Schizophrenia: Symptoms, Causes, & Treatments

What Is Schizophrenia?

Schizophrenia spectrum disorders refer to psychotic symptoms that significantly impact daily functioning. Those with schizophrenia experience negative, positive, and cognitive symptoms, but the severity depends on the person and treatment management.

Experts previously categorized different types of schizophrenia, such as paranoid, disorganized, and catatonic, according to presenting symptoms. However, they have since introduced the umbrella term “schizophrenia spectrum disorders” to encompass various presentations.¹

The categories of schizophrenia symptoms include:

• Negative symptoms: The negative symptoms of schizophrenia involve the restriction or absence of appropriate emotional expression, fluency of thought and speech, and appropriate or productive behavior.
• Positive symptoms: The positive symptoms of schizophrenia reflect an excess or distortion of functioning. These include hallucinations, delusions, disorganized speech, and grossly disorganized or catatonic behavior. Some people with schizophrenia experience anosognosia during hallucinations or delusions.
• Disorganized symptoms: Disorganized symptoms include problems with functioning, thinking or speaking impairments, and blunted or flat affect. Symptoms can also manifest as forgetfulness, repetitive behavior, and difficulties with goal-directed behavior.²
• Cognitive symptoms: Cognitive symptoms of schizophrenia refer to issues with attention, verbal learning and memory, executive function, and working memory. These can range in severity and type.²

Schizophrenia Symptoms

Schizophrenia is a progressive mental illness with little chance of improvement or reversal of symptoms without treatment. In fact, someone with schizophrenia may appear rather high-functioning before declining in school, work, relationships, usual activities, and personal responsibilities as symptoms manifest.

In the early development of symptoms, known as the prodromal phase of schizophrenia, the individual may struggle to accept the validity of the first presence of hallucinations and delusions. But as symptoms progress, the individual can become increasingly convinced that these experiences reflect something mysteriously surreal or a hidden truth that requires further acknowledgment or understanding.

Below are the signs and symptoms of schizophrenia:

• Hallucinations: People with schizophrenia can experience hallucinations from any perceptual dimension, including auditory, visual, tactile (touch), somatic (bodily), or gustatory (taste/smell). The most common type of schizophrenic hallucination is auditory, particularly hearing voices.
• Delusions: Schizophrenic delusions can encompass a range of bizarre and non-bizarre false ideas. Non-bizarre reflects plausible situations, while bizarre involves something that does not occur in reality.
• Disorganized speech patterns: People with schizophrenia may present tangential, disrupted, or incoherent speech. At times, schizophrenic speech may sound like a “word salad.”
• Disorganized behavior: People with schizophrenia can exhibit disorganized thoughts and behavior, and their affect may not be socially appropriate to the given situation.
• Catatonia: Catatonia in schizophrenia includes a lack of speech, odd or strange movements, and remaining very still.
• Negative symptoms: The negative symptoms of schizophrenia include problems with goal-oriented activities, anhedonia (lack of pleasure), flat or blunted affect, and social withdrawal.

Signs of Schizophrenia

Sings of schizophrenia vary based on the situation, individual, and presenting symptoms. What triggers schizophrenia is unknown, but signs typically emerge in late adolescence and early adulthood.

Early warning signs of schizophrenia include:

• Social withdrawal
• Drop in academic performance
• Sleep disturbances
• Lack of motivation
• Trouble concentrating
• Increased irritability

Schizophrenia Causes & Risk Factors

Specific schizophrenia causes are unknown. However, various influences affect development, and the predominant causal factor of schizophrenia appears to be genetic. People with the genetic markers for schizophrenia are at a greater risk of symptoms than those without these genes. Evidence also suggests environmental factors may influence the onset of schizophrenia, such as trauma and stress.

Below are possible causes of schizophrenia:³

• Childhood trauma: Trauma changes the brain, which may increase susceptibility to developing mental health conditions, including schizophrenia.
• Brain chemistry: Some evidence shows that people with schizophrenia have imbalances of serotonin, glutamate, and dopamine.
• Genetic factors: Scientists have long observed that schizophrenia runs in families. Individuals with schizophrenia likely have first-degree relatives with the condition.
• Birth complications: Obstetric complications, including preeclampsia, inertia of labor, and a gestational age younger than 33, may increase the risk of developing schizophrenia.
• Drug use during youth: While drugs alone likely do not cause schizophrenia, some research has shown that chronic use of cannabis, LSD, amphetamines, and cocaine may correlate with psychotic disorders.
• Chronic stress: Stress may be a factor in triggering the initial onset of schizophrenic symptoms.
• Abnormal brain structures: Research shows schizophrenia is related to brain changes in several essential systems, including the medial temporal lobe regions and prefrontal cortex.

How Is Schizophrenia Diagnosed?

A mental health professional trained in diagnosing schizophrenia and other psychotic disorders can assess for schizophrenia. They will use the DSM-5 schizophrenia criteria to review current symptoms and establish a working diagnosis. In addition to current schizophrenia diagnostic criteria, mental status and physical exams can rule out other possible medical or neurological issues.

Treatments for Schizophrenia

Treatment for schizophrenia ultimately involves a collaborative approach among various mental health providers and services that address different areas of dysfunction. Establishing and maintaining comprehensive treatment services for people with schizophrenia can be challenging for several reasons. However, understanding individual needs can help make the process more seamless and effective.

Therapy

Numerous treatment options are available for schizophrenia, and therapy can be effective during all stages of development. A therapist can help people better understand their symptoms and manage the stress of everyday life. Therapists can also provide a supportive, compassionate environment to process other related concerns, including corresponding trauma or relationship issues.

Below are therapy options for treating schizophrenia:

• Cognitive-behavioral therapy (CBT): CBT helps people understand the relationship between their thoughts, feelings, and actions. Changing negative thoughts can improve how people feel and react to stress.
• Family therapy: Family therapy may help family members better understand schizophrenia and provide support to their loved ones.
• Recovery-oriented cognitive therapy (CT-R): This therapy aims to improve resiliency and empowerment for people with psychotic disorders.
• Cognitive enhancement therapy (CET): Also called cognitive remediation, CET can help people strengthen social and occupational skills often deficient with schizophrenia.
• Social skills training: Social skills training focuses on increasing the quality of social interactions and relationship satisfaction.

Medication

Treatment for schizophrenia typically requires antipsychotic medications and others to help improve functioning. Antipsychotics can effectively reduce and manage positive symptoms, particularly hallucinations and disorganized thinking.

Unfortunately, less robust options are available for negative symptoms. Doctors can recommend other psychiatric medications in tandem with antipsychotics to improve related symptoms, including depression and anxiety.

Can Schizophrenia Be Cured?

There is currently no cure for schizophrenia. However, schizophrenia is considered a treatable condition, and people can live meaningful lives when managing their symptoms and triggers. People with schizophrenia should adhere to treatment to improve their chances of recovery success. Failure to comply with treatment may lead to symptom regression.

Living & Coping with Schizophrenia

Because schizophrenia can threaten many different areas of life, actions beyond medication and psychotherapy are necessary for long-term success. While this mental disorder can be pernicious, many people with schizophrenia enjoy accomplishments through various creative and vocational pursuits and fulfilling relationships.

Below are healthy ways to cope with symptoms of schizophrenia:

• Keep taking medications as prescribed: Medication can reduce or eliminate unwanted schizophrenia symptoms, so adhering to your prescription is crucial. Talk about any difficult side effects you experience with your doctor or psychiatrist.
• Maintain self-care: Self-care is essential for maintaining emotional wellness. Regularly prioritize activities that feel pleasurable and uplifting.
• Seek local resources: Local community resources can help you with everything from budgeting to vocational skills. Tapping into these resources can help improve your quality of life.
• Lean on loved ones: Your loved ones are your support system– build trustworthy connections with people who care about your well-being.
• Avoid substance use: Substance use often exacerbates mental illness and may worsen your schizophrenia symptoms.

Final Thoughts

Living with schizophrenia can be challenging for individuals and their loved ones. But, we have made significant strides in understanding and treating this condition. You are not alone, and you are not simply your diagnosis. Taking care of yourself and learning to live full, vibrant lives with schizophrenia is possible with the right treatment.