Schizophrenia & Psychosis: Understanding The Facts
Did you know that about 1 in 100 people in Ireland will be diagnosed with schizophrenia or a related condition?
If you, or someone you know, has been affected by psychosis or schizophrenia, you’re not alone: millions of people worldwide have experienced psychosis – but the condition is often misunderstood.
Forget the stereotypes – schizophrenia is not about “split personalities”, being dangerous, or any of the other ideas that you may have seen portrayed in film and TV. In reality, schizophrenia is a treatable medical condition that affects how a person thinks, feels and experiences the world.
This article breaks down the facts, clears up some common myths and provides guidance on the help that is available.
What is psychosis?
Psychosis happens when a person has trouble separating what’s real from what’s not – it refers to a particular set of symptoms, including hallucinations, delusions and confused thinking.
Hallucinations
All sorts of thoughts rush through our minds throughout the day – our brains usually do a good job of filtering out unhelpful thoughts and focusing in on thoughts that are important. We’ve all been in a position, however, where something we didn’t want to think about – often something stressful – keeps popping into our minds, despite our best efforts.
During a period of psychosis, your brain doesn’t filter out the unwanted thoughts as well as you would like – and some thoughts become so prominent that your brain misinterprets them as sounding out loud. Because people are usually feeling badly about themselves during a period of psychosis, it’s often the case that these are nasty, self-critical thoughts, like, “You’re worthless” or “Everyone hates you”. These hallucinations can, unsurprisingly, be very distressing to the person experiencing them.
Delusions
Someone with psychosis may firmly believe things that aren’t true. Thinking, for example, that someone is planning to harm them or that they are being followed or watched. Sometimes there may be a grain of truth in these beliefs but they may be blown out of all proportion. This is a very frightening position to be in.
Confused thinking
Not being able to think clearly is another feature of psychosis. This can include easily losing your train of thought or not being able to put your thoughts into words.
What is schizophrenia?
Schizophrenia is a mental health disorder where the person experiences periods of psychosis. In addition to experiencing hallucinations, delusions and confused thinking, there’s also often reduced motivation or drive to look after oneself. It’s also often associated with a decline in how people are functioning, for example a drop in how well someone is doing in school, in work or in relationships.
Why do people develop schizophrenia?
There’s no single cause. Research shows that genetics plays a role but that’s only one factor. Stress may also play a role and can impact on relapses, as can drugs.
Common myths about schizophrenia
Myth: “People with schizophrenia have multiple personalities”.
Truth: People with schizophrenia do not have multiple/split personalities – this is a (Hollywood-driven) myth – they have one personality, the same as everyone else.
Myth: “People with schizophrenia are violent”.
Truth: People with schizophrenia are more likely to be victims (not perpetrators) of violence.
Myth: “People with schizophrenia can’t be treated”.
Truth: There are effective treatments for schizophrenia – and the earlier someone begins treatment, the better the outcomes.
Treatment and recovery
Treatment is usually delivered in specialist community mental health teams in collaboration with your GP. Some parts of the country have specific “early intervention in psychosis” teams within their mental health services. Treatment typically involves medication and psychological treatments.
The types of medication used to treat schizophrenia are called “antipsychotics” or “neuroleptics” and these are prescribed by psychiatrists within the mental health service. Non-medication interventions can also play an important role – for example, one-to-one or group talking therapies, family education, and work/skills training can all play a role. These are often delivered by nurses, psychologists, clinical social workers and occupational therapists in mental health services. Research clearly shows that early intervention is important – the sooner treatment begins for psychosis, the better the outcome usually is.
It’s also important to look after your physical health. People with schizophrenia die 10-20 years earlier than the rest of the population, often due to preventable conditions, like heart disease, stroke, and smoking-related illnesses. Regular physical health checks with your GP can identify and treat these problems earlier.
Where to get help
If you are concerned about schizophrenia in a friend or family member, speak to a GP, who can advise on the best course of action. They can determine whether a referral to specialist mental health services is appropriate.
While schizophrenia is often a long-term condition, it’s important to recognise that people can live long healthy lives with the appropriate health and social supports.
Prof Ian Kelleher
Consultant psychiatrist, chair of child and adolescent psychiatry at the University of Edinburgh, and an Academy of Medical Sciences professor, researching ways to prevent mental illness.