Schizophrenia is a severe and complex mental health condition that significantly affects how a person thinks, feels, and behaves. It is a chronic disorder, meaning it tends to be long-lasting, often requiring ongoing management and support. People living with schizophrenia may experience episodes where they find it difficult to distinguish between reality and their thoughts or perceptions.

Types of Schizophrenia

While schizophrenia presents differently in each individual, it is generally classified into several types based on predominant symptoms:

• Paranoid Schizophrenia: Marked by intense delusions and auditory hallucinations, often involving feelings of persecution or conspiracy.
• Catatonic Schizophrenia: Characterised by disturbances in movement, which can range from physical rigidity to excessive, repetitive movements.
• Undifferentiated Schizophrenia: When a person exhibits symptoms of schizophrenia that don’t fit neatly into other subtypes.
• Residual Schizophrenia: Where positive symptoms (like hallucinations or delusions) have reduced, but negative symptoms (such as withdrawal or lack of motivation) persist.

What Causes Schizophrenia?

The exact cause of schizophrenia remains unknown, but it is thought to result from a complex interplay of genetic, biological, and environmental factors. Research suggests that the following may contribute:

• Genetics: Having a close family member with schizophrenia increases the risk, though it’s not solely inherited. Most people with a family history do not develop the condition.
• Brain Chemistry: Imbalances in neurotransmitters, particularly dopamine and glutamate, may affect how the brain processes information, leading to symptoms.
• Environmental Triggers: Stressful life events, childhood trauma, abuse, or significant life changes can trigger symptoms in those predisposed to the condition.
• Prenatal Factors: Exposure to infections during pregnancy, malnutrition, or complications at birth may increase the likelihood of developing schizophrenia later in life.

It’s important to understand that schizophrenia is no one’s fault—it’s a medical condition, not a result of poor upbringing, character flaws, or personal weakness.

Symptoms of Schizophrenia

Symptoms can vary significantly between individuals but are often grouped into three categories:

1. Positive Symptoms (adding to reality):

• • Hallucinations: Hearing, seeing, or feeling things that aren’t there. Auditory hallucinations (hearing voices) are the most common.
  • Delusions: Strongly held false beliefs, such as thinking you’re being watched or controlled by external forces.
  • Disordered Thinking: Difficulty organising thoughts, leading to incoherent speech or trouble following conversations.

2. Negative Symptoms (taking away from normal functioning):

• • Apathy or Lack of Motivation: Struggling to start or sustain activities.
  • Social Withdrawal: Avoiding friends and family, loss of interest in previously enjoyed activities.
  • Flat Affect: Reduced emotional expression, appearing emotionally “blank” or unresponsive.

3. Cognitive Symptoms:

• • Poor Concentration: Difficulty focusing, remembering things, or making decisions.
  • Disorganised Thinking: Trouble with logical thinking, leading to confused speech or behaviour.

Symptoms can appear gradually or suddenly, and they often fluctuate over time.

How Is Schizophrenia Diagnosed?

Diagnosing schizophrenia isn’t straightforward, as symptoms may overlap with other mental health conditions, such as bipolar disorder or major depression with psychosis. A comprehensive evaluation by a mental health professional, usually a psychiatrist, is essential.

The diagnostic process typically includes:

• Detailed Medical and Psychiatric History: To rule out other conditions or substance-related issues.
• Mental Status Examination: Assessing mood, behaviour, thinking patterns, and perception.
• Physical Examination and Tests: Blood tests or brain scans may be conducted to exclude physical causes like brain tumours, infections, or substance abuse.

In many cases, a multi-disciplinary team, including psychiatrists, psychologists, and social workers, collaborates to ensure an accurate diagnosis and holistic care.

Treatment for Schizophrenia

While schizophrenia is a lifelong condition, effective treatment can help manage symptoms, reduce relapses, and improve quality of life. Treatment is often tailored to the individual and may include a combination of the following:

1. Medication:

• • Antipsychotics: The cornerstone of treatment, these medications help control hallucinations, delusions, and disorganised thinking. There are two types:
    • Typical (first-generation) antipsychotics: Effective but may have more side effects.
    • Atypical (second-generation) antipsychotics: Often preferred due to fewer side effects.
  • Mood Stabilisers or Antidepressants: Used if there are symptoms of mood disorders alongside schizophrenia.

2. Psychotherapy:

• • Cognitive-Behavioural Therapy (CBT): Helps individuals understand and manage their symptoms, develop coping strategies, and reduce distress caused by psychosis.
  • Supportive Therapy: Focuses on emotional support and stress management techniques.

3. Social and Vocational Support:

• • Social Skills Training: To enhance interpersonal relationships and daily functioning.
  • Vocational Rehabilitation: Support in finding and maintaining employment.

4. Family Therapy and Education:

• • Involving family members in treatment can improve outcomes, providing them with tools to support their loved one effectively.

5. Community-Based Support:

• • Supported Housing: For individuals who need help with daily living.
  • Case Management: To coordinate care and support recovery in the community.