Symptoms of Schizophrenia

• 'Positive' and 'negative' symptoms
• Symptoms change from time to time
• Self harm, suicide and violence

Contrary to popular belief, schizophrenia is not a 'split personality'. However, people with schizophrenia may have perceptions of reality that are extremely different from those shared by others around them. They often suffer distressing symptoms such as hearing voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. Living in a world distorted by hallucinations and delusions, people with schizophrenia may feel frightened, anxious and confused, and may be left fearful and withdrawn. Their speech and behaviour can become so disorganized that they may be puzzling or frightening to others. Partly because of the alternative realities they experience, people with schizophrenia may behave very differently at various times.

Sometimes they may seem distant, detached, or preoccupied and may even sit in a fixed position not moving or uttering a sound for hours on end. At other times they may move about constantly, always occupied, appearing wide-awake, attentive and alert.

People with schizophrenia usually experience two types of symptoms.

These are psychological features 'added' as a result of the disorder, but not normally seen in healthy people:

• hallucinations (hearing voices is the most common)
• delusions
• disorganized thinking
• agitation

These are psychological capabilities which most people possess, but which people with schizophrenia have 'lost':

• drive or initiative
• social interaction
• enthusiasm
• emotional responsiveness

The symptoms of the condition usually vary over time, worsening during periods of relapse and improving during periods of remission. Some people have only one psychotic episode; others have many episodes during a lifetime, but lead relatively normal lives during the interim periods, appearing emotionally healthy and stable. However, the individual with 'chronic' schizophrenia, or a continuous or recurring pattern of illness, may be left with some of the 'negative symptoms' and may require long-term treatment, generally including medication.

Research has shown that people with a psychiatric illness account for up to a fifth of individuals seen to deliberately self-harm themselves, and suicide is a risk for people with schizophrenia. It is important to note that suicide results from many complex factors and it is more likely to occur during periods of family and individual crisis. Any feelings and talk of suicide should be taken seriously, and a GP, psychiatrist or other health professional should be contacted to discuss any concerns.

The vast majority of individuals with schizophrenia are not violent. The news and entertainment media tend to link mental illness with violent behaviour, but people with a mental illness are more likely to harm themselves, or be harmed, than they are to hurt other people. Individuals who experience paranoid and psychotic symptoms can become worse if treatments/support and medication are discontinued and this may lead to violence, but where violence does occur it is most frequently targeted at family members and friends, and most often occurs at home. However, with the correct and appropriate interventions, the risk of these incidences can be dramatically reduced. It is important to know that substance abuse (using street drugs and excessive use of alcohol) increases the risks of violent behaviour in people with schizophrenia, just as it does with people who have no mental illness.