Schizophrenia is a mystery, a puzzle with missing pieces. This complex biochemical brain disorder affects a person’s ability to determine what is reality and what is not. It is as though the brain sends perceptions along the wrong path, leading to the wrong conclusion. People with schizophrenia are affected by delusions (fixed false beliefs that can be terrifying to the person experiencing them), hallucinations (sensory experiences, such as hearing voices talking about them when there is no one there), social withdrawal and disturbed thinking.

 

What is schizophrenia?

Schizophrenia is a mental illness that affects the way you understand and interact with the world around you.

At the beginning of an episode, people may feel that things around them seem different or strange. They may start to experience problems concentrating, thinking or communicating clearly, or taking part in their usual activities. At the height of the episode, people may experience breaks from reality called psychosis. These could be hallucinations (sensations, like voices, that aren’t real) and delusions (strong beliefs that aren’t true, like the belief that they have superpowers). Some people feel ‘flat’ or numb. They may also experience changes in mood, motivation, and the ability to complete tasks. After an episode, signs can continue for some time. People may feel restless, withdraw from others, or have a hard time concentrating.

The exact course and impact of schizophrenia is unique for each person. Some people only experience one episode in their lifetime while others experience many episodes. Some people experience periods of wellness between episodes while others may experience episodes that last a long time. Some people experience a psychotic episode without warning while others experience many early warning signs. No matter how someone experiences schizophrenia, researchers agree that early treatment can help reduce the impact of episodes in the future.

 

Key facts

• Schizophrenia is a chronic and severe mental disorder affecting 20 million people worldwide (1).
• Schizophrenia is characterized by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common experiences include hallucinations (hearing voices or seeing things that are not there) and delusions (fixed, false beliefs).
• Worldwide, schizophrenia is associated with considerable disability and may affect educational and occupational performance.
• People with schizophrenia are 2-3 times more likely to die early than the general population (2). This is often due to preventable physical diseases, such as cardiovascular disease, metabolic disease and infections.
• Stigma, discrimination and violation of human rights of people with schizophrenia is common.
• Schizophrenia is treatable. Treatment with medicines and psychosocial support is effective.
• Facilitation of assisted living, supported housing and supported employment are effective management strategies for people with schizophrenia.

 

Symptoms

Schizophrenia is a psychosis, a type of mental illness characterized by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common experiences include:

• hallucination: hearing, seeing or feeling things that are not there;
• delusion: fixed false beliefs or suspicions not shared by others in the person’s culture and that are firmly held even when there is evidence to the contrary;
• abnormal behaviour: disorganised behaviour such as wandering aimlessly, mumbling or laughing to self, strange appearance, self-neglect or appearing unkempt;
• disorganised speech: incoherent or irrelevant speech; and/or
• disturbances of emotions: marked apathy or disconnect between reported emotion and what is observed such as facial expression or body language.

 

Magnitude and impact

Schizophrenia affects 20 million people worldwide but is not as common as many other mental disorders. Schizophrenia also commonly starts earlier among men.

Schizophrenia is associated with considerable disability and may affect educational and occupational performance.

People with schizophrenia are 2 - 3 times more likely to die early than the general population . This is often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases.

Stigma, discrimination and violation of human rights of people with schizophrenia is common.

 

Causes of schizophrenia

Research has not identified one single factor. It is thought that an interaction between genes and a range of environmental factors may cause schizophrenia.

Psychosocial factors may also contribute to schizophrenia.

 

Who does it affect?

Schizophrenia can affect anyone. It usually starts to affect people in the teen years, though females often start to experience the illness a little later than males. No one knows exactly what causes schizophrenia or why it can affect people so differently. Genes, the way a person’s brain develops, and life events may all play a part.

 

What can I do about it?

While there is no cure for schizophrenia, people can and do recover. Recovery may mean learning to reduce the impact of problems, work around challenges, or maintain wellness. Most people use some combination of the following treatments and supports.

Some people need to spend time in hospital if they experience a severe episode of psychosis. This is a time to figure out the best treatment for you and begin your journey to health. Before you leave the hospital, care providers should help you map out the service providers (like doctors, counsellors, and social workers) who will be involved in your care and support your recovery.

Medication
Medication called antipsychotics may help reduce the severity of symptoms like hallucinations and delusions, and may eliminate these symptoms all together for many people. Continuing medication after you feel well again may help reduce the risk of relapse (when symptoms come back). There are many different kinds of antipsychotics, so it may take time and patience to find the best one for you.

All medications can cause side effects—some of which can be uncomfortable or difficult. It’s best to have ongoing, open conversations about medication with a doctor so that everyone understands how a medication is affecting you, what can be done, and what other options you may have.

 

Counselling and supports
Counselling can help with many problems like low mood, anxiety, and relationships. You can learn helpful skills like problem-solving and setting goals. There are also therapies to help reduce the impact of delusions and hallucinations. Schizophrenia can affect people’s goals around education, work, and independent living. Professionals like occupational therapists and social workers can help with daily living, social skills, employment or volunteer training, and community activities. They can also connect you with community supports like home care, housing, and income assistance.

A big part of managing schizophrenia is relapse prevention. You can learn what might trigger an episode and learn to recognize early warning signs of an episode. The goal is to learn when to seek extra supports, which may help reduce the impact or length of the episode.

Self-care is important for everyone. Small steps like eating well, getting regular exercise, building healthy sleep habits, spending time on activities you enjoy, spirituality, and connecting with loved ones can make a big difference.

Schizophrenia can leave people feeling very isolated and alone. At times, many people who experience schizophrenia feel uncomfortable around others. But many also worry about what others will think of them. The right relationships can be supportive and healing. Your support team can help you connect with support groups.

How can I help a loved one?
Supporting a loved one can be hard. It can be difficult to understand what a loved one is experiencing, and their behaviour may be confusing at times. Many people worry about their loved one’s future. The good news is that schizophrenia is treatable—and love and support can go a long way. Here are some tips for helping a loved one:

• Learn more about schizophrenia so you have a better idea of what to expect and how you can help.
• Schizophrenia can have a big impact on people’s ability to concentrate and make sense of information. Loved ones may not react to things in ways you expect or may struggle with tasks that seem simple to you. It’s okay to feel frustrated, but it isn’t anyone’s fault.
• If a loved one has trouble following conversations, choose a quiet space and speaking calmly and clearly.
• It’s best to avoid arguing with delusions or hallucinations. A more helpful strategy is to focus on the feelings that delusions or hallucinations bring up.
• Ask your loved one how you can help. This may be a simple as helping with day-to-day tasks.
• Talk about dealing with emergencies when your loved one is feeling well and decide how you can contribute. Write it down in a crisis plan and share it with your care team. This is also a good time to talk about behaviours you aren’t willing to deal with.
• Learn more about support services for care providers through your loved one’s care team, provincial or territorial health services, or community organizations.
• Depending on the barriers that your loved one experiences, planning for the future with tools like a Registered Disability Savings Plan can bring peace of mind.
• Set your own boundaries, and seek support for yourself when you need it. Think about joining a support group for loved ones and seeking counselling for the entire family.