Everyone has thoughts sometimes that they worry about. In a small number of people, unusual thoughts and intense feelings can be a sign of a mental illness called schizophrenia. People who have been diagnosed with schizophrenia have a difficult time being able to tell the difference between what is real and what is imagined.

What is schizophrenia?

Some people think that schizophrenia is when a person has multiple personalities. This is NOT true. Schizophrenia is a serious mental illness that interferes with a person’s thoughts, emotions, relationships, and decision making skills. It can make a person’s thoughts seem unclear and confusing, especially to others. It can make it difficult to do ordinary things. All of these changes can leave a person feeling sad, worried, lost, or scared.

How do you get it?

The chances of someone developing schizophrenia are very small. According to the National Institute of Mental Health, only about 1% of people in the US have this illness. The chances of having schizophrenia are higher if a person has a close relative, such as a parent or a sibling, who has been diagnosed with it. Other influences may be a person’s environment and life events, such as experiencing traumatic events early in life. Scientists are still trying to identify what causes schizophrenia, but it is likely caused by a number of factors put together.

What are the warning signs?

Schizophrenia does not have a sudden onset—meaning a person does not wake up one day with schizophrenia. Instead, the illness usually develops slowly over months or years and often comes with warning signs. These warning signs often appear when a person is becoming an adult, between the ages of 16-30. Below are a few examples of warning signs that something could be wrong:

• Withdrawal from others or wanting to spend more time alone
• Trouble doing well in school or poor performance at work
• Severe depression or anxiety
• Change in sleeping patterns, such as not being able to sleep as well or switching the hours you normally sleep
• Poor hygiene, such as not taking as many showers or not brushing your hair
• Trouble concentrating or thinking clearly
• Uneasiness with others that is new or can’t be clearly explained, or feeling worried that others want to harm you
• Feeling bothered by sights or sounds as if they are brighter or louder than usual, or seeing or hearing things that are not really there
• Preoccupation with one’s own thoughts

These warning signs show there is a problem, but they could be signs of many different kinds of problems. Sometimes these signs point to another mental or medical illness. They are especially important to pay attention to if they are severe. It’s important to notice any changes similar to these and talk about them with your parent or a trusted adult. It is very important to mention them to your health care provider or a mental health counselor or therapist.

What are the symptoms of schizophrenia?

Schizophrenia generally has certain symptoms which must be present for at least 6 months before a diagnosis can be made. These symptoms fall into two main categories: positive symptoms and negative symptoms. Positive symptoms are changes in the way you think or perceive things. Negative symptoms represent a loss of functioning. Examples of each are as follows:

Positive symptoms:

• Hallucinations: Having sensations (sight/sound/touch/taste/smell) that others don’t have. For example:
  • Hearing your name called when no one is around
  • Hearing static when you aren’t near a radio
  • Hearing a voice or voices that are not your own
  • Seeing things that aren’t there

• Delusions: Having ideas that are not based in reality. For example:
  • Believing you can read people’s minds or they can hear your thoughts
  • Believing someone else is controlling your thoughts
  • Believing you are extremely special or a gift to the world

• Confused thinking:
  • Speaking in jumbled sentences
  • Often losing your train of thought when speaking
  • Trouble following conversations
  • Trouble paying attention to others because of the thoughts or noises in your head

Negative symptoms:

• New and severe trouble with motivation or getting started on activities
• Loss of interest in social activities, people or the world around you
• Drop in ability to focus, understand or remember things
• Decrease in ability or interest in taking care of yourself physically

What is the treatment?

Even though schizophrenia is a serious mental illness it is also treatable, especially when the signs are caught early. Many people with schizophrenia live satisfying lives when they get good treatment. As with other mental illnesses, there are a few approaches to treatment that, when used all together, work the best. One approach is taking medicine prescribed by a psychiatrist or psychiatric nurse practitioner. Another approach is through individual or group therapy. There are also community programs that can help with daily living and job goals. It’s helpful for family members to become educated so the person dealing with this illness is never alone in the journey.

How can I talk to my health care provider?

If you are concerned about your own thoughts and/or feelings the best thing you can do is bring it up with your health care provider or talk to a mental health counselor or therapist.  This might feel scary, especially if you are unsure of what you have been experiencing, and that’s okay. Try to remind yourself that your health care provider is there to help. Some ways to bring it up are by saying “I’ve been feeling really strange lately and I don’t really know what’s going on” or “I sometimes feel like my mind is playing tricks on me.” Your doctor will be able to have a deeper conversation with you to help figure out if what you’re experiencing is normal or if there are things you can do to make it better.

What if I see these signs in a friend or family member—how can I help?

It can be hard to be with someone who is behaving oddly or not like themselves. If you are concerned for a friend or family member it’s important to tell a responsible person. Talk to your health care provider and another trusted adult, such as a parent or other family member, a religious leader, or a teacher.