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What is schizophrenia?

If you or a loved one has been diagnosed with schizophrenia, you are not alone. About 1% of Americans have schizophrenia. About the same percentage of men and women develop schizophrenia. Schizophrenia is characterized by delusions, hallucinations, disorganized speech and behavior, and other symptoms that cause social or occupational dysfunction. For a reliable diagnosis of schizophrenia, a person must exhibit at least two of these symptoms during a 1‐month period. And at least one of the symptoms must be delusions, hallucinations, or disorganized speech.

Schizophrenia is a serious illness that can sometimes make it very hard for people to tell what is real from what is not. At the moment there is no cure. But schizophrenia is a treatable disease. Schizophrenia treatments allow many people with schizophrenia to manage their disorder.

Schizophrenia diagnosis

According to the DSM‐5,* a medical reference commonly used by health care professionals to aid in diagnosis, the symptoms of schizophrenia include:

  • Experiencing delusions (believing in things that are not true)
  • Having hallucinations (seeing things that are not there or hearing voices in your head)
  • Disorganized speech (talking but not making sense)
  • Extremely disorganized behavior (eg, like wearing layers of winter clothing on a summer's day; disheveled appearance) or catatonic behavior (eg, staying in the same position for an extended period of time)
  • Absence of emotional expression (your face seems blank) or absence of spontaneous speech or lack of desire or motivation to pursue any goals

These symptoms significantly interfere with your ability to care for yourself, your general functioning, and your relationships. Your health care professional may discuss some or all of the above symptoms with you. It's important to openly share your feelings with him or her.

*Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Your health care professional may discuss some or all of the above symptoms with you. It's important to be open with him or her about how you're feeling.

For friends and family

"Is my loved one relapsing again? What should I do?”

Fear can overshadow the lives of people who care for those with schizophrenia. It is important that you know how to recognize and deal with the signs and symptoms of schizophrenia, including:

  • Hallucinations
  • Delusions
  • Confused thinking and speech
  • Emotional flatness (lack of expression)

Start by talking to a health care professional about signs and symptoms that your loved one displays and ask for advice on how to handle specific situations. Here are some general guidelines.

  • Be natural and kind, not condescending
  • Stay as calm as possible
  • Don’t belittle or argue about delusional beliefs
  • Don't be overprotective. It's acceptable to leave your loved one alone. However, caregivers should watch their loved one for signs of suicidal thoughts or actions
  • Define limits regarding which behaviors are not acceptable (for example, dangerous behavior such as smoking in bed)
  • Don't criticize too much; tell your loved one when he or she is doing something right

Remember, too, that there is only so much you can do. There may be times you wish you could do more, but, unfortunately, you can't make the disease "go away." It's important to accept the reality of schizophrenia and to have realistic expectations of your loved one.

"Will my loved one harm himself or herself?"

It is important to know that approximately 5% to 6% of people with schizophrenia commit suicide. About 20% attempt suicide at least once over the course of their illness. This is another reason why early and appropriate treatment is so important.

Talk to your loved one's doctor if you are worried. Individuals who experience heightened symptoms of schizophrenia may require intensive treatment, including hospitalization. Hospitalization is sometimes necessary to treat:

  • Severe delusions or hallucinations
  • Serious suicidal thoughts
  • An inability to care for oneself

"What kind of future can he or she have?"

When someone you love has schizophrenia, the illness can get in the way of leading a productive life. Finding an appropriate treatment plan and learning to cope with the day-to-day challenges is an important part of helping your loved one live with schizophrenia.

But try not to lose sight of the fact that you can help your loved one set goals and work to achieve them. Depending on how well your loved one is doing, the goal could be as simple as doing his or her own laundry or as challenging as completing a college degree.

"What's going to happen after we're gone? Who will take care of my loved one?"

It's common for parents and other caretakers of an individual with schizophrenia—especially if he or she is unable to live independently—to become preoccupied with these questions. There are no easy answers. But you may achieve some peace of mind if you discuss your options with your loved one's doctor or social worker. While the options may not seem ideal, almost any plan you develop will be better than none.

"What happens if our lives revolve around him or her?"

Providing care to a loved one with schizophrenia may seem overwhelming at times. To help you cope, it is important that you give yourself the attention and care you deserve. Consider these suggestions.

  • Take time out to relax and enjoy favorite activities or hobbies
  • Do not neglect your own health. This means getting regular check-ups, good nutrition, adequate sleep, and exercise
  • Speak openly about your needs, rather than repressing them and growing resentful
  • Avoid needless frustrations by recognizing limitations—your own, as well as your loved one's
  • Accept all the help and support you can get. Be creative about ways to share the responsibilities of caring for your loved one
  • When possible, try to see the humor in situations. Laughter is a great stress reliever

"Was it something we did?"

The answer is no. No one should feel shame or guilt, and no one is to blame. Schizophrenia is a disorder—not the result of bad parenting, trauma, abuse, or personal weakness.

Sometimes it's good to talk with people outside the family to learn how to let go of any guilt. Schizophrenia support groups are good for sharing experiences with others. It's always useful to talk to people who have "been there."