Psychotic Symptoms / Schizophrenia

Schizophrenia is rare, affecting about 1% of the population. The onset of this condition often first presents in late adolescence or young adulthood. According to the World Health Organization (WHO), about 24 million people worldwide have this disorder.

The symptoms of Schizophrenia are sometimes confused with those of bipolar disorder, and the individual with these symptoms needs the assistance of an experienced mental health care practitioner.

Schizophrenia is a serious mental health disorder that can significantly impact a person’s ability to think clearly and interact appropriately. Based on these results, we strongly advise that an individual seeks follow-up care with their primary care doctor or other qualified mental healthcare provider at their earliest convenience, and we encourage one to bring these results to your appointment to guide your discussion. It’s important to know that even when symptoms are not always present, Schizophrenia becomes worse over time without treatment. Patients with Schizophrenia usually require antipsychotic medication to treat their symptoms. We encourage individuals to work with their doctor to determine if medication therapy is appropriate.

Schizophrenia often accompanies other conditions

While one's reported symptoms may be consistent with Psychotic Symptoms / Schizophrenia, sometimes one condition is related to another condition. For example, individuals with Schizophrenia have a high likelihood of experiencing depression and substance use disorders, and many also suffer from anxiety disorders. Many people with Schizophrenia are also heavy cigarette smokers. In most cases, healthcare professionals will treat the primary condition first (the schizophrenia), and if the other symptoms do not resolve, then proceed to treat the next condition.

Specifically, when individuals struggle with Schizophrenia in addition to depression or substance use disorders, treating the underlying Schizophrenia tends to improve all other symptoms. The exception is when a person’s depression or substance use disorder is so severe that they need immediate relief, and at that point, other interventions must be considered.

What it looks like

Psychotic symptoms/ Schizophrenia are a thought disorders, meaning it can affect how a person perceives the world around them. It’s common for a person with Schizophrenia to experience paranoid delusions such as a persistent fear that others are plotting against them. Some may experience delusions of grandeur such as believing they are fulfilling a divine mission or receiving messages from God. Some people with schizophrenia may suddenly take on extreme religious or political beliefs, and this can sometimes be a drastic shift from beliefs they previously held.

People with schizophrenia may also experience auditory hallucinations, such as hearing voices other people do not hear, or visual hallucinations, such as seeing people or things that others do not see. It’s important to note that auditory hallucinations are heard with the ears, and should not be confused with a person’s own inner monologue, which is not heard in your ears, and is not a symptom of Schizophrenia. For those experiencing delusions and/or hallucinations, they usually seem very real, and it may be difficult for them to differentiate reality from delusion.

Sometimes Schizophrenia can affect how a person communicates with others, for example, a person with Schizophrenia might feel like their mouth isn’t saying the words their brain is trying to express. This is sometimes referred to as “word salad”.

Alcohol and psychotic symptoms / schizophrenia

It’s important for a person with Schizophrenia to understand the risks of using alcohol and other recreational substances. The National Institute of Health found that individuals with Schizophrenia were at a higher risk for violent behavior when they also had a substance use disorder (2009). It will be helpful for one to discuss their alcohol and recreational drug use with their treatment provider.

Two categories of symptoms

Mental health professionals will sometimes talk about Psychotic Symptoms / Schizophrenia as having two categories of “positive” and “negative” symptoms, but these terms are misleading when used in a mental health context. One way to tell them apart is to think of the plus (+) and minus (-) symbols, and to think of symptoms as a problem being added or a function being subtracted. For example, hallucinations are considered a “positive” symptom because it is the addition of a new issue. A negative symptom would be a withdrawal from social interactions and inability to maintain daily living activities.

Despite how overwhelming these symptoms may sound, it is possible for a person with Schizophrenia to achieve full or partial remission from their most intrusive symptoms, such as hallucinations and delusions. Some patients may experience mild “breakthrough” symptoms when they’re highly stressed or haven’t gotten enough sleep, however these resolve quickly, usually within the same day, without additional treatment.

One of the greatest challenges for a person with Schizophrenia is finding a new way to maintain their health once they’ve received this diagnosis. Schizophrenia very often affects a person’s self-awareness, and they may completely forget to do their typical daily tasks, such as showering or eating. When a person begins to fall behind on taking care of themselves, it naturally makes their Schizophrenia symptoms worse, but the lack of awareness that comes with Schizophrenia perpetuates the unhealthy habits. This is why it’s important for people with Schizophrenia to work with their therapist and their loved ones on maintaining self-care.

Remembering to take medication is key

Remembering to take medication every day as prescribed is one of the biggest keys to success for a person with Schizophrenia. Antipsychotic medications can sometimes have unpleasant side effects, which might make a patient with Schizophrenia want to stop taking it. However, Schizophrenia is an illness where symptoms will resurface without ongoing use of antipsychotic medication. In recent years, there have been many groundbreaking innovations in the treatment of psychotic disorders like Schizophrenia, particularly with the use of long-acting injectable medications that don’t have to be taken daily, but are instead injected into the hip once per month. These medications have been shown to help patients with Schizophrenia manage their symptoms and keep them from requiring hospitalization. As medication options continue to improve, so do the chances of success for patients with Schizophrenia.

Traditional employment can pose challenges

Because Psychotic Symptoms / Schizophrenia significantly impacts daily functioning and self-awareness, traditional employment settings can present numerous challenges. Patients with Schizophrenia are encouraged to seek out local work programs, many of which have public or private funding to assist a person with Schizophrenia in finding and maintaining a job. About 80% of people with Schizophrenia receive disability benefits in the United States so that they are not required to work full time to support themselves. Many individuals who receive social security disability benefits continue to supplement their income by working part-time. Maintaining part-time or volunteer work can be very helpful to a person with Schizophrenia, as it not only provides a sense of purpose, but a means of social interaction.

Having schizophrenia is nobody's fault

It is not unusual for a person with Schizophrenia to experience symptoms for months or even years before they receive a diagnosis. But it’s important to know that Schizophrenia is never anyone’s fault. Because Schizophrenia was so poorly understood in the early to mid-1900’s, it was not unusual for parents to be blamed for their child’s illness, but this belief is no longer accepted in the mental health community. Experts in psychiatry agree that genetic and environmental factors can play a role in someone developing Schizophrenia, both of which are things human beings cannot control. Like other chronic conditions, Schizophrenia requires medication and routine monitoring from a medical provider. It may be helpful for individuals grappling with the possibility of having Schizophrenia to take a close friend or family member with them to their first appointment.

Outlook

People who are diagnosed with Schizophrenia often feel alone, confused, or even betrayed when they are first diagnosed. This is a completely normal and understandable reaction, but it’s important to remember that there is hope. Symptoms are typically at their most severe by the time an individual gets treatment, and it can take several days or even weeks for a person with Schizophrenia to fully recover from a psychotic episode.

Typically, when a person with Schizophrenia takes their psychiatric medication consistently, positive symptoms, such as hallucinations and delusions will occur infrequently, or not at all. The consensus among psychiatry providers is that taking medications on time, every day is the first step in keeping a patient with Schizophrenia healthy.

Medications most often prescribed for Schizophrenia, known as antipsychotics, work by blocking dopamine receptors in the brain. Dopamine is a neurotransmitter, and when someone’s brain is taking in too much of it, this can cause the psychotic symptoms associated with Schizophrenia. And in essence, Schizophrenia is a neurotransmitter malfunction that can only be addressed with medication. While there are many vital components to treating Schizophrenia, including talk therapy, exercise, and healthy diet, medication is what will give a person with Schizophrenia their best chance to get well and stay healthy throughout their lifetime. Individuals who do not take medication to treat their Schizophrenia have a high risk of becoming homeless and having a profoundly shortened lifespan. For that reason, much of this report addresses the importance of medication compliance.

In good company

Many prominent people reportedly have experienced Schizophrenia, such as mathematician John Nash, singer Brian Wilson of the Beach Boys, and Zelda Fitzgerald, the wife of author F. Scott Fitzgerald. The famous painter, Vincent Van Gogh as well as President Abraham Lincoln’s wife, Mary Todd Lincoln, are also believed to have suffered from Schizophrenia.

The current thinking on what causes schizophrenia

Why do some people develop Schizophrenia? It is largely seen as a genetic disorder and usually first presents in adolescence or young adulthood; however, there have been patients with Schizophrenia who reported experiencing their first symptoms after using hallucinogenic drugs. Some researchers have identified a specific gene, 22q11.2 deletion, and people with this gene have 20 times the risk for developing Schizophrenia compared to others.

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