Everything You Need To Know About Schizophrenia

This serious—and often misunderstood—condition can be challenging for both patients and their families; but with the right treatment, people with schizophrenia can live rewarding lives

February 2, 2022

Schizophrenia is a serious mental health condition that affects how people think, feel, and behave. People with schizophrenia experience psychosis with symptoms that include hallucinations (seeing or hearing things that aren’t there), and delusions (believing things that cannot be true).

When people struggle with these occurrences, they often lose a shared sense of reality. They also often face stigma for behavior that strikes other people as being strange or bizarre.

Those living with schizophrenia often struggle with scary and confusing experiences. Because of this, they need compassion and understanding from those around them.

Friends and family can learn how to support loved ones with this condition. With the right treatment, people with schizophrenia can live rewarding lives.

Keep Reading To Learn

  • Possible causes and risk factors for schizophrenia
  • How schizophrenia is diagnosed
  • How to manage and treat schizophrenia

What Is Schizophrenia?

Mental health issues come in many different forms.

Schizophrenia is a serious condition that can impact how someone behaves, thinks, and feels. People with schizophrenia may appear as though they have lost touch with reality, causing severe distress for themselves, their family, and friends.

Schizophrenia is often diagnosed following the first time that a person experiences psychosis. With an episode of psychosis, someone’s mind is affected and they have trouble seeing or understanding reality. Psychosis can include hallucinations, delusions, or disordered thoughts or speech. This can be frightening and confusing to the person, especially the first time a psychotic episode is experienced.

With schizophrenia, gradual changes in social functioning, mood, and thinking can also emerge.

People sometimes confuse schizophrenia with dissociative identity disorder (DID), but each is a different condition with different symptoms.

When a person has DID, instead of experiencing delusions or hallucinations, they feel “checked out” from the world around them. Someone with DID may feel incredibly organized and in control of the situation they’re in, provided they aren’t dissociating from themselves at the time. Meanwhile, someone with schizophrenia is likely to experience confusion; they may believe, hear, or see things that aren’t real, or feel out of control.

By better understanding schizophrenia and recognizing the signs and symptoms related to it, we can help people to find and access the care and support they need.

In Her Own Words

Deconstructing Stigma participant Mindy

As a participant in McLean’s Deconstructing Stigma campaign, Mindy shares her story of living with schizophrenia.

Deconstructing Stigma participant Mindy

Understanding the Signs and Symptoms

For someone to be diagnosed with schizophrenia, they must experience psychotic symptoms such as abnormal thinking, odd behaviors, changes in vision, hearing, or smell. They often experience themselves, and the world, in a distorted way. For a diagnosis to be confirmed, symptoms must persist for at least six months.

In many cases, schizophrenia symptoms show up during early adulthood. It is likely that more subtle signs of schizophrenia are present earlier but may be missed. Some of the more overlooked early symptoms include poor school performance, reduced motivation, and issues with personal relationships.

Men usually develop symptoms during their late teen years and early thirties, while women usually developing symptoms during their twenties and early thirties.

Often, episodes of psychosis will decrease as people get older. However, using recreational drugs, drinking, and not taking prescribed medications can make symptoms worse.

People with schizophrenia have three categories of symptoms—positive, disorganized, and negative.

Positive Symptoms

Positive symptoms are symptoms that are present but should not be, such as hallucinations and delusions.

Hallucinations include seeing or hearing things that are not there. For example, hearing voices or seeing people who may have died years ago.

Delusions include having outlandish beliefs—even in the face of evidence that disproves them. For example, someone may believe that they have superpowers.

Disorganized Symptoms

People with schizophrenia can experience disordered or disorganized thinking—including problems with memory, concentration, and sustained attention. It can be hard for someone to follow what the person is thinking or saying, or they may bounce from thought to thought without any rhyme or reason.

Motor skill-related symptoms can develop, which are also categorized as disorganized symptoms. For example, people may display abnormal movements, leading to seemingly bizarre behavior.

Negative Symptoms

People with schizophrenia often experience negative symptoms as well. Some of the most common negative symptoms of schizophrenia include:

  • A reduced motivation to go to school or work
  • Problems planning out a daily routine
  • Difficulty sustaining activities
  • An overall feeling of apathy about everyday life
  • Flat affect, which refers to reduced facial expressions and vocal tones
  • Speaking less frequently and at a lower volume

Negative cognitive symptoms can interfere with everyday activities. Following conversations, learning new things, and remembering appointments can be difficult. Some of the most common cognitive symptoms of schizophrenia include:

  • Difficulty processing information to make the correct decision
  • Difficulty focusing on the task at hand
  • Problems paying attention
  • Issues applying information that has been learned

It is important to note that many of the symptoms of schizophrenia can fade in and out. Like other medical conditions and mental health issues, schizophrenia’s severity can vary. Each person’s experience is different, with the frequency of episodes varying from person to person.

Schizophrenia in Teens

Even though schizophrenia can develop in teens, it is often overlooked when symptoms are most commonly associated with other disorders. In addition, many of the symptoms can be confused for normal teenage development.

Some of the most common symptoms of schizophrenia in teens include:

  • Withdrawing from family members and friends
  • A lack of motivation to go to school and/or engage in extracurricular activities
  • Changing sleep patterns
  • Irritability with family members and friends
  • Decrease in school performance

When compared to adults who are diagnosed with schizophrenia, teens with the condition are less likely to have delusions but are more likely to have visual hallucinations. When teenagers mention having experienced hallucinations, it is often assumed to be related to recreational drug use. Though this is a possibility, it is important not to rule out the onset of schizophrenia.

If symptoms persist but the affected teenager has not engaged in treatment, the symptoms can worsen, sometimes to a point that it can keep future treatment from being effective and helping the person maintain a normal standard of living.

It is important to keep in mind that schizophrenia can be diagnosed in this age group, and if someone is experiencing these symptoms, it is crucial to make sure that they are evaluated by a health care professional.

Understanding Psychosis

McLean OnTrack

In this video, we meet Amy and learn about what it’s like for her when she experiences psychosis.

McLean OnTrack

Reviewing the Facts About Schizophrenia

To dispel myths about schizophrenia, it is critical to understand the frequency and seriousness of this mental health condition.

Close to 3.5 million people in the United States live with a diagnosis of schizophrenia, making it one of the top 15 leading causes of disability.

Most people who have schizophrenia do not receive the care they require. They are less likely to seek the medical care they need compared to people with other mental health issues.

People with schizophrenia often also have physical illnesses, making the life expectancy of a person with schizophrenia about 20% lower than the general population.

High blood pressure and high cholesterol are not uncommon. Schizophrenia is also commonly associated with the metabolic syndrome that can cause type 2 diabetes and insulin insensitivity.

In addition, close to half of all people who are diagnosed with schizophrenia also struggle with a secondary mental health issue.

Mental illness can lead to significant financial problems. However, people diagnosed with schizophrenia face an even higher financial burden.

Between one-third and one-half of all adults who are homeless in the U.S. have been diagnosed with schizophrenia.

People with schizophrenia are also at greater risk of being involved in the criminal justice system and are more likely to be unable to work, or to struggle with other social problems.

Unfortunately, there is also a greater risk of dying at a younger age compared to the average person. Close to 5% of people with schizophrenia end up taking their own lives, a significantly higher rate than the total population.

People living with schizophrenia are at a greater risk of dying by suicide immediately after their diagnosis than later in life.

A diagnosis of schizophrenia doesn’t always mean a bad outcome. A study conducted at USC interviewed 20 men and women who effectively managed their psychotic symptoms while managing employment. They adopted coping strategies, engaged with supportive peers, and practiced cognitive strategies to help them reason through problematic thoughts.

Approximately half of patients with schizophrenia recover or have significant improvements over time, which can lead to a productive, fulfilling life.

Who Is Most Likely To Be Diagnosed With Schizophrenia?

While the overall cause of the condition is unclear, it is likely that more than one factor plays a role in who may develop schizophrenia. Some important risk factors include family history and biological factors.

Family History

Schizophrenia can run in families. This does not mean that because one family member has been diagnosed, everyone else will get it. It simply means that schizophrenia can have a genetic component.

Because genes are passed down from parents to children, it is possible for multiple people in the same family to be diagnosed. But no single gene can cause schizophrenia by itself.

A positive family history could mean that relatives are more likely to develop the condition. It’s important to talk to your providers about family history of any health conditions—including schizophrenia—so they can determine any heightened risk you or a loved one may have.

Social Factors

Someone’s environment could contribute to the development of schizophrenia. People who live in poverty, are exposed to high or chronic levels of stress, or who use drugs on a regular basis could be more likely to develop the condition. It is important to screen for social factors when considering a diagnosis.

Previous History of Mental Health Issues

It is not unusual for someone with schizophrenia to be diagnosed with other mental health issues, such as depression or substance use disorder. Anyone who has another mental health issue is at a greater risk of developing schizophrenia compared to the overall population.

Brain Structure

People with schizophrenia likely have differences in the way neurons in their brains communicate using neurotransmitters. For example, differences in the size of certain brain structures could contribute to the development of the condition.

There are many changes in brain structure that occur during puberty, including issues with dopamine, a “feel-good” chemical the brain makes. These changes could trigger episodes of psychosis in individuals who are already at risk of psychotic episodes due to genetic and environmental exposures.

How Schizophrenia Is Diagnosed

Often people with schizophrenia are diagnosed with other mental health issues first. Before making a diagnosis of schizophrenia, it is important to make sure the symptoms displayed are not developing due to medications, a substance use disorder, or another medical condition.

Below we’ve outlined the steps a medical team will take to diagnose schizophrenia. It may seem like a lot, but not every person’s diagnosis will include all these steps.

Medical History

First, the doctor takes a thorough medical history. It is important to find out what the symptoms are and when they showed up. It’s also important to know if any treatments have been tried. This helps the doctor develop a differential diagnosis, which could include schizophrenia.

Physical Exam

The doctor may perform a physical exam to rule out other problems that could be causing symptoms. It is also important to check for any related complications.

Lab Tests

The doctor may order several lab tests. These check for underlying issues that could be contributing to symptoms. For example, it is possible for electrolyte disturbances to impact the overall functioning of the central nervous system, which could contribute to many of the same symptoms. The doctor may also screen for alcohol and drugs, as some drugs can contribute to hallucinatory symptoms.

Imaging Scans

The doctor may order imaging scans, such as a CT scan or MRI. People who have suffered a brain injury may show many of the signs and symptoms of schizophrenia. This type of injury may be identifiable on an imaging scan.

Psychiatric Evaluation

To make a diagnosis of schizophrenia, it is important to involve a licensed mental health professional. They can conduct a thorough evaluation of someone’s mental health, including observing their demeanor, appearance, and possible hallucinations. They also look for evidence of schizophrenia in a family history.

Schizophrenia Can Be Treated

Untreated schizophrenia can lead to significant quality-of-life issues. However, symptoms can be managed with a well-rounded treatment plan.

Like other mental health conditions, treatment for schizophrenia may involve both prescription medications and therapy. However, not every person’s experience of schizophrenia is the same, so what works for one person may not work for another.

It is important for anyone experiencing symptoms to immediately seek help from a trained medical professional. The earlier schizophrenia is diagnosed, the sooner treatment can start, which can make a world of difference in someone’s overall prognosis.


One pillar of the treatment process involves antipsychotic medications, which are designed to reduce the frequency and intensity of psychotic symptoms. Many antipsychotic medications are available, though many also have side effects. These include restlessness, dry mouth, drowsiness, and weight gain.

Side effects often subside over time; however, there are situations where they persist. If this is the case, people may be tempted to stop taking antipsychotic medications abruptly.

It is critical for patients to keep taking antipsychotic medications. Stopping medication leads to dangerous side effects and rebound symptoms. The symptoms of schizophrenia become notably worse if medication is stopped “cold turkey.”

Young man is comforted by person with hand on shoulder

Patients who have concerns about their medications should reach out to a trained medical provider before changing anything medication-wise. That way, an alternative plan can be developed without potentially causing harm.

In many situations, people with schizophrenia also have other chronic medical conditions. Mental health providers tailor medication choices to avoid side effects that could worsen pre-existing medical conditions or decrease quality of life.

It is important for individuals and their care providers to approach the medical management of schizophrenia as a team. Doctors and patients should work together to decide on the right medications. This will help patients manage their symptoms while avoiding serious side effects.


Often, people with schizophrenia engage in talk therapy in addition to using medication to manage their symptoms. Therapy addresses the condition’s negative and disordered symptoms. Several types of therapy can be helpful, as patients can benefit from behavioral skills development, cognitive behavior therapy, and mindfulness and acceptance exercises.

Therapy is important because it teaches people living with schizophrenia how to cope with psychotic symptoms. In addition, therapy can address many of the challenges they face regularly. This helps to guide them as they pursue long-term goals, such as forming meaningful relationships, finishing school, and holding down a job.

Family therapy may also be helpful, as many people with schizophrenia rely on the support of family and friends. By participating in these sessions, family and friends can empower those with schizophrenia to cope with symptoms, deal with stressful situations, and increase their independence.

It can also be helpful for loved ones to attend family education sessions, so they can learn how to offer effective support.

Some of the most important examples and benefits of therapeutic and related social interventions for schizophrenia include:

  • Individual therapy helps normalize thought patterns
  • Stress management training teaches people how to cope with symptoms and challenges they face regularly
  • Cognitive-behavioral therapies can help people learn when they are going to relapse; they can take appropriate actions to address emerging issues sooner.
  • Social skills training is an important part of managing schizophrenia; it helps people learn how to communicate with others, which can help individuals with many aspects of day-to-day life
  • Family therapy is designed to help loved ones learn how to support someone who has been diagnosed with schizophrenia
  • Vocational rehabilitation teaches people meaningful skills that can help them land a job

It is possible for people with schizophrenia to live on their own. However, many require help in some way. For example, someone may need to check on the individual on a regular basis. A case manager can help people with schizophrenia find the support they need. With this type of assistance, many people can successfully manage their illness.

To sum up, the combination of therapy, social support, and antipsychotic medications can help many people with schizophrenia lead rewarding lives.

What About Using Electroconvulsive Therapy (ECT) To Treat Schizophrenia?

Every case of schizophrenia is different. Many people respond well to a treatment plan that consists of antipsychotic medications and therapy. Some people may still fail to respond, though. In this situation, it can be helpful to consider electroconvulsive therapy (ECT) as part of a treatment plan.

There are many misconceptions about ECT. The goal of electroconvulsive therapy is to trigger a brief seizure in the brain, which is proven to help reduce symptoms related to depression and schizophrenia.

Using ECT to treat patients with depression or schizophrenia is determined on a case-by-case basis. It is important for people to learn more and to meet with a trained mental health provider if they consider this option.

Learn more about how ECT is becoming a common treatment for depression and schizophrenia

Helping a Loved One Cope With Schizophrenia

As with any mental health condition, it is important to show compassion and be supportive to people experiencing schizophrenia. If someone you know has been diagnosed with schizophrenia, you might wonder how you can help them successfully manage their illness.

First, learn everything you can using the many reliable resources that are available. Most importantly, you should learn about helping your loved one stick to their treatment plan. This may include ensuring that they have a reliable way of tracking their medication usage or that they have a reliable way to attend therapy sessions.

Schizophrenia can be severe, and hallucinations and delusions can be difficult to witness. It can be hard to understand what someone is going through. The most important thing is to make sure your loved one knows that you are there for them.

It is also incredibly important to help your loved one abstain from using certain substances. People with schizophrenia should stay away from alcohol and drug use. Tobacco, nicotine, alcohol, and recreational drugs make treatment difficult and can complicate symptoms. These substances also interact with antipsychotic medications, making side effects worse.

People living with schizophrenia often need assistance finding affordable housing and transportation. This is where a social worker can be especially helpful. Being an advocate for a loved one in this type of situation will help ensure that they are able to take advantage of the services available to them.

Help your loved one set long-term goals. Managing this condition is an ongoing process—if people have goals, they will stay motivated to stick to their treatment plan.

Finally, you may also want to join a support group. If you are helping someone cope with schizophrenia, you are going through stressful experiences yourself. If you surround yourself with others in same situation, you may be able to lean on and learn from them.

Want More Info?

Looking for even more information about schizophrenia? You may find these resources helpful.

Interesting Articles and Videos and More

Learn more about schizophrenia and what you can do if you or a loved one is displaying signs of this disorder or are having trouble managing mental health challenges.

Helpful Links

These organizations may also have useful information:

Schizophrenia and Psychosis Action Alliance
An organization dedicated to improving the lives of those affected by schizophrenia-related brain illnesses, reducing stigma, and promoting recovery through support groups, advocacy, and public education.

Schizophrenia International Research Society
An organization that brings together researchers from around the world with the purpose of advancing the research of schizophrenia and related disorders.

Books About Schizophrenia

Book cover - Social Cognition in Psychosis

Social Cognition in Psychosis
edited by Kathryn Eve Lewandowski and Ahmed A. Moustafa
(Elsevier, 2019)