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Schizophrenia is the name given to a group of psychotic disorders illustrated by significant disturbances in thought, emotion and behaviour. A person must experience these disturbances for a significant period of time to be classified as schizophrenic, as there are other psychotic disorders which have similar symptoms.

A person with untreated schizophrenia can experience sequences of ideas that do not logically relate to one another, disorganised speech, a faulty perception of reality, and unusual motor activity or body movements. Someone who is experiencing untreated schizophrenia will often withdraw from the people around them into a land of fantasy. Schizophrenia does not mean that someone has more than one personality or a 'split' personality.

What are the causes of schizophrenia?

The causes of mental illness have been linked to several factors:

Biological factors - ie the body's chemistry, genetic make-up and physical health.

Psychological factors like the person's upbringing, emotional experiences and interactions with other people

Social factors that are to do with the person's current life situation and the cultural and social things that they are influenced by.

There seem to be several factors which have to be present in order for schizophrenia to develop, and often it's the interaction, or the combination of all those factors, which cause its development.

So, for example, there might be an interaction between a person's biological make-up, a stress or change in their environment and the person's ability to deal with this stress or change, especially if they don't have good relationships with friends and family and therefore possibly less support.

Genetics

People in the general population have a very small chance of developing schizophrenia in their lifetime, but this chance gets bigger when there's a history of family members have a history of experiencing schizophrenia.
Genetic factors seem to play a very important role in determining whether someone will develop schizophrenia. For example, a child of one parent with schizophrenia has a greater chance than the general population of developing schizophrenia and if both parents have schizophrenia the risk increases.

Environment

A baby may be affected if the mother is exposed to the flu while she is pregnant or if the baby does not get the right amount of nutrition during pregnancy. It has also been suggested that stress and/or trauma can be one of the things that may cause schizophrenia.
Family factors causing stress may affect the course of the illness, like how severe the symptoms are and how long they last, but there is no convincing evidence to say that a person's family situation causes schizophrenia.

Brain development

There could be a possibility that one of the reasons that schizophrenia can develop later in life is from the brain not developing properly whilst the baby is still inside the mother. This isn't necessarily anything that can be controlled by the mother.

Drug misuse

Some research suggests that drug misuse is related to the development of schizophrenia. It is likely that substance misuse may bring on or worsen the symptoms and get in the way of the treatment of a person with schizophrenia.

Biochemical factors

It may be that chemical imbalances in a person's brain could be involved in the cause of schizophrenia. It has been thought for a long time that the neurotransmitters (the chemicals in the brain that allow nerve cells to talk to each other) are involved in the development of schizophrenia. There are no definite answers about this yet but there is lots of research going on in this area.

The main symptoms of schizophrenia

Positive symptoms

Positive symptoms are additional experiences or excessive behaviours that are not usual for that person to go through, and are considered by the general population to be unusual. These are things like hallucinations, delusions and thought disturbances/disorganised speech.

Hallucinations

The hallucinations can be in a few different forms. The most commonly experienced are auditory hallucinations where the person can hear voices talking, laughing or making noise. The voices can comment on the person's activities, they can argue, or it may be just that the person can 'hear' their own thoughts being repeated or commented on. Noises around them may also become too much for them and hearing them could be painful.

Other sensory hallucinations can occur where the person can feel sensations that do not exist, such as burning, tingling or stinging sensations. They may experience sensations of not feeling 'real' or machine-like, or they do not feel connected to their body. Their bodies or a particular body part may feel and/or look strange to them.

Visually

They may imagine that they see things that aren't there, or find visual stimulus in an extreme form such as light could be almost blinding.

Delusions

The hallucinations may be accompanied by a delusion that the illusion may confirm and encourage. Delusions are thoughts held by a person which most people would disagree with. An example of a common delusion is where a person believes that they someone other than who they actually are, usually someone famous. Paranoid delusions can be experienced where the person believes that they are being watched or persecuted.

Disorganised Speech (thought disorder)

This means that a person has difficulty in organising their thoughts and communicating them in an order that a listener would understand. Random words or new topics are injected into the conversation which will not make any sense to the listener.

Negative symptoms

Negative symptoms are the absence of thoughts and behaviours that are normal present in people in the general population. These symptoms are often very stable and affect the person throughout their life. If you are experiencing negative symptoms, they might include:

Lack of expression

also referred to as 'blunted affect'. Sometimes people who are psychotic find that their expressions are diminished. Their face, voice tone, and gestures may seem flat, and they may seem uninterested in their surroundings (which is not necessarily the case).

Unmotivated

Also called Apathy. People often feel unmotivated and sometimes sleepy. They might have trouble doing even simple things, and feel like there is nothing they are interested in.

Lack of pleasure

Also referred to as Anhedonia. A psychotic illness often affects a person's ability to feel pleasure. Sometimes the person may no longer feel enjoyment like they used to be from things like going to the movies, or sharing a close relationship.

Difficulty speaking

Sometimes called Poverty of Speech. Sometimes the person can find it hard to speak. Often their conversations are short and uncomfortable. This can make conversation with them difficult, and frustrating for both the person experiencing this symptom, and anyone else in the conversation.

Inattention

This is when the person can often be easily distracted and this can make work, school or any activity very difficult and often highly frustrating.

Catatonia + inappropriate affect

People with schizophrenia can also experience other symptoms that don't fit into the categories of 'positive' or 'negative'.

• Catatonia - grimaces, strange facial expressions, repeated gestures, manic gestures.
• Catatonic immobility - strange positions that a schizophrenic person will hold themselves in for a long time.
• Inappropriate affect - A person with schizophrenia may express a response to some news that does not match, or is not appropriate. For example, some sad news may cause them to smile and laugh.

Finding help

The most effective form of treatment is a combination of medication and support. Support means things like individual counselling, information, support from the person's family and friends, psychosocial treatment.

People with schizophrenia can also benefit a lot from a stable living environment, structure, a meaningful job/study/hobby and being kept from as much stress as possible. Medication will need to be prescribed by a doctor or psychiatrist and it is important that you seek help.

A psychologist, social worker or mental health nurse can also help manage your symptoms and help you to get on with your life. For more information on how these people can help you check out Reach Out's Who can help you section. To find a doctor or mental health professional see the beyondblue Directory of Medical and Allied Health Practitioners in Mental Health You may also want to ask friends or your local doctor if they can recommend anyone.

Remember - help is available and schizophrenia can be treated.