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Schizophrenia is a mental disorder characterized by fragmented thoughts and a distorted perception of reality. There is currently no cure. While the origins of the disease are still unclear, researchers believe that it’s likely caused by a combination of genetic and environmental factors.
It starts young
Schizophrenia symptoms tend to emerge in men when they’re in their late teens to early 20s and for women when they’re in their late 20s to early 30s. But because some of the earliest symptoms—such as trouble sleeping or feelings of irritability—can be mistaken for typical teenage behavior, it can be hard to make a diagnosis in someone at such a young age.
“It's a very common and tragic story: You see people that were high performers, did great in high school, go off to start college and the first year or two they're doing really well. Then they become more isolative and their grades start to slip,” says Richard Smith, DO, a practicing psychiatrist at Tampa Community Hospital in Tampa, Florida. Eventually symptoms continue to develop. “Their behaviors become a little more ‘off’ and eventually they end up having a break that totally changes the trajectory of their life,” Dr. Smith adds. Though the earliest signs can seem unspecific, it’s important to be on the lookout for signals including poor concentration, paranoia and changes in friend groups, appearance or hygiene.
The broader symptoms of schizophrenia can be divided into three subgroups—positive, negative and cognitive symptoms. Positive symptoms include behaviors that aren’t usually seen in healthy people, negative symptoms tend to be alterations to otherwise normal emotions and behaviors, and cognitive symptoms affect memory and everyday thinking. If someone experiences any of the following for at least 6 months, they might be diagnosed as schizophrenic.
Positive symptoms: Hallucinations and delusions are two common positive symptoms of schizophrenia. When someone has a hallucination, their senses are distorted. They may hear, see, taste, or touch things that aren’t actually there. “Many are able to see details of the universe that they believe are true that other people can't see,” says Smith. Delusions might make someone paranoid and feel like they’re being spied on or they might feel like they know something that others don’t. Smith says it’s common for other people to assume that these delusions and hallucinations are dangerous, but the reality is quite different: “Patients who are schizophrenic are more likely to hurt themselves than they are to hurt someone else,” he notes. “And they are more likely to be the victim of violence than they are to perpetrate it.” Unfortunately, the stereotype of the violent schizophrenic patient persists, which places a stigma on those dealing with this disorder.
Negative symptoms: These signs may be confused with symptoms of depression. People exhibiting negative symptoms might feel uninterested in doing familiar activities or feel disconnected from the world around them. It might also be difficult for someone experiencing negative symptoms to maintain relationships.
Cognitive problems: Patients may have difficulty remembering or thinking properly, and may even lack the ability to understand that there’s a problem in the first place.
Diagnosis and treatment
If you or a loved one shows any symptoms of schizophrenia, it’s vital to see a mental health professional. A medical examination may be required to rule out other conditions or substance abuse.
There are medications that can help control chemical imbalances in the brain and help stabilize the patient. The best treatment, however, involves a full psychosocial treatment plan, which goes beyond simply finding a medication that works. A more holistic treatment approach that involves therapy can help patients learn how to cope with real-life challenges such as staying in school or getting a job, and can help prevent relapses in the future.
A treatment plan that includes therapy and counseling is also important to help patients stay on medication. Many patients simply don’t like how being on medication makes them feel. “They have a sense that they're missing some part of themselves,” says Smith. “It's almost like they have a superpower and medication is going to take it away.” That’s why the support of family members and loved ones is also crucial. “The success of schizophrenia patients to a great extent depends on their support system,” says Smith. The good news is that with comprehensive treatment and support, most patients can manage their condition effectively.
