What is schizophrenia?

Schizophrenia is a disease that makes it hard to think clearly, manage emotions, and interact with other people. It can cause:

• Delusions. These are beliefs that are not real.
• Hallucinations. These are things that you may see or hear that are not really there.
• Paranoia. This is the belief that others are lying, cheating, using you, or trying to harm you.

The disease may change your ability to enjoy life, express emotions, or function. You may hear voices or behave strangely. You may also keep to yourself or have trouble speaking or understanding speech.

You may need lifelong treatment with medicines and counseling. This helps keep the disease under control.

When schizophrenia is not treated, the risks are higher for suicide, a hospital stay, and other problems. Early treatment called coordinated specialty care (CSC) may help a person who is having their first episode of psychotic thoughts. Ask your doctor about CSC.

At first, changes can be vague and hard to notice. Later, you may have hallucinations, delusions, or confusing thoughts and speech. Treatment will help stop your symptoms (remission). But over time symptoms can return (relapse), and you'll need treatment to help improve again.

Symptoms of schizophrenia include losing interest in or not caring about things and not taking care of yourself, like not bathing or eating regularly. Other symptoms include hearing voices or having confusing thoughts. Memory loss or having trouble talking are symptoms that affect how you think. Symptoms may appear suddenly or develop slowly.

Medicines can help treat your symptoms. Counseling and therapy help you change how you think about things and deal with the illness. In the recovery process, you learn to cope with your symptoms, set goals, and get support. Recovery usually is a lifelong process.

Your doctor will ask you questions about your health and any symptoms you may have had, such as hearing voices or having confusing thoughts. You'll have a physical exam. Your doctor may suggest tests, such as blood tests or imaging tests, to see if your symptoms may be caused by another health problem.

Medicines are the best treatment for schizophrenia. You may take more than one medicine at a time. It may take time to find which medicines are right for you.

The ones used most often are:

• Antipsychotic medicines. These include aripiprazole, clozapine, and haloperidol.

Other medicines often are used along with the ones listed above. They include:

• Antianxiety medicines. Examples are clonazepam and diazepam.
• Antidepressants. These include amitriptyline, citalopram, desipramine, escitalopram, and fluoxetine.

• Show your love. Understand that the behavior you may see is part of the illness, not the person you love.
• Understand that symptoms that make no sense to you are real to your teen. Don't argue with, give up on, or make fun of your teen. Help your teen feel safe and in control.
• Learn about schizophrenia. Understand what happens in schizophrenia and how you and your teen can cope with it. This may make it easier for you and your teen to work together on treatment.
• Work together as a family. Get family therapy. Know what may or may not be helpful, and don't ask your teen to make changes too quickly. You and your family may benefit from therapy even if your teen does not want to participate.
• Help during hallucinations and paranoia. Call your teen quietly by name, or ask your teen to tell you what they are going through. Be calm and soothing. Don't argue or tell your teen that the voices are not real. Call for help if you think the situation could become dangerous.
• Be sure that your teen takes their medicines. Talk about how the medicines help symptoms. You also can help by watching for side effects.
• Be aware of your own and other people's negative attitudes (stigma) toward the illness and your teen. Do what you can to fight stigma and teach people about schizophrenia.

Where to get help 24 hours a day, 7 days a week

If your teen talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Encourage good health habits

• See that your teen doesn't drink alcohol or use illegal drugs. This makes treating schizophrenia harder. If your teen has a problem with drugs or alcohol, get help.
• Encourage your teen to be active. Exercise and activity can help your teen stay fit.
• See that your teen gets enough sleep. Sleep can help mood and stress levels.
• See that your teen eats healthy foods. This helps the body deal with tension and stress. Whole grains, dairy products, fruits, vegetables, and protein are part of a balanced diet.

Help Yourself

• Find your own support. Finding your own support can help you deal with the illness and the sense of loss you may feel. Caring for someone who has schizophrenia is not easy.
• Take care of yourself. Do things you enjoy, such as seeing family or going to movies.
• Don't feel you need to do everything possible to help your teen.
• Don't do it alone. Ask others to help you. The more support you have, the more help you can give. Get help from a local organization. Your city or state may have programs to help you. Ask at your local or state health department.

Schizophrenia is a complex illness. Experts don't know what causes it or why some people get it and others don't. But some things increase your chances of getting it. These are called risk factors.

You may be at risk for schizophrenia if:

• Your mother, father, brother, or sister has it.
• Your mother had certain problems while she was pregnant with you. For example, you may have a higher risk if your mother didn't get enough to eat (malnutrition), had a viral infection, or took certain medicines for high blood pressure.
• You or a family member has another disorder that's like schizophrenia. An example of this is a delusional disorder, which means that you believe things that you know are false.
• You have substance use disorder. Experts don't know if substance use triggers schizophrenia or if schizophrenia makes a person more likely to have this problem.

Social skills training helps you get along better with other people in daily life, at work, and in social situations. These classes also help you develop skills for your personal relationships and can help you learn how to take care of yourself.

In all classes, you'll become aware of and try to change symptoms of schizophrenia that may make it hard to interact with other people. Your training may help you:

• Make better eye contact.
• Respond more quickly to others.
• Smile, frown, or use facial expressions that fit the situation.
• Talk as loudly or softly as needed.

You'll also learn skills that will help you with your treatment. These may include:

• How to manage your medicines.
• How to tell if your medicine is causing side effects and what to do.
• How to know if you're having a relapse and what to do.
• How to find the help you need.

Experts don't know what causes schizophrenia. It may have different causes for different people. Brain chemistry and brain structure can play a role. So can family history. Problems that harm a baby's brain during pregnancy may also help cause it.

Schizophrenia is an illness that can affect your ability to think clearly, manage your emotions, and interact with others. Most people who have schizophrenia hear and sometimes see things that aren't there (hallucinations). They often believe certain things that aren't true (delusions). And they may think that others are trying to harm them (paranoia).

An action plan says in writing what you can do to help prevent a relapse of schizophrenia and what you need to do if you have signs of a relapse. You will need the help of others to get through a relapse.

An action plan also lists the general signs of a relapse and those that may be special to you.

• Write down the common signs of a relapse. They include:
  • Staying away from or not being interested in other people.
  • Forgetting things.
  • Having problems concentrating.
  • Daydreaming.
  • Not paying attention to what is going on.
• Work with your doctor to find out if you have any special relapse signs.

An action plan lists things that need to be taken care of during a relapse. Think about:

• Who will take care of your children if you have any.
• Who will manage your money and finances.
• Which hospital or other facility you'd like to go to.
• Who to tell if you have a relapse.

Action plans also can include legal documents. Write these when you have few or no symptoms, and ask your doctor and lawyer to help you.

• An advance directive tells your wishes for treatment during a relapse. It can be very useful if you have severe symptoms of fear or suspicion of others during a relapse.
• A durable power of attorney says who will be in charge of making decisions when you can't decide things yourself. This document is very helpful if you refuse treatment during a relapse when you would otherwise accept it.
• A power of attorney lets you choose someone to help you deal with money during a relapse. Find someone you trust to co-sign financial documents, such as credit card applications or mortgages, to protect yourself financially while you are having a relapse.