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This page was clinically reviewed by Dr Michael Phelan (MBBS, BSc, FRCPsych), Consultant Psychiatrist at Priory Hospital Roehampton London in January 2021.

At Priory, we understand that it can be very difficult to cope with schizophrenia, and the symptoms that are associated with this condition, including experiencing hallucinations and delusions, can be distressing for the sufferer.

Overall, schizophrenia can cause dramatic changes in the way that people think, feel and act on a daily basis. The signs and symptoms of schizophrenia can vary from person to person; they can start suddenly for some people, or develop gradually, and may come and go over a long period of time.

It’s important to recognise that the earlier schizophrenia is diagnosed and treated, the greater your chances of being able to effectively manage your condition and reduce the associated symptoms.

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). These include:

What are the positive symptoms of schizophrenia?

  • 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’

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. 

What are the negative symptoms of schizophrenia?

  • 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

These behaviours can start suddenly for some people, while they can also develop over time, with each person’s experience of schizophrenia varying between each individual. The condition usually occurs for the first time in late teens or early 20s, it affects up to 1 in 100 people in the UK, with men and woman having a similar risk of developing it.

When you experience the more extreme symptoms of schizophrenia, this is called having episodes of the illness, at which time your symptoms are particularly severe. This is usually followed by a period when there are fewer symptoms, with this ‘active’ and ‘inactive’ cycle of the condition known as acute schizophrenia.

Family therapy and schizophrenia

Schizophrenia can impact families in many different ways and it can often be a challenging illness to cope with. 

Families and significant others play a crucial role in helping people who suffer with schizophrenia, and family therapy can provide valuable experience for everyone. Family therapy provides an opportunity for all members of the family to express and explore each other’s thoughts, emotions and interactions. 

Learn more about the importance of family therapy when understanding schizophrenia here.

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. 

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For details of how Priory can provide you with assistance regarding mental health and wellbeing, please call 0800 840 3219 or click here to submit an enquiry form. For professionals looking to make a referral, please click here

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