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Help With Schizophrenia

Curated and updated for the community by APA

Topic Information

Schizophrenia is a chronic brain disorder that affects about one percent of the population. When schizophrenia is active, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking and lack of motivation. However, with treatment, most symptoms of schizophrenia will greatly improve and the likelihood of a recurrene can be diminished.

While there is no cure for schizophrenia, research is leading to innovative and safer treatments. Experts also are unraveling the causes of the disease by studying genetics, conducting behavioral research, and using advanced imaging to look at the brain’s structure and function. These approaches hold the promise of new and more effective therapies.

The complexity of schizophrenia may help explain why there are misconceptions about the disease. Schizophrenia does not mean split personality or multiple-personality. Most people with schizophrenia are not any more dangerous or violent than the general population. Most people with schizophrenia live with their family, in group homes or on their own.

Read more on symptoms & treatment

  • Jun 09, 2021
Be Well at Work: Helping Employees with Depression

Depression is one of the most comment mental illnesses and has a significant impact on workers and employers. An estimated one in eight working-age adults has depression, yet only about half of adults with depression are diagnosed, and less than half of those diagnosed receive recommended care.(1) In addition to the health impacts of depression on individuals and families, it also takes a significant economic impact. A new study highlights the Tufts Be Well at Work program, that helps employees with depression. Published in Psychiatric Services, a journal of the American Psychiatric Association, the study presents the results from 15 years of research evaluating the occupational, clinical, and economic impact of Be Well at Work.

  • May 27, 2021
The Economic Cost of Depression is Increasing; Direct Costs are Only a Small Part

Depression is one of the most common mental disorders and can cause tremendous challenge and burden for individuals and families. It also carries a large economic cost. The economic burden of major depressive disorder among U.S. adults was an estimated $236 billion in 2018, an increase of more than 35% since 2010 (year 2020 values), according to research published in early May in the journal Pharmacoeconomics.

  • May 17, 2021
Cannabis: Understanding the Risks

At a recent session at the APA Annual Meeting, a panel of psychiatrists addressed many of the common misconceptions around cannabis. With more states legalizing cannabis and changing public perceptions, there is confusion around its safety and uses. At the APA session, Smita Das, M.D., Ph.D., M.P.H., provided an overview of cannabis and its current use. To date, 16 states and the District of Columbia have legalized cannabis for recreational use by adults, and 36 states legalized it for medical use. However, cannabis is still a federal schedule 1 substance (most restricted schedule) under the Controlled Substances Act.

My friend with schizophrenia smokes marijuana and drinks a lot, it that related to the schizophrenia?

Substance abuse is a common problem in persons with schizophrenia, including tobacco, marijuana, alcohol and other drugs. Abuse has all the usual health-related problems, but the presence of schizophrenia complicates this issue. Patients may stop their antipsychotic medications if they believe it interferes with the marijuana or alcohol effect. Disorganized thinking and behavior may be made worse. Marijuana increases the risk of schizophrenia in vulnerable young people and may complicate the course of schizophrenia. Impaired cognition is common in schizophrenia and misused drugs adversely affect cognition, such as attention, memory, task orientation and the like. There are many good reasons to avoid substance misuse. More

Does everyone with schizophrenia need to take medication? Can therapy help someone with schizophrenia?

All persons with schizophrenia need drugs some of the time and most will do better with continued use of medication to help control symptoms and prevent relapse. But the drugs are not effective for all aspects of the illness. Cognitive behavioral therapy may help with certain symptoms and supportive psychotherapy can support personal strengths and improve quality of life. Vocational programs increase the chances of successful employment. Family psychoeducation can give patients and family members a better understanding of the disorder and what will be helpful. A relationship with a case worker may help with the problems of daily living and supportive psychotherapy may help. New treatments such as neuromodulation are being developed and drugs with novel mechanisms of action are being tested. 

So, yes, drug treatment is important, but many patients will not take medication continuously for long periods and many experience side effects that have to be addressed. An integrated, comprehensive approach works best. More

What are the first symptoms someone would notice if they had schizophrenia?

The earliest signs and symptoms come before a diagnosis can be certain. There is now a growing emphasis on identifying young people at high risk for a psychotic disorder and offering treatment and services in advance of a full psychotic experience. At this stage symptoms and signs include problems with personal relationships and school or work performance, experiencing odd phenomena such as hearing a voice or noise but being uncertain if it was really heard, or becoming excessively suspicious. Also, some people may develop a “loner” lifestyle, a sense that something is wrong and that one’s mind is playing tricks, and other things that mark a change in life course. These may are not always early schizophrenia symptoms, but it is a good time for clinical assessment and care in hopes of preventing a progression to a full first episode of psychosis.

At first episode of schizophrenia, common symptoms include paranoia, hearing voices or seeing visions, disorganization of thoughts and behavior, low motivation and reduced experience of pleasure, anxiety, fear, depression, sleep disturbance, social withdrawal and sometimes poor emotional control seen as anger and hostility.

All the signs and symptoms can occur at a mild level in people who are not ill. A diagnosis must look at the severity of the symptoms, their impact on function and resulting distress. It is critical to rule out other possible causes of these symptoms before a diagnosis of schizophrenia. More

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About the Expert:

William Carpenter Jr., M.D.
Professor of Psychiatry and Pharmacology
University of Maryland School of Medicine
Editor-in-Chief, Schizophrenia Bulletin
October 2020

Patient Stories
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Myles’ Story

Myles was a 20-year old man who was brought to the emergency room by the campus police of the college from which he had been suspended several months ago. A professor had called and reported that Myles had walked into his classroom, accused him of taking his tuition money and refused to leave.

Read More 

Editor's Choice

May 11, 2021
Through my eyes: What it’s like to live with schizophrenia
Medical News Today

If you have ever wondered what it’s like to live in an alternate reality, then you have imagined my entire life. In 2018, I was diagnosed with early onset schizophrenia. Based on my earliest memories, hallucinations, delusions, and bizarre thinking have always influenced the way I see the world. My condition has grown with me, and it has shaped the trajectory of my life. Without my schizophrenia, I would not be the person I am today. Although my experience has often been harrowing, I am grateful for the life I have lived and the chance it has given me to give back to others.

April 28, 2021
Mom who struggled to accept her son's schizophrenia talks about crisis services
ABC News

Nick O’Rourke was diagnosed with schizophrenia at age 20. It’s been 15 years since then, and his mom, Mimi Feldman, says it’s as if her son is “stuck in time.” For Nick O’Rourke there is no one-size-fits-all treatment available, said Feldman. “I never give up hope, but the medications -- the standard medications – not great,” she said. Nick O’Rourke’s parents, however, say that the medication he’s been taking most recently, Clozapine, has made him the best version of himself that they’ve seen in a decade.

April 27, 2021 
7 Ways to Support a Loved One with Schizophrenia
Healthline

Schizophrenia is a mental health condition that involves a disconnect from reality.  Along with symptoms that affect concentration and memory, people living with schizophrenia experience psychosis, which includes hallucinations and delusions. They might lose interest in their usual activities, struggle with self-care, and withdraw from loved ones. If your loved one lives with schizophrenia, you might wonder how you can best offer support. Here’s a look at seven ways to help, along with some tips on what to avoid: Read up, Validate, Ask questions, Stay in touch, Make a crisis plan, Offer encouragement, Help with goals.

Resources

Additional Resources and Support

Physician Reviewed

Felix Torres, M.D., MBA, DFAPA
August 2020