Schizophrenia

Schizophrenia is a disorder which affects thinking, feeling and behaviour. It usually starts between the ages of 15 to 35 and affects about one in every 100 people during their lifetime.

Causes of schizophrenia

The causes of schizophrenia aren’t known for sure. It’s likely that several different factors, a combination of which will vary from person to person, may have an affect. These include:

• Genetic links - one in ten people with schizophrenia has a parent with the condition.
• Damage to the brain during pregnancy or birth.
• Use of recreational drugs, including ecstasy, LSD, amphetamines (speed), cannabis and crack.
• Stress.

Symptoms of schizophrenia

Symptoms that represent a change in behaviour, or thoughts are called ‘positive’ symptoms. These include:

• Delusions - believing something completely even though others find your ideas strange and can't work out how you've come to believe them.
• Difficulty thinking – finding it hard to concentrate, drifting from one idea to another. Other people may find it hard to understand you.
• Feeling controlled – feeling as though your thoughts are vanishing, that they‘re not your own, or that your body is being taken over and controlled by someone else.
• Hallucinations - hearing, smelling, feeling or seeing something that isn’t there. Hearing voices is the most common problem. The voices can seem utterly real. Although they may be pleasant, they are more often rude, critical, abusive or annoying.

Loss of normal thoughts, feelings or actions are known as ‘negative’ symptoms. They include:

• Loss of interest, energy and emotions. You don't bother to get up or go out of the house. You don't get round to routine jobs like washing, tidying, or looking after your clothes. You feel uncomfortable with other people.
• Some people hear voices without negative symptoms. Others have delusions but few other problems. If someone has only muddled thinking and negative symptoms, the problem may not be recognised for years.

Treatment for schizophrenia

The earlier help is sought, the better the outlook - and the less need for hospital treatment.

Treatments include:

Antipsychotic medication

This helps to weaken any delusions and hallucinations, and helps you to think more clearly and look after yourself better. It can control (but not cure) the symptoms in around four out of five people, and works best when taken regularly, even if you’ve felt better for some time.

Older, ‘typical’ antipsychotics

These work by reducing the action of a chemical in the brain called dopamine. They can cause side effects such as:

• Stiffness
• Shakiness
• Feeling slow
• Restlessness
• Sexual difficulties
• Unwanted movements, mainly of the mouth and tongue

Newer, ‘atypical' antipsychotics

These work on different chemicals in the brain and are less likely to produce unwanted movements, but can cause:

• Weight gain
• Diabetes
• Tiredness
• Sexual problems

Psychological treatments for schizophrenia

Cognitive behavioural therapy can help people live with their experiences or even help work out what makes them unwell. You can then find new ways of thinking or behaving that help you to stay well.

Counselling may help. Talk to someone for support with the daily problems of life.

Family therapy can help people to cope better with the illness. Sessions help families learn about the disorder, ways of supporting someone with schizophrenia and how to solve some of the practical problems that may arise..

Support for schizophrenia

Community support includes:

• Day centres, offering support and advice on education and employment, and a place to spend time with other people.
• Work projects, offering help to get you back to work.
• Supported accommodation, where staff (on-site or visiting) can help with day-to-day problems.
• Community mental health team key-workers can offer support with practical problems, medication or talking treatments.
• Occupational therapists can help to develop skills for living, working and socialising.

Self-help:

• Learn to recognise the signs – these can include basic things such as going off your food, feeling anxious or sleeping badly. Someone you trust may be able to warn you if they see you becoming unwell.
• Avoid stress, or using drugs or alcohol to feel better. Make sure you are able to do things you enjoy.
• Try to keep healthy - eat well, don't smoke and keep fit.

Helping someone else with schizophrenia

It can be hard to understand when the person you know starts to behave differently, avoids other people and become less active. If they have delusional ideas, they won't always talk about them, or if they’re hearing voices, may suddenly look away from you as they listen. When you speak to them, they may say little, or be difficult to understand.

A person with schizophrenia can be more sensitive to stress, so you can help by avoiding arguments and keeping calm.

If you’re caring for a relative, healthcare professionals will be able to help you. They can advise on psychological treatments, drugs and side-effects, and suggest things to improve recovery.