3.1 Schizophrenia

Schizophrenia is not an especially common mental illness, with a lifetime prevalence of 0.5-1%. However, it is arguably the most feared and stigmatized, and so warrants attention.

Schizophrenia is a long-term condition that often has a significant impact on an individual’s life. It entails a breakdown in thoughts and behaviour, which often manifest as erratic and unusual behaviour. If untreated, people with schizophrenia usually struggle to function at work and in relationships.

Contrary to common misconceptions, people with schizophrenia do not have multiple or “split” personalities and they are not likely to engage in violent behaviour.

The condition often develops slowly and usually emerges in adolescence and young adulthood. Most people have episodes in which their symptoms are especially pronounced, followed by periods of relative stability.

Broadly speaking, symptoms can be classified into “positive” and “negative” symptoms.

3.2 Positive Symptoms of Schizophrenia

Positive symptoms entail a change to behaviour and thoughts, which usually take the form of delusions and hallucinations.

When someone hallucinates, they hear, touch, see, smell and taste things that do not exist. They may hear voices or see people. Sometimes these entities are perceived as harmless or even friendly, but they can be threatening or even urge the individual to harm themselves.

Delusions are firmly held beliefs that are untrue. Someone with a delusion rarely responds to logical arguments. Someone with persecutory delusions believes that another person or organisation is trying to harm or kill them. Those with grandiose delusions believe that they are unique or powerful in some way. For instance, they might believe that they are a famous celebrity or a messianic figure.

3.3 Negative Symptoms of Schizophrenia

Negative symptoms entail social withdrawal and diminished functioning. For instance, an individual may stop engaging with others and rarely express any emotion – this is known as “flattened affect”. Someone may have a mix of symptoms from both categories. They may experience their own thoughts as disorganised, and they might struggle to concentrate. Their moods may fluctuate with no apparent cause.

Negative symptoms often appear several years before an individual’s first schizophrenic episode. Sometimes this is referred to as the “prodromal period”. The symptoms slowly worsen until the onset of the first acute episode, which can be highly distressing for both the sufferer and those around them. A person with schizophrenia often has little or no insight into their condition, which can make it hard to persuade them to seek help.

3.4 Psychosis

Psychosis is not only seen in those with schizophrenia. People with other mental illnesses may also have trouble ascertaining what is “real” and what is not. For instance, some people with severe depression experience feelings of deep worthlessness and guilt. They may come to believe that they have committed a terrible crime and might even feel compelled to confess to the police, despite the fact they could not have done it. Someone who is displaying symptoms of psychosis is said to be having a “psychotic episode”.