Schizophrenia

What is schizophrenia?

Schizophrenia is an illness that affects thinking, feelings and behaviour in about 1% of the population at some point in their lives.

It is a major cause of disability and can affect people from all cultures and ethnic groups. Men are slightly more likely to develop the illness than women. Most people with schizophrenia first develop the condition between the ages of 16-35.

The symptoms of schizophrenia can be very dramatic and frightening for people experiencing them. They can include seeing or hearing things that are not really there – known as hallucinations, or developing unusual, often frightening beliefs, known as delusions.

Schizophrenia can also cause confused thinking which can make it difficult to follow the meaning of people’s speech. These experiences are sometimes known as ‘positive symptoms’ or psychosis. In addition to these symptoms people often have difficulty with motivation and concentration and may withdraw from social situations. These are known as ‘negative symptoms’ of schizophrenia.

Having schizophrenia does not mean that a person has a ‘split personality’. The media often stereotypes people with the condition as dangerous or violent – this is actually rare, and people with schizophrenia are more likely to be victims of crime.

Causes

We do not know exactly what causes schizophrenia, but genetics and life experiences both play a part. A number of factors have been identified which can put someone at increased risk of developing schizophrenia:

  • Having a close relative with schizophrenia
  • Experiencing problems during pregnancy and birth
  • Use of illegal drugs, including cannabis and amphetamines
  • Traumatic life events (especially in childhood)

In most cases, exactly how these things increase the risk is not yet known.

Getting help

If you think you or someone close to you may have psychosis or schizophrenia, it is important to speak to a GP or other health professional as soon as possible. The earlier the condition is diagnosed and treated, the better the outcome tends to be for the person affected.

Most people with the symptoms of psychosis or schizophrenia will be referred to mental health services for assessment.

If someone is given a diagnosis of psychosis or schizophrenia they should receive a care plan outlining how health and social care services will be able to help.

Treatments

There is no cure for schizophrenia, but in most people, symptoms can be either completely controlled or improved a lot by treatment. Many people with the illness go on to live a stable life, work, and have relationships.

A group of medicines called antipsychotics are often used to reduce symptoms of psychosis. There is evidence that these medicines work well for large numbers of people, especially in controlling hallucinations and delusions. A small number of people may not benefit very much from these treatments.

It may take a trial of a few different medications to find which works best for an individual and to balance benefits with side effects.

Psychological treatments can also help, and the National Institute for Health and Care Excellence (NICE) recommends that people with schizophrenia should be offered a combination of medicine and talking therapies.

Cognitive Behavioural Therapy (CBT) works by helping the person to identify unwanted thoughts and feelings and change them.

Other kinds of support such as Family Intervention therapy can be very useful too. This focuses on helping families understand schizophrenia, and how best to support their relative. It also tries to identify and reduce things in the person’s environment, such as stress, that can cause relapses or prevent the best possible recovery.

In severe cases, people with schizophrenia may need to spend time in hospital until they recover from symptoms of psychosis. Others may need a lot of support in their day-to-day lives on a longer term basis.

Tips for people with schizophrenia
  • It’s important to keep taking your medication unless your doctor advises otherwise. This is true even if you feel well, as the medicine dampens down the symptoms. Stopping the medicine can lead to symptoms returning. Stopping suddenly can have other negative effects too, depending on your specific treatment.
  • If you have any worries about your medication or its side effects, speak to your doctor. There are usually ways of managing side effects, but if not then other tablets may be available.
  • Talk to other people with experience of schizophrenia. It can help to know you’re not the only one, and they might be able to offer advice on managing the condition.
  • Symptoms vary a lot between different people. Learn to recognise what happens when you become unwell and be aware of the warning signs. This should be a part of your care plan and it can be useful to share these details with your family.
  • Consult your GP, psychiatrist, or pharmacist before taking any new over-the-counter drugs, and avoid illegal ones altogether – they will almost certainly make things worse.
  • Try to stay as physically healthy as possible – eating healthily, exercising and getting enough sleep are also good for keeping mentally well. Some medications can cause weight gain as a side effect, so keep an eye on your weight after starting a new treatment – the team looking after you should do this too.
  • Becoming stressed and using alcohol or drugs to make yourself feel better can make the condition worse and lead to becoming unwell.
  • Lifestyle changes, such as giving up smoking, can make a real difference to your health. If you planning to cut down or give up smoking ask advice from your doctor and mental health team.

 

Tips for partners, families and carers
  • The symptoms of schizophrenia can be a difficult for partners, families and carers to understand, so it’s important to learn as much as you can about it. Find out about the symptoms and the warning signs of a relapse.
  • Build up a good relationship with the health professionals treating the person with schizophrenia. Don’t be afraid to ask questions or share your concerns with them.
  • Make a plan with the person with schizophrenia so you know what to do if they show signs of becoming unwell.
  • Go to appointments with the person with schizophrenia whenever possible, and encourage them to ask questions for themselves
  • Let them know they are doing well. Coping with schizophrenia can be a huge challenge, and a positive approach can really help.
  • Where possible try to do things with the person rather than for them. This will help them to be independent and empower them to do things for themselves.

Resources

Jonny Benjamin challenges an expert

Neurogeneticist Professor Mick O’Donovan led the biggest genetic study of schizophrenia ever conducted, shedding new light on the biological cause of the condition. Mental health campaigner Jonny Benjamin, who lives with schizoaffective disorder, made the journey from London to Cardiff’s MRC Centre for Neuropsychiatric Genetics and Genomics to find out what the findings mean. Here, Jonny recounts the conversation.

 

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