Psychotic Disorders

Schizophrenia

Schizophrenia is a serious, chronic mental disorder affecting how a person thinks, feels, and behaves. People with schizophrenia may experience hallucinations, delusions, disorganized thinking, and impaired functioning. With proper treatment, many people with schizophrenia can manage symptoms and lead productive lives.

Symptoms

Positive symptoms: hallucinations (hearing voices), delusions (false beliefs), disorganized speech, catatonic behavior

Negative symptoms: flat affect (reduced emotional expression), social withdrawal, lack of motivation, reduced speech, inability to experience pleasure

Cognitive symptoms: poor concentration, impaired working memory, difficulty planning, reduced processing speed

Causes

Complex interaction of genetics and environment
Multiple genes contribute to risk
Brain chemistry: dopamine and glutamate imbalances
Brain structure differences (enlarged ventricles, reduced cortical volume)
Prenatal risk factors (infections, malnutrition, stress)
Cannabis use during adolescence increases risk in vulnerable individuals

Diagnosis

Requires at least 6 months of symptoms with at least 1 month of active-phase symptoms (delusions, hallucinations, disorganized speech). Must rule out schizoaffective disorder, mood disorders with psychotic features, substance-induced psychosis, and medical conditions. Brain imaging and blood tests help exclude other causes.

Treatment Options

Antipsychotic medications (lifelong treatment usually needed)

Second-generation antipsychotics: Risperidone, Olanzapine, Quetiapine, Aripiprazole

Clozapine for treatment-resistant cases

Long-acting injectable antipsychotics for adherence

Psychosocial interventions: CBT for psychosis, social skills training

Family psychoeducation and therapy

Vocational rehabilitation

Supported housing programs

When to Seek Help

Seek immediate help if someone is hearing voices or seeing things others don't, expressing bizarre or paranoid beliefs, showing significant personality changes, withdrawing from social contact, or showing declining ability to care for themselves.

Your Action Plan

1.Step 1: Trust your treatment team — they can see things from the outside that are hard to see from the inside

2.Step 2: Take medication EVERY DAY as prescribed — this is the single most important thing you can do for stability

3.Step 3: If pills are hard to remember, ask about monthly injections — same medication, no daily decisions

4.Step 4: Learn YOUR early warning signs: what happens first when you start to become unwell?

5.Step 5: Maintain routine: regular sleep, meals, light exercise, social contact — structure prevents relapse

6.Step 6: Avoid cannabis and other drugs — these can trigger psychotic episodes directly

7.Step 7: Reduce stress where possible — stress doesn't cause schizophrenia but can trigger episodes

8.Step 8: Stay connected to at least one person you trust — isolation worsens the disease

9.Step 9: Cognitive rehabilitation programs can help with memory and concentration difficulties

10.Step 10: Recovery IS possible — many people with schizophrenia live full, meaningful lives with proper treatment