What is Schizophrenia?
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Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. If left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective treatments are available. When delivered in a timely, coordinated, and sustained manner, treatment can help affected individuals engage in school or work, achieve independence, and enjoy personal relationships.
In this article, we will cover some of the disorders, their causes, diagnosis, and how to recognize the symptoms. Diagnosis and the treatments and also living with the disease or living with someone who has schizophrenia.
Different Types of Schizophrenia?
In the past, there were different subtypes of schizophrenia, including:
Paranoid schizophrenia.
Disorganized, or hebephrenic schizophrenia.
Catatonic schizophrenia.
Childhood schizophrenia.
Schizoaffective disorder.
Types of Schizophrenia
Paranoid schizophrenia.
Paranoid schizophrenia, or schizophrenia with paranoia as doctors now call it, is the most common example of this mental illness.
Schizophrenia is a kind of psychosis, which means your mind doesn’t agree with reality. It affects how you think and behave. This can show up in different ways and at different times, even in the same person. The illness usually starts in late adolescence or young adulthood.
Disorganized or hebephrenic schizophrenia.
Disorganized schizophrenia is one of the five subtypes of schizophrenia. It is characterized by disorganized behavior and speech and includes disturbance in emotional expression. Hallucinations and delusions are less pronounced with disorganized schizophrenia, though there is evidence of these symptoms occurring.
Catatonic schizophrenia.
Catatonic schizophrenia is one feature of a serious mental illness called schizophrenia. Schizophrenia prevents you from separating what’s real from what’s not, a state of mind called psychosis.
Catatonic schizophrenia affects the way you move in extreme ways. You might stay totally still and mute. Or you might get hyperactive for no reason. The new name for this condition is schizophrenia with catatonic features or schizophrenia with catatonia.
Childhood schizophrenia.
Childhood schizophrenia is an uncommon but severe mental disorder in which children interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), behavior, or emotions. It may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs your child’s ability to function.
Childhood schizophrenia is essentially the same as schizophrenia in adults, but it occurs early in life and has a profound impact on a child’s behavior and development. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, education, and emotional and social development.
Schizoaffective disorder.
Schizoaffective disorder is a mental health disorder that is marked by a combination of schizophrenia symptoms, such as hallucinations or delusions, and mood disorder symptoms, such as depression or mania.
The two types of schizoaffective disorder — both of which include some symptoms of schizophrenia — are:
- Bipolar type, which includes episodes of mania and sometimes major depression
- Depressive type, which includes only major depressive episodes
Schizoaffective disorder may run a unique course in each affected person.
Untreated schizoaffective disorder may lead to problems functioning at work, at school, and in social situations, causing loneliness and trouble holding down a job or attending school. People with schizoaffective disorder may need assistance and support with daily functioning. Treatment can help manage symptoms and improve quality of life.
Paranoid schizophrenia seems to be the most common type of mood disorder of the five.
Schizophrenia occurs in about 1.1 percent of the population, while paranoid schizophrenia is considered the most common subtype of this chronic disorder.1 The average age of onset is late adolescence to early adulthood, usually between the ages of 18 to 30.
In this article, we will be focusing on paranoid schizophrenia. Causes, diagnosis, symptoms treatments, and a few other topics. Please feel free to contact me via my website if you have any questions.
Paranoid schizophrenia Causes
Paranoid schizophrenia, or schizophrenia with paranoia as doctors now call it, is the most common example of this mental illness.
Schizophrenia is a kind of psychosis, which means your mind doesn’t agree with reality. It affects how you think and behave. This can show up in different ways and at different times, even in the same person. The illness usually starts in late adolescence or young adulthood.
People with paranoid delusions are unreasonably suspicious of others. This can make it hard for them to hold a job, run errands, have friendships, and even go to the doctor.
Although it’s a lifelong illness, you can take medicines and find help to stop symptoms or make them easier to live with.
Paranoid Symptoms
Delusions are fixed beliefs that seem real to you, even when there’s strong evidence they aren’t. Paranoid delusions, also called delusions of persecution, reflect profound fear and anxiety along with the loss of the ability to tell what’s real and what’s not real.
They might make you feel like:
- A co-worker is trying to hurt you, like poisoning your food.
- Your spouse or partner is cheating on you.
- The government is spying on you.
- People in your neighborhood are plotting to harass you.
Paranoid schizophrenia can lead to self-isolation and fear of strangers and even friends, and family members. This paranoia can work as an on-and-off switch.
People with schizophrenia aren’t usually violent. But sometimes, paranoid delusions can make them feel threatened and angry. If someone is pushed over the edge, their actions usually focus on family members, not the public, and it happens at home.
You could also have related hallucinations, in which your senses aren’t working right. For example, you may hear voices that make fun of you or insult you. They might also tell you to do harmful things. Or you might see things that aren’t really there. Learn more about the symptoms of paranoia.
Paranoid Schizophrenia affects a person’s perception and can involve hallucinations and delusions. When these happen, it can be hard to know what is real and what is not.
Paranoid delusions can cause a person to fear that others are watching them or trying to harm them. Also, a person experiencing a delusion may believe that media such as the television or the internet are sending them special messages.
These feelings and beliefs can cause severe fear and anxiety, disrupt daily life, and limit a person’s ability to participate in work and relationships, including those with family.
Studies suggest that nearly 50% of people with schizophrenia experience paranoia.
Before 2013, healthcare professionals considered paranoid schizophrenia to be a distinct type of disorder. However, the Diagnostic and Statistical Manual of Mental Disorders, which provides expert guidelines, now classifies paranoia as a symptom, rather than a subtype, of the disorder.
Experts explained their choice to remove the subtypes from the classification, citing “limited diagnostic stability, low reliability, and poor validity.”
Signs and symptoms
Schizophrenia is a lifelong mental health condition. Symptoms often emerge when a person is in their late teens to early 30s.
It can affect a person’s:
- thought processes
- perceptions and feelings
- sleep patterns
- ability to communicate
- ability to focus and complete tasks
- ability to relate to others
Symptoms of schizophrenia can include:
- a lack of motivation
- slow movement
- changes in sleep patterns
- low libido, or sex drive
- a lack of self-care
- disorganized thinking
- changes in body language and emotions
- withdrawing from family, friends, and activities
- hallucinations and delusions
A delusion is something that a person believes to be true, even when strong evidence suggests that it is false. A person may believe that someone is planning to harm them, for example.
People with paranoia may experience a combination of the following:
- feeling upset, anxious, angry, and confused
- being suspicious of those around them
- believing that someone is persecuting them
- fearing that someone is following, chasing, poisoning, or otherwise plotting against them
- feeling as if someone else is controlling their thoughts and actions
- feeling as if their thoughts are disappearing or being taken away from them
- suicidal thoughts and behavior
If a person experiences any of the above, they should receive immediate medical care.
Causes and risk factors
Schizophrenia is a neuropsychiatric disorder. The exact causes are unclear, but they likely involve a combination of genetic factors and environmental triggers.
Risk factors may be:
Genetic: Those with a family history may have a higher risk.
Medical: These may include poor nutrition before birth and some viruses.
Biological: Features of the brain’s structure or the activity of neurotransmitters, such as dopamine, may contribute.
Environmental: Stress, past trauma, and abuse may trigger symptoms in people already at risk.
One study suggests that people with schizophrenia and paranoia may have social cognitive impairments that make it harder for them, for example, to recognize people’s emotions or trust others. However, drawing conclusions about this will require more research.
Use of drugs
Some recreational drugs that affect the mental processes, such as amphetamines, cocaine, cannabis, and LSD, may trigger psychosis or schizophrenia in people with a susceptibility.
Experts say that the use of drugs is more common among people with schizophrenia, but it is not clear whether the drugs trigger the disorder, or whether having schizophrenia increases the likelihood of using drugs to cope with symptoms.
Various substances can also interfere with treatment. Anyone with concerns about the link between schizophrenia and substance use should speak with a doctor.
Diagnosis
If a person seeks help for symptoms that may indicate schizophrenia, a doctor will consider their personal and family medical histories and physical health, as well as the symptoms.
They may also request diagnostic tests, such as blood tests, to rule out other possible causes of the symptoms.
Diagnostic criteria
For a doctor to diagnose schizophrenia, a person needs to exhibit signs of the disorder continuously for at least 6 months.
This may involve:
- delusions
- hallucinations
- disorganized speech
- Social and occupational dysfunction
- highly disorganized or catatonic behavior
- emotional flatness or a lack of pleasure in everyday life
A doctor can only diagnose schizophrenia if these signs cannot be explained by any other health issue, such as drug or alcohol abuse or a mood disorder.
Overall, it can take some time to reach a diagnosis.
According to the National Alliance on Mental Illness (NAMI), Black and Latinx people in the United States are more likely than others to receive an incorrect diagnosis of schizophrenia. This may be due to racial bias, difficulty accessing suitable healthcare, or both.
Treatment
Schizophrenia is a lifelong condition, but treatment can help relieve the symptoms. If a person stops the treatment at any point, their symptoms may return.
It can take time to find the best approach, which may be a combination of treatments. The right combination depends on factors such as which symptoms are present, how severe they are, and the person’s age.
It helps if the person and their doctor are able to work together to develop and tweak the treatment plan, NAMI reports.
Medications
Drugs called antipsychotics can reduce the occurrence of disturbing thoughts, hallucinations, and delusions.
It can take time to find a suitable option, however. Also, around 30% of people do not have a good reaction to antipsychotic drugs. In around 7% of cases, the drugs are ineffective.
If the person’s symptoms do not respond to at least two antipsychotics, the doctor may prescribe clozapine (Clozaril). This is not the first choice, due to the risk of adverse effects.
Psychotherapy and social support
Counseling and other types of therapy can help a person with schizophrenia live independently.
Some options include:
- vocational training therapy
- cognitive behavioral therapy
- supportive psychotherapy
- cognitive enhancement therapy
Also, social support can help a person find work and housing and improve their communication skills and overall well-being. This may involve a peer support group.
Caregivers and loved ones can help by learning about schizophrenia and encouraging the person to follow their treatment plan.
One study has suggested that people with schizophrenia and paranoia benefit from support and treatment that are specifically tailored to these issues.
Complementary medicines
According to NAMI, the following may play a role in a wider treatment plan:
- acupuncture
- meditation
- nutritional interventions
While these may help, they cannot replace traditional treatment.
Some researchers have suggested that cannabidiol (CBD), an ingredient in cannabis, could play a role in treating schizophrenia. However, confirming this will require more research.
Please make cannabis use for medical purposes legal in your geographic area.
It is important that people with schizophrenia discuss any complementary treatments with their doctors.
Living with schizophrenia
Without treatment, schizophrenia can significantly disrupt a person’s life, including their ability to work, study, and care for themselves.
Some helpful strategies include:
- following the treatment plan carefully, including taking medications as prescribed
- bringing up any concerns about treatment with a healthcare provider
- making use of available support, which may involve friends, crisis services, and specialized healthcare facilities
- making healthful choices regarding diet, exercise, and the use of drugs, alcohol, and tobacco
- talking about the experience of schizophrenia with friends, family members, healthcare providers, and supportive peers
How Can You Help?
Have a loved one with schizophrenia? Your support can make a huge difference by helping them find the right treatment, cope with symptoms, and build a rich, satisfying life.
The love and support of family and friends play an important role in schizophrenia treatment and recovery. If you have a loved one with schizophrenia, you may be struggling with any number of difficult emotions, including fear, guilt, anger, and frustration. You may feel helpless in the face of your loved one’s symptoms, worried about the stigma of schizophrenia, or confused and embarrassed by their strange behaviors. You may even be tempted to hide your loved one’s illness from others.
But it’s important to remember that a diagnosis of schizophrenia is not a life sentence. Recovery is possible, especially with your love and support.
To help someone with schizophrenia, it’s crucial you:
- Accept the illness and its difficulties.
- Not buy into the myth that someone with schizophrenia can’t get better or live a full and meaningful life.
- Do your best to help your loved one feel better and enjoy life.
- Pay attention to your own needs.
- Maintain your sense of humor and remain hopeful.
Is there a Genetic Connection?
Researchers estimate that about 80% of the risk for developing schizophrenia is hereditary, but that doesn’t mean that people with faulty genes will actually develop the disorder.
Schizophrenia is believed to be caused by an interplay of genetic and environmental factors. “The remaining risk factors are environmental,” Nuechterlein explains.
Genes are only one part of the equation anyway. The other part is environmental. Even if you have a lot of the genes associated with schizophrenia risk, in order to actually develop the disorder, those genes have to be activated by outside factors.
Herbs That Help
St.Johns Wort
Also known as Hypericum, this herb has positive effects on the brain. This herb is a good anti-depressant and it relieves fear, anxiety, and depression. Hypericum can boost your mood and reduce anxiety. The best method of consumption is in the form of tea, brewed from this herb.
Ginkgo Biloba
Ginkgo biloba is a common Chinese herb that is used to treat various ailments. It is proven to be effective in treating various mental disorders. This herb can help develop mental functions and boost energy levels. It is also effective against mood swings and delusions.
Centella
Gotu kola; as it is commonly known, Centella is a rejuvenating herb used in traditional medicine for many years. Gotu kola can calm the mind and relieve anxiety. This herb strengthens the blood vessels and improves blood circulation to the brain. It improves memory and intelligence and is known to refurbish the brain cells and nerves. Therefore, it is considered to be an excellent brain stimulant.
Korean Ginseng
This herb is an excellent energy booster. The phytochemicals present in this plant can help the body combat stress and anxiety. These chemicals also improve the action of neurotransmitters in the brain and improve memory. This herb is also effective against depression and aids sleep.
Kava Kava
This herb is widely used to treat anxiety and depression. Many studies have proven the effectiveness of this herb in treating anxiety-related mental disorders. Kava is known to inhibit dopamine activity. Increased dopamine levels have been linked to schizophrenia. This property of the herb is beneficial in treating the symptoms of schizophrenia.
Passion Flower
Passionflower is known to treat depression, anxiety, and hysteria. It is acclaimed for its mind-calming properties. The natural compounds present in passionflower are known to improve the functioning of a chemical called GABA (gamma-aminobutyric acid) in the brain. GABA blocks the nerve impulses in the brain. This property benefits those with schizophrenia disorder as the mind can be controlled and calmed.
Rosemary
Rosemary is an excellent antioxidant and it battles the free radical damage in the brain. This herb acts similar to passionflower. The compounds present in this herb are known to increase the levels of GABA. This herb should be avoided by expectant mothers and lactating women.
Chamomile
Chamomile is rich in a compound called apigenin, which can calm the mind. This herb is also mildly sedative and it is known for its behavior-altering activity. It is widely consumed as a tea. Traditional Chinese herbs such as Dong Quai, Ding Xin Wan, and Cheng qi tang are used to treat many mental disorders including schizophrenia. Some of the above-mentioned herbs may cause reactions when taken with other drugs. It is important to consult the right specialist before adopting these herbs as a part of your treatment plan.
Always consult with your doctor before taking any herbal remedies.
Your Diet and Schizophrenia
Eat More: Fruits
Many studies suggest that people with schizophrenia often don’t get enough fiber. Fruits — raspberries, pears, apples, and others — are some of the best sources of it. Fiber helps lower “bad” cholesterol and aids in digestion. Fiber-rich diets may lower your chance of some health problems that often are associated with schizophrenia, like heart disease, diabetes, and obesity. Fruits have healthy vitamins, too.
Eat More: Vegetables
Low in fat and calories, packed with fiber and important vitamins, and without any heart-heavy cholesterol, vegetables are another staple missing in the diet of many people who have schizophrenia. Potassium, a key nutrient that may help keep your blood sugar in check, is in veggies like lima beans, kidney beans, and sweet potatoes.
Eat More: Salmon and Other Fatty Fish
Omega-3 fatty acids can’t be made by the body. You need to get them through food. Why do you need them? A growing amount of research says that omega-3 fatty acids can prevent and ease the symptoms of schizophrenia and slow the disease’s progress. Salmon and mackerel are great sources of those acids. Don’t like fish? Ask your doctor about omega-3 supplements.
Eat More: Chicken Marinara
Research suggests that vitamins and niacin can slow the advance of schizophrenia and help ease its symptoms. One rich source of niacin is chicken; another is marinara sauce.
Eat More: Oysters and Crab
Experts say there may be a relationship between low levels of zinc and schizophrenia. Oysters, crab, and lobster are high in this nutrient. You can also find it in beef and in fortified cereals. It’s available in supplements, too, but talk to your doctor before you take any of those.
Eat More: Clams
A number of reports have shown low levels of vitamin B12 in those with psychosis — a set of mental disorders that schizophrenia is one of. Other research says a bit more B12 can ease symptoms.
Clams are a big source of B12. It’s found in liver, trout, and in some bread, too.
Eat More: Spinach
The king of leafy greens, spinach is high in folate. (It’s called folic acid when it’s used in supplements or to fortify foods.) Folate can help ease symptoms of schizophrenia. Along with spinach, you can find it in black-eyed peas, asparagus, and beef liver.
Eat More: Cod Liver Oil
Studies on vitamin D’s effect on schizophrenia are mixed. Still, more Vitamin D — produced mainly from exposure to the sun, but available naturally in cod liver oil, swordfish, and salmon — might help some folks who have the disorder.
Eat More: Non-dairy Yogurt
The gut microbiome — that swamp of bacteria in your intestines — gets a lot of attention. Some research has linked bad gut bacteria to schizophrenia. Getting more prebiotics, which is found naturally in fruits and veggies, may help. More “live culture” probiotics — which are in yogurt, kimchi, and sauerkraut — might help, too. Try to avoid dairy/whey products that contain casein antibodies.
A No-No: Bread
Some experts believe that sensitivity to wheat can be a factor in mental health conditions like schizophrenia. One study suggests some people with schizophrenia had their condition improve when they switched to a gluten-free diet. Gluten is a protein found in wheat and other grains. Talk with your doctor about it.
No Good: Refined Sugars
It’s been well established that most people with schizophrenia are bad eaters and that their odds of getting diabetes are higher. A diet that carries a low glycemic load — a measure of sugar in your blood — might ease the symptoms of schizophrenia. Cutting out refined sugars, found in things like sweetened beverages, candy, and cake, is a good place to start.
Research indicates that taken in high doses, B vitamins – such as B-6, B-8, and B-12 – can significantly reduce schizophrenia symptoms. Additionally, a combined dose of several vitamins was shown to have the same beneficial effect. However, low doses of the vitamins were revealed to be ineffective.
Thank you for reading
Michael
Comments are welcome
I was about to close down my computer when I saw your site come up. As I live with somebody who has a mental illness, I was fascinated to read and learn more about this. I confess, until now, I have been a bit ostrich like, so your article has helped me a lot. I had no idea there was such a wide range of schizophrenia types. The fact that 80% of the risk has a hereditary link, is really striking. Do you think a DNA test could highlight risks? I see you refer to complementary medicines, are you aware of any super foods that might help to alleviate schizophrenia?
Hi Trevor,
Thank you for your comments. DNA tests confirmed that certain genetic patterns in that DNA chunk were more common among people with schizophrenia.
However, the study doesn’t prove that the DNA chunk causes schizophrenia. It also doesn’t rule out the possibility of other genetic traits that accompany schizophrenia. There is no definite answer here and it is still being researched.
I apologize for not adding anything about diet or herbs that have proven to be helpful with schizophrenia, also the B vitamins. After reading your comment I have rectified that and added more information.
All the best,
Michael
Schizophrenia is a serious illness. You’ve summed it up perfectly, I have my experience having had someone in my mother’s family suffering from this mental illness. Mom’s cousin had schizophrenia, she was a normal child and then when she was at high school, at the age of about 16, she started to have some symptoms. Her father was an alcoholic so I think that might have played a role as well.
She was intelligent and loved reading historical books and novels and you could have a nice talk with her, but when she had attacks of paranoia, she sometimes said for instance she had a snake in her belly and such crazy things.
You provide some good tips on how to deal with this.
Hi Lenka,
Thank you for your comments. Your mom’s cousin sounds like a great person. It is unfortunate she got schizophrenia. Life does give us some battles we need to fight. I hope she is doing well. All the things she felt, I am sure were very real to her. By the way, I added some diet and herbal supplements that are helpful.
All the best,
Michael
Thank you, Michael. She died about 4 years ago, was almost 70. The poor woman didn’t have a very happy life. You are right, all the things she felt and saw were very real to her. Shame we couldn’t help her in any way.
All the best,
Lenka
Hi Lenka,
Sorry to hear she passed away. It is to know what to say and do when you know someone is suffering from schizophrenia. Sounds like there was a lot of caring there and I am sure everyone did the best they could. Lenka, I did add more information to my article about diet(foods that and bad), herbal health, and the benefits of taking B vitamins
Best wishes,
Michael