People with schizophrenia can have a hard time telling what’s real and what’s not. They may see things that aren’t there or hold firm beliefs that fly in the face of fact. Understanding schizophrenia’s nature can help patients and their loved ones regain a sense of control.
It's crucial to recognize that schizophrenia is a real illness, not a character flaw, says Philip D. Harvey, PhD, a professor of psychiatry and behavioral sciences at the University of Miami. With advances in brain research, he says, "it will become clear that this is a condition that is caused by biological factors."
Recent studies have shown that the brains of people with the disorder tend to look and work differently from those without mental illness. Scientists suspect that some of these differences develop before birth, although symptoms usually don't appear until young adulthood, between ages 16 and 30.
“Positive” doesn’t mean something is good. It means that someone has overactive, distorted aspects of thinking. Positive symptoms include:
Hallucinations: seeing or hearing things that aren't real. The most common hallucination in schizophrenia is hearing voices.
Delusions: unshakable but false beliefs. Some people think they are being followed or persecuted. Others believe they are famous or have superhuman powers.
“Negative” symptoms are more subtle. They can seem like signs of depression. These include speaking in a dull voice and finding no pleasure in daily life.
People with cognitive symptoms might have trouble concentrating, remembering things, or making decisions. This can make it hard to keep a job or manage daily activities.
"It's very important for people to realize that cognitive problems and a reduction of motivation are symptoms of the illness," Harvey says, "and not signs of laziness."
Begin Treatment Right Away
Doctors diagnose schizophrenia when someone has psychotic episodes (hallucinations or delusions) that can’t be explained by drug abuse or other medical conditions.
Starting an antipsychotic medication immediately offers the best hope of getting symptoms under control.
"The longer a person goes without treatment, the greater the risk of damage to the brain and a poor outcome,” says Steven Jewell, MD, an associate professor of psychiatry at Northeast Ohio Medical University.