Schizophrenia: symptoms, triggers and treatment

Are you or someone you know struggling with schizophrenia? Our expert team is here to support you on your journey to recovery.

Get personalised treatment and support for schizophrenia with a free consultation from our specialists.

This page was clinically reviewed by Dr Geoff Lawrence-Smith (MBBS, MRCPsych, BSc, PGCAP, FHEA), Consultant Psychiatrist at Priory Wellbeing Centre Harley Street, in June 2022.

Schizophrenia is a relatively common condition with a range of different symptoms which can vary enormously in their severity. Most people with schizophrenia have bouts of illness when they experience symptoms, such as feelings of paranoia, delusional beliefs and hallucinations.

Schizophrenia can cause confusion and difficulties in concentrating and controlling thoughts and some people have long term problems with organisational skills and motivation. The earlier schizophrenia is diagnosed and treated, the greater the chances of recovery or effective reduction in associated schizophrenia symptoms.

If you have schizophrenia, your understanding and interpretation of events around you may be distorted compared to others. You may see or hear things which aren’t truly there, or have beliefs and ideas which appear removed from reality, and can lead to unusual behaviours in response to these events which feel entirely real from your perspective.

If you have been recently diagnosed with schizophrenia or know someone who has, Priory Wellbeing Centres and UK hospitals are located nationwide for your convenience. This means you can book an initial assessment and receive personalised specialist mental health treatment and support from some of the UK’s leading therapists and consultants without having to travel long distances.

Symptoms of schizophrenia

Schizophrenia is a type of psychotic illness and is associated with a wide range of symptoms, including hallucinations, delusions, confused thoughts and changes in behaviour.

Schizophrenia symptoms can be categorised into ‘positive’ symptoms (things that start to happen) and ‘negative’ symptoms (things that stop happening).

schizophrenia symptoms

  • Hallucinations – people with schizophrenia may experience hallucinations that cause them to see, hear or feel things that aren’t real. The most common type of hallucinations that are associated with schizophrenia are auditory hallucinations, whereby individuals hear voices in their head that no-one else can hear. The voices may tell you what to do, act as a running commentary on your thoughts and actions (e.g. saying things like “he’s opening the door”), or say threatening things to you. Often, there’s more than one voice and the conversation tends to be very personal in nature, demonstrating an intimate knowledge of your beliefs and habits. The voices may also talk to each other about you
  • Delusions – these are strong beliefs that an individual holds even when they are presented with evidence to the contrary. In schizophrenia, delusions may centre upon paranoia, whereby you may become convinced that you’re being spied on, persecuted, or controlled in some way, or they may cause you to hold grandiose beliefs such as thinking that you’re a famous actor, a monarch, or that you have superpowers
  • Disorganised thoughts and speech – people with schizophrenia may find it difficult to organise their thoughts and speech. Your thoughts may seem jumbled and random and when you talk, your words may not make sense. In addition, this confusion may mean that you’re unable to comprehend what other people are saying and you may appear to be distracted and ‘zoned out’ to others. People with schizophrenia may also have trouble concentrating and may jump from one idea to another
  • Changes in behaviour – your behaviour may become gradually more unpredictable. For example, you may start behaving inappropriately in certain situations or find that you become agitated for no apparent reason, which may even cause you to shout and swear
  • Abnormal patterns of movement – schizophrenia can cause people to develop abnormal patterns of movement. You may find yourself repeating the same actions over and over again or seem to be ‘jumpy’ and ‘twitchy’ all the time. At the other end of the spectrum, people with schizophrenia may stay still for hours on end, sometimes in what can seem to be very uncomfortable positions – something known as ‘catatonia’ or a ‘catatonic state’
  • Lack of emotion – an individual with schizophrenia may seem to be emotionless, detached, and unable to display any feelings. When you speak, your voice can sound flat and monotonous. This lack of emotional responsiveness is known as ‘flat affect’
  • Social withdrawal – someone with this condition may stop making plans with friends and family, and stop socialising with anyone. This can lead to you becoming withdrawn, isolated and struggling to leave the house, as well as having an adverse effect on personal relationships
  • Struggling to look after themselves – schizophrenia can make it hard for you to engage in ordinary, day-to-day tasks and responsibilities such as washing yourself, getting dressed, or eating
  • Lack of motivation, ambition and commitment – individuals with schizophrenia may have trouble finishing tasks that they’ve started, or even getting started at all. You may lose interest in activities and people that were once important to you. If you are employed, you might find it difficult to turn up for work on time, or even at all, and may have a reduced desire to do well in your career. This may lead to job loss, financial difficulties and even homelessness

Less severe forms of selective mutism may see your child become confident enough to communicate through gestures such as shaking or nodding their head to agree or disagree with what is being said, even if the situation is making them feel socially uncomfortable. If your child is diagnosed with more severe selective mutism, they may shy away from using alternative forms of communication for fear of being pressured into talking through this behaviour.

Therapeutic treatment programmes look to reduce the debilitating symptoms of selective mutism, helping your child to feel comfortable showing off their personality in a variety of social settings.

Schizophrenia triggers

It's likely that a trigger that has led to illness in the past could also cause future relapses, so it is important to identify and avoid such a trigger. Most common triggers include:

Stress

Higher than usual levels of stress potentially exacerbating symptoms or causing relapse in schizophrenia.

Losing someone close to you, going through financial difficulties, or feeling lonely or isolated are other stressful life events which can trigger symptoms of the illness.

Recreational drug use

Recreational drug use appears to increase the risk of relapse as well as poorer outcomes in people who already have the illness. It is recommended that you avoid using recreational drugs if you have schizophrenia.

Although some people with schizophrenia can enjoy an occasional small amount of alcohol, it can also precipitate relapses and interact with medication so is usually best avoided altogether. Recreational drugs, especially cannabis and stimulant drugs like amphetamines, can increase your risk of having a relapse of schizophrenia.

How to help someone with schizophrenia

If you are caring for or supporting someone with schizophrenia, there are many resources online which can help you understand what your friend or family member is going through, and how you can work towards feeling more confident in offering advice and support.

Friends, family, partners and companions are some of the most vital people in a person's care network and their support can make a relapse less likely.

Here are some general tips which can help someone with the condition manage their symptoms:

Try not to argue or raise your voice 

When someone is experiencing positive symptoms or psychosis during an episode of schizophrenia, it can be hard not to try to correct or challenge some of their beliefs or thoughts which may seem strange to yourself.

It is important to remember that the world through their eyes is absolutely real for them, perhaps even scary and distressing. Confronting them on what they are experiencing and thinking may discourage them from communicating their thoughts with you or make them feel isolated and alone. This can create a barrier when you are trying to help someone work through their symptoms and experiences.

Ask how you can help

Due to the varying experiences a person can have when they have schizophrenia, it can be useful to simply ask them how you can help them with their symptoms. Some people with the condition may simply want to work through their delusions and hallucinations and have someone with them who understands what they are going through, or they may even want you to help them get professional medical help such as that offered at Priory.

Look out for signs of depression

Schizophrenia is one of the most distressing mental health conditions to cope with, particularly due to its long-term nature. Schizophrenia is often associated with depression which, if not recognised and treated, may lead to suicidal thoughts. It is important that symptoms of depression are treated as seriously as the schizophrenia itself.

Finally, it is important for the people in a person's support network to be mindful that over half of people with schizophrenia can be helped to get better and about 1 in 4 people recover completely.

Schizophrenia is often a misunderstood mental health condition, but with the right support and treatment, someone struggling with schizophrenia can manage their condition and symptoms, and live the life they deserve.

Schizophrenia diagnosis

There are many misconceptions within society and the media about what a diagnosis of schizophrenia actually entails.

If you have been diagnosed with the condition, it is important to know that notions of having a ‘split personality’, or that someone with the disorder is potentially violent or dangerous are largely incorrect, as most people with schizophrenia rarely commit violent crimes. While the word schizophrenia translates as having ‘two minds’, this description relates to a person's personal experience of disordered thinking and experiences, rather than referring to their personality.

How is schizophenia treated?

Expert treatment for schizophrenia is available through Priory and can include a combined treatment programme comprising medication, counselling and therapy. These will be prescribed and delivered according to your personal needs and wishes over the course of your care.

Our overall aim is to help and support your independence and try to improve your quality of life while recognising and working with you to avoid the events or circumstances that might trigger a deterioration in your mental health.

Medication

During an acute phase of schizophrenia where you are experiencing heightened symptoms, you may be given antipsychotic medication. These medicines tend to have sedative qualities to help reduce the impact of your symptoms, although any side effects can be reduced by reviewing these with you regularly.

Your medication programme will be carefully monitored and worked through during your treatment with Priory, with you and your consultant working together in order to choose the right medicine for your specific needs.

You may also be offered antidepressants, mood stabilising drugs and sedative medicines as necessary. Once the acute phase has passed, the medication may be reduced and simplified. You may need some form of medication for a year or longer after an acute phase to reduce the risk of relapse and help you continue to manage the condition and lessen its impact on your day-to-day life.

Counselling for schizophrenia

Counselling may be helpful if you have schizophrenia, with noticeable progress sometimes possible from as few as ten sessions. These sessions help you to make sense of your experiences and learn to cope with day-to-day issues. Counselling can encourage you to re-learn core life skills to help you return to normal life as soon as possible.

Cognitive behavioural therapy (CBT)

CBT helps you to understand your thought processes and learn strategies for coping with your feelings and reactions to the symptoms you experience, helping you manage behaviour more effectively through a problem solving and action-oriented approach. CBT can help you consider your personal experience of symptoms and whether your thinking styles may be unhelpful or contribute to your distress.

Family therapy

These sessions are aimed at understanding, supporting and managing some of the many difficulties that arise in a family setting if you have schizophrenia. The aim of this therapy is to encourage family members to research the illness and learn ways to work with you to optimise your home environment. Doing this can reduce the chance of situations in/around the home triggering an increase of your symptoms.

Physical health

People with schizophrenia seem to have poorer physical health than the general population so it's very important that you pay attention to maintaining a healthy diet, exercising when you can, and try to reduce your smoking or stop altogether. Some antipsychotic medications can affect how your body produces energy from food (metabolism) which can lead to weight gain, so it's very important to work closely with your GP and psychiatrist to minimise the chances of this.