Schizophrenia is a mental health condition that affects your interpretation of reality. How is schizophrenia diagnosed and how is it treated?

5 minute read 

Schizophrenia is a commonly misunderstood mental illness, and myths and misconceptions about the condition abound. Receiving a diagnosis of schizophrenia can be a frightening and confusing time, and while the condition can be serious, with the right treatment, many people with schizophrenia lead healthy and fulfilling lives.

What is schizophrenia?

Schizophrenia is a chronic (long-term) mental health condition that affects your interpretation of reality. It is a type of mental health disorder known as psychosis, which means people with the condition may be unable to understand what is real and what isn’t.

Schizophrenia symptoms can significantly impact many areas of a person’s life, including relationships, work, education, and physical health.

Symptoms of schizophrenia

Symptoms of schizophrenia may vary from person to person, but often include problems with cognition (thinking), behaviour and emotions. Symptoms may also change, improve, or worsen over time. In men, symptoms commonly start in the early to mid-twenties and in women in the late twenties.

People with schizophrenia do not have a “split personality” and the condition does not usually cause people to become violent.

Symptoms of schizophrenia may include:

• Hallucinations — seeing or hearing things that aren’t there. The most common type of hallucinations in people with schizophrenia are auditory hallucinations, or “hearing voices”.

• Delusions — false beliefs not based on reality

• Disorganised thoughts and speech — such as giving the wrong answer to a question, or speaking in meaningless sentences (word salad)

• Disorganised movements or behaviour — may include difficulty performing tasks, agitation, lack of response or excessive movement

• Loss of interest in daily activities, self-care, and personal hygiene

• Avoiding people and social situations

• Feeling disconnected from your feelings and emotions

What causes schizophrenia?

It isn’t fully understood what causes schizophrenia, but it is believed to be a combination of genetic and environmental factors.

Risk factors

Some things that may increase your risk of developing schizophrenia include:

• A family history of schizophrenia

• Having an illness such as an infection or autoimmune disease that affects your brain

• Extreme stress over a long period of time

• Lead exposure

• Living in a densely populated environment

• Problems during your mother’s pregnancy, such as gestational diabetes, preeclampsia, malnutrition, or vitamin D deficiency

• Low birth weight

• Birth complications such as being born by emergency caesarean section

• Recreational drug use, particularly marijuana use at an early age

When to see a doctor

If you, or a loved one, are experiencing symptoms of schizophrenia, it’s important to see a doctor as soon as possible. Early diagnosis and treatment are vital in ensuring the condition is managed as effectively as possible.

In many cases, people with schizophrenia aren’t aware of their condition and may not seek help. This means it often falls to family and friends to support and guide their loved one to the right services.

How is schizophrenia diagnosed?

There’s no single test for schizophrenia and the condition is diagnosed by assessing your symptoms and behaviour. If schizophrenia, or another mental health condition, is suspected, your GP will refer you to a specialist mental health team for diagnosis and treatment.

Your GP may want to rule out other conditions that could be causing your symptoms with tests such as a blood test, imaging tests like a CT or MRI, or a test to measure the electrical activity in your brain called an electroencephalogram (EEG).

Treatment for schizophrenia

Treatment for schizophrenia is normally with a combination of medication and talking therapy, such as cognitive behavioural therapy (CBT). There are also some things you can do yourself to help manage your symptoms.

Medication

Medication for schizophrenia is normally with a type of drug called an antipsychotic. These drugs don’t cure schizophrenia, but can help to reduce symptoms such as delusions, hallucinations, anxiety, and disordered thinking.

You may be prescribed antipsychotics short or long term, and you may need to try several medications before finding the one that works best for you.

Talking therapy

The most common type of talking therapy used to treat schizophrenia is cognitive behavioural therapy (CBT). CBT aims at identifying and changing negative thought patterns and behaviour so that you can respond to difficult situations in a more effective way.

If you have schizophrenia, CBT can help you:

• Cope with symptoms such as delusions or hearing voices

• Reduce and manage stress 

• Manage any side effects from your medication

• Manage any other mental health issues you may have, such as social anxiety and depression

Self-care

Some things you can do yourself to help manage the symptoms of schizophrenia include:

• Learn the early warning signs — the signs that your condition is worsening are different for everyone, but may include difficulty sleeping, increased anxiety, feeling afraid or suspicious of others, difficulty concentrating and hearing quiet voices

• Maintain your relationships — social isolation and loneliness can make schizophrenia symptoms worse

• Take care of your physical health — eat a balanced diet, take regular exercise, make sure you get enough sleep and avoid smoking, alcohol, and recreational drugs

• Reduce stress as much as possible — stress can worsen symptoms of schizophrenia. Some ways you can reduce stress include reducing your workload and responsibilities, spending time in nature, taking gentle exercise or listening to music.

• Do things you enjoy — make time to do the things you enjoy, like cooking, listening to music, or something creative like drama or art

• Get support — support from a schizophrenia support group can provide information and advice on coping with schizophrenia. They can also put you in touch with other people with the condition which can help you build relationships and feel less alone.

FAQs

What should I do if I think a loved one has schizophrenia?

It can be distressing to see a loved one showing symptoms of schizophrenia. The most important thing is not to panic, and to encourage your loved one to get the help they need. If this doesn’t work, you can contact your GP or mental health services yourself.

You can find more information on what to do if you’re worried about someone’s mental health on this factsheet from Rethink Mental Illness.

What happens if you don’t treat schizophrenia?

Left untreated, schizophrenia symptoms often get progressively worse and may even cause changes to your brain’s structure over time. Untreated schizophrenia may also lead to additional problems, including depression, alcohol and drug abuse, unemployment, homelessness, self-harm, and even suicide.

Can you live a normal life with schizophrenia?

With the right support and treatment, many people with schizophrenia can live relatively normal lives, including living independently, holding down a job, and having friends and relationships. It’s common to experience an occasional return of symptoms, known as a relapse, and learning to recognise the early warning signs and reach out for support is an important part of managing the condition.

Can schizophrenia be cured?

There is currently no cure for schizophrenia. A small percentage of people go into remission from schizophrenia and no longer experience symptoms, but symptoms can reoccur at any time.

Further support

For more information and support on coping with schizophrenia contact:

• Mind provides information and support for those dealing with mental illness by phone and email.

• Hearing Voices Network offers information and support to people experiencing hallucinations or altered perceptions

• Hub of Hope is a database that provides access to local and national mental health support across the UK.

• National Paranoia Network offers support to people experiencing paranoid thoughts

• Rethink Mental Illness offers information and support to those experiencing mental illness