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What is schizophrenia?
It is a mental disorder which affects
thinking, feeling and behaviour. It is most likely to start between
the ages of 15 to 35 and will affect about 1 in every 100 people
during their lifetime.
Although the word ‘schizophrenia’ is often
associated with violence in the media, this is the exception rather
than the rule. Hospital admission is often not needed and many
people with schizophrenia live a stable life, work, and have
relationships.
What causes schizophrenia?
It seems to be a combination of different
factors. These include genes, subtle brain damage at birth or viral
infections during pregnancy and childhood abuse. Street drugs
(ecstasy, LSD, amphetamines and crack) can probably trigger it,
particularly in teenagers using cannabis. Stressful events and
family tensions make it worse.
What are the symptoms of schizophrenia?
“Positive” symptoms
include:
- Hallucinations - hearing, smelling, feeling
or seeing something that isn’t there. Hearing voices is the most
common problem. These can seem utterly real. Although they can be
pleasant, they are more often rude, critical, abusive or
annoying.
- Delusions - believing something completely
even though others find your ideas strange and can't work out how
you've come to believe them.
- Difficulty thinking – you find it hard to
concentrate and tend to drift from one idea to another. Other
people can find it hard to understand you.
- Feeling controlled – you may feel that your
thoughts are vanishing, or that they are not your own, or that your
body is being taken over and controlled by someone else.
“Negative” symptoms
include:
Loss of interest, energy and emotions. You may
not bother to get up or go out of the house. You don't get round to
routine jobs like washing, tidying, or looking after your clothes.
You may feel uncomfortable with other people. Some people hear
voices without negative symptoms. Others have delusions but few
other problems. If someone has only muddled thinking and negative
symptoms, the problem may not be recognised for years.
Can treatment help?
The earlier you get help, the better the
outlook - and less need for hospital treatment.
Antipsychotic Medication
This helps to weaken any delusions and
hallucinations. It should also help you to think more clearly and
to look after yourself better. It can control (but not cure) the
symptoms in around 4 out of 5 people. It works best when taken
regularly, even when you have felt better for some time.
Older, ‘Typical’
antipsychotics These work by reducing the action of a
chemical in the brain called dopamine. They can cause side effects
such as stiffness and shakiness and feeling slow, restlessness,
sexual difficulties and unwanted movements, mainly of the mouth and
tongue.
Newer, ‘Atypical'
antipsychotics These work on different
chemicals in the brain. These are less likely to produce
unwanted movements but can cause weight gain, diabetes, tiredness
and sexual problems.
Psychological Treatments
- Cognitive Behavioural Therapy can help you to
live with your experiences or even help you to work out what makes
you unwell. You can then find new ways of thinking or behaving that
help you to stay well.
- Counselling can help if you need to talk to
someone or if you need support with the daily problems of
life.
- Family therapy can help you and your family
cope better with the illness. Sessions can help families learn
about the disorder, ways to support someone with schizophrenia, and
how to solve some of the practical problems that can arise.
Social Support and Recovery
- Day centres - offer classes, advice about
education and employment, and a place to spend time with other
people.
- Work projects - they will support you in
getting back to work.
- Supported accommodation – staff (on-site or
visiting) can help with day-to-day problems.
- A community mental health team key-worker can
support you, both with practical problems and with medication or
talking treatments. Occupational therapists can help you develop
skills for living, working and socialising.
Self-Help
- Learn to recognise the signs that you are
getting unwell – these can include basic things like such as going
off your food, feeling anxious or sleeping badly. Someone you trust
may be able to warn you if they see you becoming unwell.
- Try to avoid getting too stressed, or using
drugs or alcohol to feel better. Make sure you are able to do
things that you enjoy.
- Try to keep healthy - eat well, don't smoke
and keep fit.
Helping someone else
It can be hard to understand what is
happening. The person you know starts to behave differently, avoids
other people and become less active. If they have delusional ideas,
they won't always talk about them. If they are hearing voices, they
may suddenly look away from you as they listen to the voice. When
you speak to them, they may say little, or be difficult to
understand.
A person with schizophrenia can be more
sensitive to stress, so you can help by avoiding arguments and
keeping calm.
Can I talk to the mental health team?
If you are caring for your relative, you
should be able to get information from healthcare professionals.
They can advise on psychological treatments, drugs and
side-effects, and can suggest things to improve recovery.
May 2008: This is an abridged version of our
main leaflet.
Copyright (2008) Royal College of
Psychiatrists
You can link to, download, print, photocopy
and distribute this leaflet free of charge. But you must not change
it or repost it on a website.
This leaflet is made available through the
generosity of the Charitable Monies Allocation Committee of the
mental health charity St Andrew's, Northampton
Charity registration number (England and Wales) 228636 and in
Scotland SC038369.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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