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KEY POINTS
- Schizophrenia is a rare but serious condition that causes changes in your thoughts, emotions, and behavior. Problems with the way you think may make it very hard to deal with everyday life.
- Medicines are a very important part of the treatment. Other treatment may include therapy and learning ways to manage stress. In severe cases, you may need to be treated in the hospital.
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What is schizophrenia?
Schizophrenia is a rare but serious condition that causes changes in your thoughts, emotions, and behavior. If you have this condition you may:
- Hear voices that others do not
- Have behavior that is unusual
- Say things that others do not understand
- Not be able to tell what is real from what is imagined
- Have trouble showing your emotions
Schizophrenia usually causes serious problems in everyday activities.
What is the cause?
The exact cause of this disorder is not known.
- Schizophrenia tends to run in families. If a child has one parent who has schizophrenia, then the chances of the child developing it are 10 times that of other children. Most children will not develop schizophrenia even if they have a parent with the disorder.
- Stress, childhood abuse, neglect, and bullying also play an important part. They can increase the risk of developing the disorder, or make the symptoms come sooner and be more severe. This disorder is not caused by poor parenting.
- People with this disorder may have physical changes in their brain. These changes may mean that some parts of the brain are more active or less active than in other people.
- The brain makes chemicals that affect thoughts, emotions, and actions. People with schizophrenia may have differences in certain brain chemicals that can affect their behavior.
- Some drugs can cause or increase schizophrenia symptoms. These include LSD, marijuana, cocaine, and amphetamines.
- If a woman has a virus or nutrition problems while she is pregnant, it increases the risk that the child will develop schizophrenia later in life. Low oxygen levels from long labor or premature birth may also increase the risk.
Schizophrenia usually starts in the late teens or in the twenties. Symptoms usually increase over 3 to 5 years. Sometimes schizophrenia starts suddenly over a few weeks. A few people have been diagnosed in childhood and some after age 40. Several million people in the United States are affected. It occurs slightly more often in men than in women.
What are the symptoms?
No single symptom defines this illness. Some of the symptoms are behaviors that would not be seen in people without mental illness. These types of symptoms are called positive symptoms. They may come and go, and they may be mild to severe. Positive symptoms include:
- Hearing, seeing, smelling, or feeling things that others do not
- Believing things that are not true, such as thinking that others are trying to hurt you
- Having trouble thinking clearly
- Stopping talking in the middle of a sentence
- Making up words that have no meaning
- Repeating certain motions over and over, or sometimes not moving at all
Some people with schizophrenia show fewer of the usual emotions and behaviors that other people do. These are called negative symptoms. Negative symptoms are often harder to recognize and may be mistaken for depression or other mental illnesses. Negative symptoms include:
- Having few facial expressions, such as smiles or frowns
- Dressing oddly, like wearing winter gloves in summer
- Not bathing or combing your hair
- Speaking in a flat voice or talking very little or not at all
- Having trouble enjoying anything
Other problems with the way you think may make it very hard to lead a normal life, such as:
- Having trouble using information to make a decision
- Having trouble paying attention
- Having trouble using information that you have just learned
How is it diagnosed?
Your healthcare provider or therapist will ask about your symptoms, medical and family history, and any medicines you are taking. You may have tests or scans to make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.
A mental health professional should make the final diagnosis. The diagnosis is made based on a thorough psychiatric interview with you and family members.
How is it treated?
Medicines
Medicines are a very important part of the treatment. Several types of medicines can help. Your healthcare provider will work with you to select the best one for you. You may need to take more than one type of medicine. These medicines may cause side effects, but you and your healthcare provider will watch for them. Your healthcare provider may change how much or how often you take your medicine, or change the medicine you have been taking.
It is important to stay on your medicine to keep your symptoms under control. If you are thinking about stopping your medicine, talk to your provider first. Do not stop taking your medicine without your healthcare provider's approval.
Therapy or counseling
This disorder changes the way you relate to others and the way you think about everyday activities. It may be hard for you to talk or interact with other people. People with schizophrenia are more likely than other people to commit suicide, be a victim of crime, be arrested, or be homeless. Therapy can help you learn about the disorder, cope better with your symptoms, and get support and advice about how to manage daily challenges.
Cognitive behavioral therapy (CBT) focuses on changing your thinking and behavior. The therapist helps you learn how to:
- Check out the reality of your thoughts
- Cope with voices in your head
- Manage your daily stress
- Change negative thought patterns
- Identify early warning signs that symptoms are getting worse
- Set goals and motivate yourself
Group therapy allows you to share and learn from others with similar problems. It can help you deal with work, relationships, and side effects from drug therapy. It usually takes place in a group of 6 to 10 people, under the guidance of a therapist.
Family therapy is often very helpful. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family to make changes.
The illness may make it hard to organize your thoughts, solve problems, and make decisions. You may have trouble taking care of yourself or telling others what you need. You will probably need a therapist or case manager to help you manage your daily needs. You may live in a group setting with others who also have this illness.
You may need to spend some time in a hospital if you are thinking about hurting yourself or someone else, or if you are unable to take care of yourself.
How can I take care of myself?
- Get support. Talk with family and friends. Join a support group in your area.
- Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga or deep breathing when you feel stressed.
- Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, talk with your healthcare provider about how to quit. Avoid alcohol and drugs because they can make your symptoms worse. Exercise according to your provider's instructions.
- Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
- Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse. Sometimes this illness makes you afraid of even your provider or therapist. Watch for this and be honest with your provider or therapist about it.
Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others.
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