Schizophrenia

Schizophrenia is a mental health condition that affects how you think, feel and behave. It can make it hard to know what’s real and what isn’t.

It can lead to symptoms like:

• Delusions: Strong beliefs that aren’t based in reality
• Hallucinations: Seeing, hearing or sensing things that aren’t there
• Psychosis: Disorganized thinking and behavior make it hard to stay grounded

These symptoms can have a major impact on your daily life and relationships.

This condition affects an estimated 1 in 300 people worldwide.

While it’s a lifelong disorder, treatment can help you manage symptoms so you can feel better.

Symptoms of schizophrenia

People with schizophrenia often don’t know they have symptoms. But others, like friends and family, may notice them.

Symptoms may include:

• Delusions: Believing things that aren’t true, even with clear evidence (like thinking someone’s controlling your actions)
• Hallucinations: Sensing things that aren’t really there (like hearing voices, seeing people or feeling something touch you when nothing’s present)
• Disorganized speech: Trouble organizing your thoughts while speaking, making it hard to stay on topic or be understood
• Disorganized or catatonic behavior: Moving or acting in ways others might not expect (like laughing excessively, making repetitive motions or staying very still)
• Negative symptoms: Reduced ability to function (like showing little emotion, speaking in a flat tone or losing motivation to socialize or enjoy activities)

Schizophrenia causes

The cause of schizophrenia isn’t known. Experts believe it may happen for different reasons, like:

• Chemical imbalances of neurotransmitters (dopamine and glutamate), used for cell-to-cell communication in your brain
• Brain development problems before birth
• Loss of connection between different areas of your brain

Risk factors of schizophrenia

Your risk may increase due to the following:

• Genetics: A biological parent or sibling also has the condition
• Environmental factors: Exposure to viruses or malnutrition before birth
• Substance use: Using certain substances during your teen and young adult years, especially at a younger age or with more frequent use

Complications of schizophrenia

Complications of schizophrenia may include:

• Feeling suspicious, paranoid or scared
• Not caring about your hygiene and appearance
• Experiencing depression and anxiety
• Using addictive substances to try to ease symptoms

Your risk of suicidal thoughts and suicide also increases with schizophrenia. If you ever need help or someone to talk to, call or text 988 (U.S.). This is the Suicide & Crisis Lifeline. Someone can speak with you 24/7. If you need immediate medical attention, call 911 or your local emergency services number.

How doctors diagnose schizophrenia

A healthcare provider can diagnose schizophrenia by learning more about your symptoms. To do this, they’ll observe your behavior or ask you questions about what you’re experiencing. They’ll compare those with the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). They’ll also take a complete medical history.

A diagnosis usually happens during the late teen years or early adulthood. Males typically notice symptoms sooner (early 20s) than females (mid 20s to early 30s). Schizophrenia in children is rare but possible.

Schizophrenia test

There aren’t any diagnostic tests for schizophrenia. But healthcare providers may run tests to rule out other conditions before diagnosing schizophrenia, like:

• Imaging tests: CT or MRI scans to check for stroke, brain injury, tumors or structural changes
• Lab tests: Blood, urine or cerebrospinal fluid tests to rule out infections, poisoning or chemical imbalances
• Brain activity tests: An EEG to check for disorders like epilepsy

How is schizophrenia treated?

Treatment for schizophrenia may include:

• Medications: There are different types of medications available, usually antipsychotics, to help manage symptoms.
• Psychotherapy: Talk therapy, like cognitive behavioral therapy for psychosis (CBTp), may help you better understand how your thoughts influence your behaviors. It could help you reduce stress and learn healthy coping skills that may improve daily functioning and prevent complications.
• Rehabilitation: Supportive services like resilience training, family therapy, cognitive support, and help with work or school are available. They can improve coping skills, communication, thinking abilities and long-term success.

If medications don’t improve your symptoms, your provider may recommend other options. One is electroconvulsive therapy (ECT). ECT is a safe treatment that sends small electric signals to your brain. It causes a short seizure to help your brain work differently.

Schizophrenia medication

Antipsychotic medications are a key part of treating schizophrenia. These may include:

• Aripiprazole (Abilify®, Aristada®)
• Brexpiprazole (Rexulti®)
• Cariprazine (Vraylar®)
• Clozapine (Clozaril®)
• Haloperidol (Haldol®)
• Lurasidone (Latuda®)
• Lumateperone (Caplyta®)
• Olanzapine (Zyprexa®, Lybalvi®, Symbyax®)
• Quetiapine (Seroquel®)
• Risperidone (Risperdal®, Perseris®, Risperdal Consta®)
• Xanomeline and trospium (Cobenfy™)

There are two main types of antipsychotics: first and second generation. First generation (typical) blocks dopamine receptors. Second generation (atypical) targets dopamine and serotonin receptors. These medications adjust the balance of these brain chemicals (neurotransmitters). An imbalance of chemicals may cause symptoms like delusions and hallucinations.

Emerging treatments are expanding. One example is a newly approved combination of xanomeline and trospium chloride (Cobenfy). This works through the cholinergic system. This system helps control things like memory, thinking and muscle movement. It doesn’t mainly target dopamine receptors the way traditional antipsychotics do. It marks the first in a new class of antipsychotic drugs.

Talk to your provider about what possible side effects to look out for if you start a new medication.

When should I see my healthcare provider?

If you have schizophrenia, you’ll need to schedule regular visits with your healthcare provider. Follow up with them as recommended and anytime you notice changes in your symptoms. Let them know if you have any medication side effects, especially ones that are disruptive to your daily routine. They may be able to adjust your treatment or recommend other options that work better for you.

What can I expect if I have schizophrenia?

This mental health disorder varies greatly from person to person. While schizophrenia can affect many parts of daily life, treatment may help you manage symptoms more effectively.

Symptoms often come in cycles. These are periods when they flare up and times when they improve, but don’t fully go away completely. It’s important to continue treatment as directed, even when you’re feeling better, to prevent setbacks and maintain progress.

Some people respond well to treatment but may still face ongoing challenges, like difficulty thinking clearly or staying focused. This is common. Your care team can work with you to adjust your treatment as needed.

Schizophrenia isn’t deadly on its own. But without treatment, it can lead to serious problems, like a higher chance of suicide. That’s why ongoing care, support and open communication with your providers are essential.