Schizophrenia

Schizophrenia is a serious mental illness that, according to Health Canada, affects 1 percent of the population. Although it is often feared and misunderstood, schizophrenia is a treatable condition. Schizophrenia often interferes with a person's ability to think clearly, distinguish reality from fantasy, manage emotions, make decisions, and relate to others. The first signs of schizophrenia typically emerge in the teenage years or early 20s, often later for women. Most people with schizophrenia contend with the illness chronically or episodically throughout their lives and are often stigmatized. A person with schizophrenia does not have a “split personality," and almost nobody with schizophrenia is dangerous or violent toward others while receiving treatment.

What are the symptoms of schizophrenia?

The symptoms of schizophrenia are generally divided into three categories: positive, negative, and cognitive.

  • Positive symptoms are overt symptoms that are not seen in healthy people. They include delusions and hallucinations. A delusion is a false belief that is rigidly held and is not part of the usual set of beliefs of the individual's culture or subculture. For example, the individual may believe that other people are reading her/his thoughts, others are secretly monitoring and threatening her/him, or s/he can control other people's minds. Hallucinations are things a person sees, hears, smells, or feels that no one else can. Auditory hallucinations (in particular hearing voices) are the most common type of hallucination in schizophrenia.
  • Negative symptoms are disruptions to normal emotions and behaviours. These symptoms are harder to recognize because evidence of schizophrenia can be mistaken as signs of depression or other conditions. They include an emotional flatness or lack of expression, an inability to start and follow through with activities, and a lack of pleasure or interest in life.
  • Cognitive symptoms pertain to thinking processes. For example, a person with schizophrenia may have difficulty prioritizing tasks, performing certain kinds of memory functions, and organizing their thoughts. A common problem associated with schizophrenia is referred to as a lack of insight; the person is unaware that s/he is ill. This is not willful denial, but a symptom of the mental illness, which makes participating in treatment very difficult.

What treatments are available for schizophrenia?

Schizophrenia is a treatable and manageable illness. Medication can help to manage the symptoms, so it is the centrepiece of effective treatment. People with schizophrenia sometimes stop treatment because of the unpleasant side effects of medications, a lack of insight into the disruption of the disorder, disorganized thinking, or a conviction that the medication is no longer working. Discontinuing prescribed medication is associated with an increased risk of relapsing into an acute psychotic episode. Psychosocial treatments help people with schizophrenia develop coping strategies to deal with some of the practical challenges of the illness, such as self-care, difficulty with communication, securing/sustaining employment, and forming and keeping relationships. Those who receive regular psychosocial treatment are also more likely to continue taking their medication, and they are less likely to have relapses or be hospitalized.

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