eliminate these symptoms all together for many people. Continuing medication after you feel well again may help reduce the risk of relapse (when symptoms come back). There are many different kinds of antipsychotics, so it may take time and patience to find the best one for you. All medications can cause side effects—some of which can be uncomfortable or difficult. It’s best to have ongoing, open conversations about medication with a doctor so that everyone understands how a medication is affecting you, what can be done, and what other options you may have.
- Counselling and supports – Counselling can help with many problems like low mood, anxiety, and relationships. You can learn helpful skills like problem-solving and setting goals. There are also therapies to help reduce the impact of delusions and hallucinations. Schizophrenia can affect people’s goals around education, work, and independent living. Professionals like occupational therapists and social workers can help with daily living, social skills, employment or volunteer training, and community activities. They can also connect you with community supports like home care, housing, and income assistance. A big part of managing schizophrenia is relapse prevention. You can learn what might trigger an episode and learn to recognize early warning signs of an episode. The goal is to learn when to seek extra supports, which may help reduce the impact or length of the episode.
- Self-care – Self-care is important for everyone. Small steps like eating well, getting regular exercise, building healthy sleep habits, spending time on activities you enjoy, spirituality, and connecting with loved ones can make a big difference. Schizophrenia can leave people feeling very isolated and alone. At times, many people who experience schizophrenia feel uncomfortable around others. But many also worry about what others will think of them. The right relationships can be supportive and healing. Your support team can help you connect with support groups.
With proper and improved medication, extensive community support (especially in housing) and skilled psychotherapy, many people with schizophrenia will be able to function in the community. With these resources to draw from, many people with schizophrenia could live independently, work, enjoy family and friends. The search for a cure continues with hope for success increasing every day.
Families can be a big help. Working closely with health care professionals, family members can learn about the illness. Families can also provide useful information to the health care professionals. They can find ways to support people with schizophrenia and provide a nurturing environment that encourages communication.
Here are some tips for helping a loved one:
- Learn more about schizophrenia so you have a better idea of what to expect and how you can help.
- Schizophrenia can have a big impact on a person’s ability to concentrate and make sense of information. Loved ones may not react to things in ways you expect or may struggle with tasks that seem simple to you. It’s okay to feel frustrated, but it isn’t anyone’s fault.
- If a loved one has trouble following conversations, choose a quiet space and speak calmly and clearly.
- It’s best to avoid arguing with delusions or hallucinations. A more helpful strategy is to focus on the feelings that delusions or hallucinations bring up.
- Ask your loved one how you can help. This may be as simple as helping with day-to-day tasks.
- Talk about dealing with emergencies when your loved one is feeling well and decide how you can contribute. Write it down in a crisis plan and share it with your care team. This is also a good time to talk about behaviours you aren’t willing to deal with.
- Learn more about support services for care providers through your loved one’s care team, provincial or territorial health services, or community organizations.
- Depending on the barriers that your loved one experiences, planning for the future with tools like a Registered Disability Savings Plan can bring peace of mind.
- Set your own boundaries, and seek support for yourself when you need it. Think about joining a support group for loved ones and seeking counselling for the entire family.