What is Schizophrenia? What are the Symptoms of Schizophrenia?
What is schizophrenia?
Schizophrenia is a chronic and severe disorder that affects how a person thinks, feels, and acts. Although schizophrenia is not as common as other mental disorders, it can be very disabling. Approximately 7 or 8 individuals out of 1,000 will have schizophrenia in their lifetime.
People with the disorder may hear voices or see things that aren’t there. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. This can be scary and upsetting to people with the illness and make them withdrawn or extremely agitated. It can also be scary and upsetting to the people around them.
People with schizophrenia may sometimes talk about strange or unusual ideas, which can make it difficult to carry on a conversation. They may sit for hours without moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are really thinking.
Families and society are impacted by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they may rely on others for help. Stigmatizing attitudes and beliefs about schizophrenia are common and sometimes interfere with people’s willingness to talk about and get treatment for the disorder.
People with schizophrenia may cope with symptoms throughout their lives, but treatment helps many to recover and pursue their life goals. Researchers are developing more effective treatments and using new research tools to understand the causes of schizophrenia. In the years to come, this work may help prevent and better treat the illness.
What are the symptoms of schizophrenia?
The symptoms of schizophrenia fall into three broad categories: positive, negative, and cognitive symptoms.
Positive symptoms are psychotic behaviors not generally seen in healthy people. People with positive symptoms may “lose touch” with some aspects of reality. For some people, these symptoms come and go. For others, they stay stable over time. Sometimes they are severe, and at other times hardly noticeable. The severity of positive symptoms may depend on whether the individual is receiving treatment. Positive symptoms include the following:
Hallucinations are sensory experiences that occur in the absence of a stimulus. These can occur in any of the five senses (vision, hearing, smell, taste, or touch). “Voices” (auditory hallucinations) are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices can either be internal, seeming to come from within one’s own mind, or they can be external, in which case they can seem to be as real as another person speaking. The voices may talk to the person about his or her behavior, command the person to do things, or warn the person of danger. Sometimes the voices talk to each other, and sometimes people with schizophrenia talk to the voices that they hear. People with schizophrenia may hear voices for a long time before family and friends notice the problem.
Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near.
Delusions are strongly held false beliefs that are not consistent with the person’s culture. Delusions persist even when there is evidence that the beliefs are not true or logical. People with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others. These are called “delusions of reference.”
Sometimes they believe they are someone else, such as a famous historical figure. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. These beliefs are called “persecutory delusions.”
Thought disorders are unusual or dysfunctional ways of thinking. One form is called “disorganized thinking.” This is when a person has trouble organizing his or her thoughts or connecting them logically. He or she may talk in a garbled way that is hard to understand. This is often called “word salad.” Another form is called “thought blocking.” This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder might make up meaningless words, or “neologisms.”
Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available.
Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:
- “Flat affect” (reduced expression of emotions via facial expression or voice tone)
- Reduced feelings of pleasure in everyday life
- Difficulty beginning and sustaining activities
- Reduced speaking
People with negative symptoms may need help with everyday tasks. They may neglect basic personal hygiene.
This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by schizophrenia.
For some people, the cognitive symptoms of schizophrenia are subtle, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. Similar to negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Often, they are detected only when specific tests are performed.
Cognitive symptoms include the following:
- Poor “executive functioning” (the ability to understand information and use it to make decisions)
- Trouble focusing or paying attention
- Problems with “working memory” (the ability to use information immediately after learning it)
Poor cognition is related to worse employment and social outcomes and can be distressing to individuals with schizophrenia.
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