Schizophrenia

Schizophrenia is a serious mental health condition that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and their loved ones.

While schizophrenia is a chronic condition, it can be managed effectively with treatment. Many people with schizophrenia can lead productive, fulfilling lives with proper medication, therapy, and support. Early diagnosis and treatment are important for better outcomes.

Schizophrenia symptoms are grouped into several categories:

Positive Symptoms (additions to normal behavior):

• Hallucinations: Seeing, hearing, or feeling things that aren't there
• Delusions: False beliefs that aren't based in reality
• Disorganized thinking: Difficulty organizing thoughts
• Disorganized speech: Incoherent or illogical speech
• Abnormal motor behavior: Agitation, catatonia, unusual postures

Negative Symptoms (reductions in normal behavior):

• Reduced emotional expression: Flat affect, lack of facial expression
• Reduced motivation: Lack of interest in activities
• Social withdrawal: Isolating from others
• Difficulty with speech: Brief, empty responses
• Difficulty with daily activities: Self-care, work, school

Cognitive Symptoms:

• Difficulty concentrating: Trouble focusing
• Memory problems: Especially working memory
• Difficulty with executive function: Planning, organizing
• Slow processing speed: Thinking more slowly

Symptoms usually begin in late teens to early 30s, and men often develop symptoms earlier than women.

Call Emergency Services (112 in Sweden) if:

• Thoughts of suicide or self-harm
• Severe psychotic symptoms
• Dangerous behavior
• Inability to care for self
• Immediate danger to self or others

Important: Schizophrenia requires professional treatment. Self-care should complement, not replace, professional care.

1. Take Medications as Prescribed:

   • Don't skip doses
   • Don't stop medications without doctor approval
   • Report side effects
   • Work with doctor to find right medications
   • Medications are usually long-term

2. Attend Therapy:

   • Regular therapy sessions
   • Learn coping strategies
   • Address symptoms
   • Build skills
   • Stay connected

3. Maintain Routine:

   • Regular schedule
   • Daily structure
   • Predictability helps
   • Regular sleep
   • Regular meals

4. Avoid Triggers:

   • Stress management
   • Avoid alcohol and drugs
   • Get adequate sleep
   • Manage life changes
   • Recognize early warning signs

5. Support System:

   • Family and friends
   • Support groups
   • Healthcare team
   • Don't isolate
   • Accept help

6. Self-Care:

   • Adequate sleep
   • Healthy eating
   • Regular exercise
   • Stress management
   • Activities you enjoy

• Thoughts of suicide or self-harm
• Severe psychotic symptoms
• Dangerous behavior
• Immediate danger
• Medical emergency

• Symptoms developing or worsening
• Medications not working
• Side effects from medications
• Need to adjust treatment
• Questions about management

• Regular psychiatric appointments
• Medication monitoring
• Therapy sessions
• Follow treatment plan
• Report changes

Diagnosing schizophrenia involves:

1. Psychiatric Evaluation:

   • Detailed history
   • Symptom assessment
   • Mental status examination
   • Family history
   • Medical history

2. Physical Examination:

   • Rule out medical causes
   • Check for other conditions
   • Assess overall health

3. Other Tests (if needed):

   • Blood tests
   • Brain imaging (to rule out other causes)
   • Other medical tests

Diagnosis requires:

• Symptoms for at least 6 months
• Significant impairment in functioning
• Not due to substance use or other medical condition

Comprehensive Treatment:

1. Antipsychotic Medications:

   • First-generation: Older medications
   • Second-generation: Newer medications (often preferred)
   • Long-acting injections: For some people
   • Work with doctor to find right medication
   • Usually long-term treatment

2. Psychosocial Treatments:

   • Individual therapy: Cognitive-behavioral therapy
   • Family therapy: Involve family in treatment
   • Social skills training: Improve social functioning
   • Supported employment: Help with work
   • Case management: Coordinate care

3. Hospitalization (if needed):

   • Severe symptoms
   • Safety concerns
   • Medication adjustment
   • Crisis stabilization
   • Usually short-term

4. Rehabilitation:

   • Life skills training
   • Vocational support
   • Social support
   • Community integration
   • Ongoing support

Early Intervention:

• Recognize early warning signs
• Seek help promptly
• Early treatment improves outcomes
• Better long-term prognosis
• Prevent complications

Ongoing Management:

• Continue treatment
• Take medications as prescribed
• Attend therapy
• Maintain support
• Recognize warning signs

In schizophrenia:

1. Brain Chemistry: Imbalance in neurotransmitters (dopamine, glutamate)
2. Brain Structure: Differences in brain structure
3. Symptoms Develop: Positive, negative, cognitive symptoms
4. Impact: On thinking, perception, behavior
5. Functioning: Affects daily life

Causes:

• Genetics: Strong genetic component
• Brain development: Differences in brain structure/function
• Environmental factors: Stress, trauma, complications during birth
• Complex interaction: Of multiple factors

• Most common age of onset
• Can disrupt education and career
• Early treatment crucial
• Support important
• Recovery possible

• May have been living with condition for years
• May need different treatment approach
• Higher risk of medical complications
• May need more support
• Treatment still effective

How to Help:

• Educate yourself: Learn about schizophrenia
• Be supportive: Offer understanding and patience
• Encourage treatment: Support medication and therapy
• Recognize warning signs: Know when to seek help
• Take care of yourself: Supporting someone can be challenging

What to Avoid:

• Don't blame or criticize
• Don't enable unhealthy behaviors
• Don't ignore symptoms
• Don't try to "fix" them yourself
• Don't neglect your own needs

No. Schizophrenia is not the same as dissociative identity disorder (split personality). Schizophrenia involves psychosis (loss of touch with reality), not multiple personalities.

Most people with schizophrenia are not violent. When violence occurs, it's usually related to untreated symptoms, substance use, or other factors. With treatment, the risk is very low.

Schizophrenia is a chronic condition, but it can be effectively managed. Many people with schizophrenia can lead productive, fulfilling lives with proper treatment and support. Recovery is possible.

Modern antipsychotic medications are much better than older ones. While some people may experience side effects, the goal is to find medications that effectively treat symptoms with minimal side effects. Work with your doctor to find the right medication.

Yes. Many people with schizophrenia work, especially with treatment and support. Some may need accommodations or supported employment programs. With proper treatment, work is often possible.