Schizophrenia

Schizophrenia is a mental illness that affects thoughts, feelings and behaviours. People with schizophrenia experience psychotic symptoms (difficulty telling things that are real from things that are not), unusual beliefs, thoughts and experiences. Schizophrenia is a type of psychosis, and is different from other psychotic illnesses such as schizoaffective disorder and delusional disorder.

Some people will have what is called a ‘psychotic episode’, but this does not necessarily mean they will go on to develop schizophrenia. You can find out more about this in our psychosis resource.

About 1 in 100 people will develop schizophrenia over their lifetimes. Schizophrenia is extremely rare in younger children and usually begins when someone is in their late teens.

We don’t yet know for sure. It is probably a combination of several different things, which will be different for different people:

• Genetic and environmental risk factors
• Having a parent with the condition
• Having an identical or non-identical twin with the condition
• Brain damage
• Using drugs and alcohol
• Stress caused by big life changes like accidents, bereavement, or moving home or school
• Family problems
• Experiencing physical, sexual or emotional abuse

When thinking about the causes of developing schizophrenia, it is important to remember that lots of different things are involved, and that no one risk factor causes schizophrenia.

People with schizophrenia experience psychotic symptoms that include:

• Delusions - These are strong, unusual beliefs. For example, thinking that you are being spied on by the TV or that you have special powers. These beliefs will be obviously untrue to others.
• Disordered thinking – Unclear, jumbled or confused thoughts that other people may find it difficult to follow.
• Hallucinations – Seeing, hearing, smelling or feeling things that aren’t really there. These experiences are called hallucinations. The most common hallucination that people have is hearing voices. Hallucinations can feel very real and frightening to the person having them.
• Loss of control – Feeling as though your feelings, impulses, thoughts or behaviours are not under your control, but are controlled by an external force.

If you are experiencing symptoms of schizophrenia, the people around you might tell you that you are acting strangely. For example, other people might notice that you are talking or laughing to yourself.

Other symptoms

If you have schizophrenia you might have difficulty:

• paying attention or concentrating
• understanding social situations
• remembering things
• being motivated to do things, e.g. attending school, doing sports, seeing friends or getting washed and dressed.

You might also find that your movements are slower, and you experience emotions less intensely. To other people, your behaviour might seem unusual, unpredictable or inappropriate.

If you or someone you know is experiencing any of these symptoms, or people around you are concerned about how you are acting, ask someone you trust for help, or speak to your GP.

Schizophrenia symptoms might develop suddenly or start more gradually. For someone to be diagnosed with schizophrenia, their symptoms must:

• go on for at least one month
• not be caused by another health condition (e.g. a brain tumour)
• not be caused by taking or stopping taking a substance (e.g. cannabis) or medication.

It is important to seek help as early as possible. The earlier you receive treatment, the more likely you are to recover well.

Speak to someone you trust if you feel like you or someone you know might be experiencing the symptoms of schizophrenia. This could be a parent, carer, friend or teacher.

The next step will be for you, or your parent or carer, to speak to your GP or school nurse. They might help you to get support from a Child and Adolescent Mental Health Service (CAMHS) or a specialist team for young people with psychosis, called an Early Intervention Team/Service (EIS).

When you have psychosis or schizophrenia, you might not realise that you are unwell, and the people around you might notice first and need to support you to get help. If you become very unwell, you could need to spend some time in hospital until your condition stabilises.

Getting help for yourself or someone you know can feel very scary and confusing. The sooner you ask for support, the sooner you or the person you know can start to get better.

How someone’s schizophrenia is treated will depend on their individual needs. If you have schizophrenia your treatment will likely include the following things.

Medication

Your doctor might prescribe you medications called ‘antipsychotics’. These are an important part of treatment for schizophrenia, and can help to reduce your symptoms. You might need to take these every day, or even multiple times a day for a long time in order to stay well.

There are different kinds of antipsychotics, and you can work with your doctor to decide which kind is right for you. As with medication of any kind, there can be side-effects. Your doctor will be able to explain to you what these are so that you know what to expect.

Talking therapies

Talking therapies like cognitive behavioural therapy (CBT), counselling or family therapies can all be helpful. They should be used alongside medication.

Lifestyle changes

If you are taking drugs or have an underlying physical illness, you might need specific help and treatment to manage these things. You and the people who support you might need help to understand more about your illness, how to manage it, and how to make it less likely that you will become ill again. You may need support to rebuild your confidence to continue with school, college or work.

For young people

• Young Minds, information on schizophrenia – Young Minds is the UK’s leading charity fighting for children and young people’s mental health. Read their information for young people on schizophrenia.
• Mind, information on schizophrenia – Find out more about schizophrenia from the mental health charity Mind.
• Rethink Mental Illness, information on schizophrenia – Read this information on schizophrenia from the charity Rethink Mental Illness.
• Talk to Frank – Talk to Frank offers accurate information on drugs and addiction.

For friends and family

• Rethink Mental Illness, information on schizophrenia for carers, friends and family – This section of the Rethink Mental Illness website offers advice and further support to carers, friends and family of people with schizophrenia.
• Epic Friends – This website aims to help young people to support their friends who might be struggling emotionally.

Revised by the Royal College of Psychiatrists’ Child and Family Public Engagement Editorial Board (CAFPEB) and the National Collaborating Centre for Mental Health (NCCMH).

This resource reflects the best possible evidence at the time of writing.

Full references for this resource are available on request.