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What Is Schizophrenia?

Schizophrenia is a chronic, disabling brain disorder that


affects about 1% of Americans. It may cause people to
hear voices, see imaginary sights, or believe other
people are controlling their thoughts. These sensations
can be frightening and often lead to erratic behavior.
There is no cure, but treatment can usually control the
most serious symptoms.

Schizophrenia Symptoms
Symptoms of schizophrenia may include:
Hallucinations -- hearing or seeing imaginary things
Delusions -- wildly false beliefs
Paranoia -- the fear others are plotting against you
Some symptoms, such as lack of enjoyment in everyday
life and withdrawal from social activities, may mimic
depression.

How Schizophrenia Affects Thoughts


People with schizophrenia often have abnormal ways of
thinking. They may have trouble organizing their
thoughts or making logical connections. They may feel
like the mind is racing from one unrelated thought to
another. Sometimes they experience "thought blocking,"
a feeling that thoughts are removed from their head.
Despite popular belief, schizophrenia is not dissociative
identity disorder (multiple personality disorder.)

How Schizophrenia Affects Behavior


Schizophrenia causes a wide range of behaviors. People
may speak incoherently or even make up words. They
may act agitated or appear stone-faced. Many people
have trouble maintaining basic hygiene or orderly homes.
Schizophrenia can also cause repetitive behaviors, such
as pacing. In contrast to common stereotypes, the risk of
violence against others is small.

Who Gets Schizophrenia?


Schizophrenia affects men and women at the same rate,
and occurs almost equally in all ethnic groups around the
world. Symptoms usually begin between ages 16 and 30.
The onset tends to be earlier in men than in women.
Schizophrenia rarely begins during childhood or after age
45. People with schizophrenia in their family may have a
higher risk for the illness.

What Causes Schizophrenia?


The exact cause is not known, but scientists suspect
genes and environment both play a role. Inside the
brain, levels of the chemical messengers dopamine and
glutamate may be out of balance. And brain structures
may be abnormal, too. For example, brain scans of
identical twins show that the fluid-filled "ventricles" can
be larger in a twin with schizophrenia, compared with a
twin who does not have the illness. Activity levels can
also be higher or lower than normal in some areas of the
schizophrenic brain.

Diagnosing Schizophrenia
There are no lab tests to detect schizophrenia, so a
diagnosis is usually based on history and symptoms. Tests
may be ordered to rule out other medical causes of
symptoms. In teenagers, a combination of family history
and certain behaviors can help predict the onset of
schizophrenia. These behaviors include withdrawing from
social groups and expressing unusual suspicions.

Medicine for Schizophrenia


Prescription drugs can reduce symptoms such as
abnormal thinking, hallucinations, and delusions. It's
thought they work by regulating certain brain chemicals
and receptors that influence thinking, perception, and
behavior. Some people have troubling side effects,
including tremors and weight gain. Schizophrenia drugs
can also interact with other medications or supplements.
In most cases, long-term medication is essential to
managing schizophrenia

Psychosocial Therapies
Counseling can help people cope with their problem
behaviors and thoughts, and improve how they relate to
others. In cognitive behavioral therapy (CBT), people
learn to test the reality of their thoughts and better
manage symptoms. Other forms of therapy aim to
improve self-care, communication, and relationship
skills. These strategies are not meant to replace
medication, but can help people already stable on
medication manage everyday challenges.

Rehabilitation
Rehabilitation may include job training, money
management counseling, and guidance in using public
transportation or shopping for groceries. The goal is to
help people with schizophrenia stay employed and
maintain as much independence as possible. Rehab
programs are particularly effective when combined with
psychotherapy.

Relapse Prevention
People with schizophrenia sometimes quit their
medications because of side effects or a poor
understanding of their illness. This raises the risk of
serious symptoms returning and triggering a full
psychotic episode. Regular psychosocial therapy can help
people stay on medication and avoid a relapse or the
need for hospitalization.

Schizophrenia and the Workplace


People with schizophrenia often have trouble finding or
keeping a job. This is partially because the disease
impairs normal thinking, concentration, and
communication. But it also stems from the fact that
symptoms begin in young adulthood, which may interfere
with education and job training. Vocational training can
help people develop practical job skills.

Schizophrenia and Relationships


Relationships can be a challenge for people with
schizophrenia. Their unusual thoughts and behaviors may
alienate friends, co-workers, and family members.
Sticking to a treatment plan can reduce social isolation.
One form of therapy focuses on forming and nurturing
interpersonal relationships. In addition, support groups
or family therapy can help loved ones better understand
the illness.

Schizophrenia and Substance Abuse


People with schizophrenia are much more likely than the
general population to abuse drugs or alcohol. Some
drugs, including marijuana and cocaine, can make
symptoms worse. Drug abuse can also interfere with
treatments for schizophrenia. Patients with a drug
problem may benefit from substance abuse programs
specifically designed for people with schizophrenia.

Schizophrenia and Pregnancy


Most drugs used to treat schizophrenia have no known
risk for increasing the risk of birth defects, but decisions
about medication treatment for schizophrenia during
pregnancy should be discussed with your doctor.

Tips for Family Members


Schizophrenia can be confused with other mental health
disorders so a careful evaluation is key. It can also be
difficult to convince someone with schizophrenia to get
help. Treatment often begins when a psychotic episode
results in a hospital stay. Once the person is stabilized,
family members can help prevent a relapse by:
Encouraging the person to stay on medication
Tagging along on follow-up appointments