What is schizophrenia?

Schizophrenia is a long-term (chronic) and serious mental illness that affects how you:

• think
• feel
• behave
• understand reality

People with schizophrenia may struggle with daily life, work and social activities.

Schizophrenia is the most common psychotic disorder in Australia. It usually starts in the late teenage years or early adulthood. It is more common in males than females.

What are the symptoms of schizophrenia?

Schizophrenia has a wide range of symptoms, including symptoms of psychosis. Psychosis is a condition where a person loses touch with reality.

Symptoms are grouped into 3 main types.

Positive symptoms

These are changes in thoughts or behaviours, such as:

• delusions — strong beliefs that aren't true or based on reality
• hallucinations — seeing or hearing things that aren't there
• unusual movements — such as repeated actions or staying still for a long time (catatonia)

Negative symptoms

Negative symptoms mean a person loses behaviours or emotions that most people have.

These may include:

• showing less emotion — having a blank face or a dull voice
• lack of motivation — not wanting to do daily activities
• less interest in things that used to be enjoyable
• avoiding people and social situations

Cognitive symptoms

These affect thinking and daily life, including:

• disorganised speech and thinking — talking in a way that jumps between topics or is hard to understand
• trouble focusing or paying attention
• forgetting things more easily

What causes schizophrenia?

The exact cause of schizophrenia is unknown. It is believed to be caused by a mix of genetics, life experiences and brain chemistry.

• Genetics — having a close family member with schizophrenia may increase your risk.
• Life experiences such as pregnancy complications, infections, high stress, childhood trauma or social isolation may play a role.
• Brain chemistry — imbalances in brain chemicals, such as dopamine, serotonin and glutamate are linked to psychosis and thinking difficulties.

Drugs, such as marijuana, LSD or speed can make psychotic symptoms worse in people with schizophrenia. Sometimes, drug use may trigger schizophrenia.

When should I see my doctor?

See your doctor or mental health professional if you think you or someone you know may have schizophrenia.

Seek urgent help if you or someone you know:

• hears voices or sees things that aren't there
• talks in a way that doesn't make sense
• acts in a very unusual or confused way

How is schizophrenia diagnosed?

Your doctor or mental health professional may diagnose schizophrenia through a mental health assessment.

To be diagnosed, you must have at least 2 or more of the following symptoms for at least one month:

• delusions
• hallucinations
• disorganised speech
• unusual movements
• negative symptoms

At least one of the symptoms must be delusions, hallucinations or disorganised speech.

The symptoms must also:

• make it hard for you to work, interact with other people or take care of yourself
• continue for at least six months (including the one month period)
• not be caused by substance abuse or another mental illness

A psychiatrist usually confirms the diagnosis and advises on the best treatment.

How is schizophrenia treated?

Schizophrenia has no cure, but treatment can manage symptoms and improve daily life. Early and regular treatment is important to prevent relapses.

Medicines

Medicine is the main treatment for schizophrenia. Antipsychotic medicines can reduce symptoms, such as hallucinations and delusions.

Some people develop side effects to medicine. This is why you should have regular check-ups with your psychiatrist or doctor.

Therapy and support

Psychological therapy can help people understand and manage their symptoms and learn new ways of coping. Options may include:

• cognitive behaviour therapy (CBT) — teaches ways to challenge delusions and cope with symptoms
• psychoeducation — teaches social skills to help with communication and daily activities
• family therapy — helps loved ones understand schizophrenia and provide support
• employment and education support — helps people return to work or study

Hospital and crisis treatment

Some people may need short-term hospital care if they:

• are at risk of harming themselves or others
• have severe hallucinations or delusions
• cannot take care of themselves

Living with schizophrenia

Living with schizophrenia can be challenging and is different for everyone. The right support can help you manage your condition.

Having family, friends and health professionals for support makes a big difference. A safe and stable home is important, especially during times when symptoms get worse.

Community services

Some people need help with daily tasks, such as cooking, cleaning or managing money. Community services can provide support.

People with schizophrenia have a higher risk of homelessness. Some may need special housing with care staff who assist with daily needs and medicines.

Lifestyle

Lifestyle changes can help you feel better. Try to:

• eat healthy
• stay active
• avoid drugs and alcohol

What are the complications of schizophrenia?

Schizophrenia can affect daily life and may lead to:

• difficulty keeping a job or completing education
• social withdrawal and relationship problems
• higher risk of substance abuse, anxiety and depression
• higher rates of homelessness and financial problems
• higher risk of suicide

Can schizophrenia be prevented?

Schizophrenia cannot always be prevented, but you can lower the risk if you:

• take care of your mental health
• manage stress
• avoid using drugs
• get help early if you notice unusual thoughts or behaviours

Resources and support

Your doctor can refer you to a public mental health service or a private psychiatrist, psychologist or private hospital.

Read more on the costs of mental health services.

There is a wide range of services available to help people who live with schizophrenia and their family or carers:

• SANE offers information about schizophrenia.
• Head to Health — for advice and to get connected to local mental health services, call 1800 595 212.
• Headspace offers a variety of tools and resources to help support young people. Chat privately with counsellors over the phone or webchat about your mental health.

For urgent help, call Lifeline on 13 11 14 or Suicide Call Back Service on 1300 659 467.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

• Embrace Multicultural Mental Health offers mental health resources and personal stories translated into more than 30 languages.
• Call the Telephone Interpreting Service (TIS) on 131 450 and ask the interpreter to call Lifeline on 13 11 14 for crisis support.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Crisis Support for Aboriginal and Torres Strait Islanders — provides a confidential, culturally safe space to yarn about your worries or concerns.
• Yarn Safe by headspace (for people aged 12 to 25 years) — chat online.