What is Schizophrenia?

by Andrea Blundell
Reviewed by Dr Sheri Jacobson

Schizophrenia can sound a big scary word. But there are a lot of misconceptions about it, and you might be surprised to learn that many people manage fairly normal lives with it.

What is schizophrenia?

Schizophrenia is a mental health condition where you persistently struggle to differentiate between what is real and what seems real to you, called ‘psychosis’.

This happens because you experience hallucinations and/or delusions, as well as disorganised thinking. A forth major symptom is a lack of emotional responsiveness.

Symptoms of schizophrenia

So what are hallucinations and delusions, anyway? And are there further symptoms?


This means you sense things as there that aren’t. The most common symptom here is hearing voices. But you can also see visuals, sense things like something brushing your skin, or even smell and taste things that aren’t real.


Delusions see you really believe in something, but that something isn’t real. Common thoughts here can be that someone is out to get you, or that you have a special power that others don’t.

Disorganised thinking

This means that your thoughts are jumbled, and maybe feel out of order. When you go to speak you can struggle to make sense. Or perhaps you think of one thing obsessively.

Other symptoms of schizophrenia can be:

  • social withdrawal (not wanting to be around others)
  • apathy (not caring about things anymore)
  • lack of emotions (you might feel blank)
  • loss of drive (not feeling ambitious or setting goals)
  • struggles being organised (your life might feel overwhelming)
  • self neglect
  • unpredictable behaviour (taking uncharacteristic and even inappropriate actions).

When it’s actually another disorder

Psychosis is not unique to schizophrenia. So just because you have hallucinations, for example, does not mean you have schizophrenia.

Other conditions that can appear similar include:

The onset of schizophrenia

Schizophrenia can be different for each individual. You might have a different mix of symptoms than another sufferer. And the way schizophrenia starts for you can differ.

For some people, it can start with a sudden, acute episode of psychosis.

But more frequently there is what is known as a 'prodromal period' before your first episode of acute psychosis. This means that for anywhere for a few days to about 18 months you exhibit negative changes to the way you function.

Prodromal symptoms can look like troubles concentrating and remembering things, struggling to communicate, losing interest in your hobbies and social life, and acting and thinking in ways that are unusual for you.

Why me?

You might feel alone if you have schizophrenia. But the National Institute for Health and Care Excellence (NICE) estimates that around one in 100 Brits have schizophrenia or psychosis.

And the World Health Organisation (WHO) estimates that there are around 20 million people worldwide with schizophrenia.

It's thought that schizophrenia is a mixture of biology and environment. In other words, you might be born with a genetic higher chance of developing schizophrenia over your lifetime. But a combination of environments -- life stressors, difficult experiences, substance abuse -- can then trigger this potential.

Can substance abuse cause schizophrenia?

Yes, substances can trigger schizophrenia if you have a predisposition to having it. This seems particularly true with cannabis use, but it can be other mind-altering substances, too, like amphetamines and cocaine.

An overview of data from studies on psychosis and schizophrenia confirmed that cannabis use itself didn't cause schizophrenia. But heavy use at a young age did indeed increase your chance of developing it, if you had a genetic liability and were exposed to the right set of stressors like childhood trauma.

How to get a diagnosis

It’s most often diagnosed in those aged 16 to 25. It is thought that hormonal changes can trigger a tendency to have schizophrenia.

But it can be diagnosed at any age. Some people develop schizophrenia in later life, and sometimes it develops in children (although rarely before aged 10).

For a diagnosis, you will need to see a psychiatrist. An assessment looks to see if you have had two of the four major symptoms (hallucinations, delusions, disorganised thinking, low emotions) for at least six months.

Myths about schizophrenia

1. You can never live a normal life.

Not true at all. Yes, you will need treatment and support. And for the first year or so, as you figure out what stablises you, might not feel normal. But otherwise, you can have a career, relationships, and achieve your goals like anyone else.

2. It means you have several personalities.

Schizophrenia can be confused with dissociative identity disorder. They are completely different. When you are schizophrenic it's not your personality that splits from reality, just your thoughts.

3. Schizophrenics are dangerous.

Unfortunately the only time schizophrenia makes the press is if someone commits a crime and has schizophrenia. Millions of people live with the condition without ever being a danger to anyone. And far more people without schizophrenia commit dangerous crimes than those with.

Is there a cure for schizophrenia?

There isn’t a quick cure, but it responds well to treatment. In late onset schizophrenia, NICE suggests that "after five years of illness one quarter of people recover completely. For most people the condition gradually improves over their lifetime." If the onset is in childhood or adolescence, about one fifth end up with only mild impairment.

Treatment might mean a mix of anti-psychotic medication and talk therapy, most often cognitive behavioural therapy. CBT helps you to catch and question your thoughts, learning how to differentiate distorted thinking from more helpful balanced thinking.

If you are living with family, then it might also be recommended to do family therapy, so that everyone can work together in productive ways to understand and help you.

Worried you are having hallucinations or delusions? Or want to try CBT therapy for schizophrenia? Use our easy booking tool now to find a therapist who can help.

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