This leaflet is provided by the Royal College of Psychiatrists, the professional body responsible for education, training, setting and raising standards in psychiatry. They also provide readable, user-friendly and evidence-based information on various mental health problems.
What is schizophrenia?
Schizophrenia is a serious illness affecting thoughts, feelings and behaviour. It is a type of psychosis. A lot of people wrongly refer to schizophrenia as having a ‘split personality’ like Dr Jekyll and Mr Hyde.
How common is it?
Schizophrenia rarely occurs before puberty and usually begins in the late teenage years. About 1 in 100 people will have schizophrenia over their lifetime.
How do I know if I have schizophrenia?
When a person has schizophrenia, they may have the difficulties described below as ‘positive’ or ‘negative’ symptoms. Some of the symptoms may seem to start suddenly, whereas others may creep in more gradually. You may have some or most of the following. Usually people have a few or most symptoms for some time (at least months) before they are diagnosed with schizophrenia.
This does not mean they are ‘good’ symptoms. They mean unusual thoughts or experiences as described below. They may feel really distressing. They can feel totally real to you and it may seem to you that other people don't understand or aren't taking you seriously.
- Unusual beliefs or delusions: these are beliefs which seem obviously untrue to others, but not to you. For example, when you are ill, you might strongly believe that there is a plot to harm you, you are being spied on through the TV or being taken over by aliens. These beliefs can obviously make you feel afraid or strange.
- Muddled thinking or thought disorder is when it is difficult to think straight. Sometimes it may feel that others do not understand what you are trying to say. Your ideas may feel jumbled up, but it is more than being muddled or confused.
- Unusual experiences called hallucinations are when you see, hear, smell or feel something that isn't really there, although you are convinced that it is. ‘Hearing voices’ is one of the most common hallucinations. This can be very frightening. It can make you believe that you are being ‘watched’ or ‘picked on’. Your friends or family may say that you are acting strangely. They may say that they hear you talking or laughing to yourself. Sometimes this is the only symptom you experience which makes it unlikely to be schizophrenia.
This does not mean they are ‘bad’ symptoms, just that they are about ‘not doing’ something. You may feel tired, not interested and not want to do normal things such as:
- Go to school.
- Play sports.
- See friends.
- Get washed and dressed.
- Do hobbies you used to enjoy.
- You may become frustrated and angry, especially towards your friends or family.
- Some people try to smoke or drink alcohol to feel better, but this tends to make things worse.
You may find the symptoms so distressing that you feel like harming yourself.
What causes schizophrenia?
This is still not fully understood. There are a number of reasons that can make a person more likely to develop schizophrenia or a similar psychotic illness.
- There may be chemical imbalances in the brain.
- Having a parent or close relative suffering from schizophrenia can increase the chance of developing a similar illness.
- Stress or extreme life events (like someone close dying).
- Using drugs like cannabis, LSD, ecstasy and speed (amphetamine).
What is the treatment for schizophrenia?
Medications called ‘antipsychotics’ are an important part of treatment and often need to be taken for a long time to stay well. As with medication of any kind, there may be side-effects. The doctor will be able to advise you on what they are and what can be done to help. If you are taking drugs like cannabis, it is very important that you stop.
Other forms of treatment are also important. Both you and your family will need help to understand the condition, to cope successfully and to prevent the illness coming back. Support is often needed to rebuild your confidence to continue with school, college or work.
You may be referred to a specialist early intervention service (EIS) if available locally. This is a team of specialists who help young people with psychosis. You also may at some point need treatment in hospital or in a specialist in-patient service.
Talking treatments can be helpful, but are usually offered in addition to medication.
What will happen in the future?
Schizophrenia is a chronic illness, which means that even if you get better, it might come back later on. This can happen if you stop taking your medication too soon, so it is really important to follow the advice given to you by your doctor. Your child and adolescent mental health service (CAMHS) or early intervention team will also help you and your family identify ways to help prevent the illness coming back (eg, following a healthy lifestyle, learning to cope with stress).
Most young people will recover from their illness with the right help and treatment. Earlier treatment leads to better recovery and increases the chances of finishing school or college, getting a job and getting on with life.
How do I get help?
It is important to speak to someone you trust and who possibly knows you well, such as your GP or teacher. They may not believe or agree with your strange beliefs or experiences, but they can still help you by listening and getting the right help for you.
It is also possible that your family or teachers will first seek help for you as you may not notice there is a problem, and find it difficult to accept that there is something wrong.
Often you will be asked to get specialist help. A CAMHS member or psychiatrist from CAMHS may need to see you to understand and assess your difficulties before treating the illness.
Recommended reading and references
- The Young Mind: An Essential Guide to Mental Health for Young Adults, Parents and Teachers, edited by Sue Bailey and Mike Shooter (2009) - an accessible, user-friendly handbook produced by the Royal College of Psychiatrists
- Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care (Update) (CG82). NICE, 2009
- Rutter M, Bishop D, Pine D, et al (eds). Rutter's Child and Adolescent Psychiatry (5th edn). Wiley-Blackwell, 2008
Content used with permission from the Royal College of Psychiatrists website: Schizophrenia: information for young people (March 2012, due for review March 2014). Copyright for this leaflet is with the Royal College of Psychiatrists.