Schizophrenia: Overview and Course of the Disorder

Schizophrenia is a common psychiatric disorder that can affect a person’s thinking, emotions, and behavior. People with schizophrenia experience periods when they have difficulty understanding the reality around them. They may hear voices that other people don’t hear. They may have unusual thoughts and suspicions, such as believing that other people are reading their minds, controlling their thoughts, or plotting to harm them.

If you or a loved one has been diagnosed with schizophrenia, all of this can sound overwhelming. But it’s important to understand that there are treatments to help improve functioning and relieve many symptoms of schizophrenia. Some individuals respond very well to these treatments and can lead rewarding and meaningful lives, but some remain severely disabled by their illness.

Living with Schizophrenia

People with schizophrenia tend to be withdrawn or extremely agitated because their experience with the illness can be terrifying. In addition to symptoms such as hallucinations and delusions, nearly all people with schizophrenia have some impairments in their memory, attention, and decision making.

Some individuals with this illness also experience a lack of expressiveness, low motivation, apathy, an inability to experience pleasure, and a disinterest in social relationships. Depression can also be a part of the illness.

Families and society are affected by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they rely on others for help. Sometimes symptoms may be so severe that a person needs to be hospitalized.

Diagnosis

Schizophrenia must be diagnosed by a trained mental health professional. Both diagnostic interviews and medical evaluations are used to determine the diagnosis. There are currently no physical or lab tests that can diagnose schizophrenia, but they can help rule out other conditions that sometimes have similar symptoms, like seizure disorders, metabolic disorders, thyroid dysfunction, brain tumor, and drug use.

The Onset

Schizophrenia often first appears during young adulthood (late teens or early twenties for men and late twenties or early thirties for women). The onset of symptoms may be abrupt or
gradual, but most people experience some early signs before the beginning of active symptoms.

These early signs may include depression, social withdrawal, loss of interests, or unusual behavior. The can also display decreases in everyday functioning at school, work, or in close relationships. These are often the first behaviors to worry family members and friends.

Recovery Is Possible

Although there is great variability, some generalizations can be made about the long-term course of schizophrenia. While many individuals do not return to their prior state of functioning, about one-half to two-thirds of people with schizophrenia significantly improve or recover, some completely.

About one-third of individuals are significantly affected by the disorder and experience frequent hospitalization, and about 10% of these individuals experience long-term institutionalization.

Managing Schizophrenia Throughout Life

The course of schizophrenia over time varies from person to person. Most people experience periods where the symptoms get much worse followed by a period of remission. Others can be more chronically ill and maintain a steady level of moderate to severe symptoms over long periods of time.

Some individuals have a milder experience. The “positive symptoms,” such as hallucinations and delusions, increase during a relapse while “negative symptoms,” such as apathy and lack of motivation, tend to be more persistent and are present between episodes.

Keep Learning and Find Support

The most important thing is to keep learning about schizophrenia and find a safe place to ask questions and feel supported. We offer a free private Facebook group for families with schizophrenia and bipolar disorder. You can also subscribe to receive our newsletter so that you can receive our latest blog posts.

Here are some additional articles you might find helpful:

• The Symptoms of Schizophrenia
• What Causes Schizophrenia and How Common Is It?
• Antipsychotic Medication: What You Should Know
• Evidence-Based Treatment for Schizophrenia
• Family Support for Schizophrenia: How Family Members Can Help