What is Schizophrenia? (An Easy Guide to Understanding)

What is Schizophrenia?

Schizophrenia is a severe mental illness that impacts how a person perceives the world. It consists of disruptions in thought processes, social interactions, perceptions, and emotions.

Schizophrenia is typically diagnosed in the late teen years to early thirties. It also tends to emerge earlier in males than females.

Most studies put the prevalence of schizophrenia in the US population as around .30-.50%.

What are the symptoms of schizophrenia?

Positive Symptoms

The most talked about symptoms of schizophrenia are the positive symptoms. These are the symptoms that are commonly portrayed in movies and other media sources when characterizing someone with schizophrenia.

One easy way to remember positive symptoms are positive symptoms are the addition of something to a person’s experience.

The positive symptoms include:

• Hallucinations: these can be visual, tactile, or auditory - the most common being auditory

• Delusions: a delusion is a fixed false belief that someone holds despite evidence to the contrary; they include: persecutory, grandiose, jealousy, erotomania or delusions of love, and somatic delusions that include believing something is wrong with them

• Thought disorder: a way of thinking that is usually unusual or illogical

• Movement disorder: when someone exhibits abnormal body movements, sometimes repeating motions over and over

Negative Symptoms

Although the positive symptoms typically steal the show, negative symptoms can be some of the most debilitating for someone to experience. The negative symptoms can be more easily remembered as symptoms that take away from someone’s experience.

The negative symptoms include:

• Loss of motivation

• Loss of enjoyment in daily activities or hobbies

• Talking in a dull voice and showing limited facial expressions

• Avoiding social interactions

• Not being able to take care of one’s needs

Cognitive Symptoms

It has not been concluded yet as to whether there are are only specific cognitive areas that are impacted by schizophrenia or if the cognitive ability as a whole is generally affected. Cognitive symptoms are a variety of symptoms that can be in the disorder before someone has onset or expression of positive or negative symptoms.

The cognitive symptoms include:

• Impaired working memory: retaining information you might need to complete a task in the moment

• Impaired processing speed: the rate at which you respond to new information

• Lowered attention: the ability to focus on something

• Vigilance: the need to focus on something that might happen

• Weaker verbal learning: Difficulty focusing on words, syllables, letters, and digits you may need and trouble using language to express themselves or explain something

• Difficulty with reasoning and problem solving: reasoning stems from perception which can be skewed or even wrong in schizophrenia

• Impaired social cognition: trouble understanding the feelings or thoughts of others, misunderstanding facial expressions, emotion, and social signals in a conversation

What are the 3 phases of schizophrenia?

The three phases of schizophrenia are prodromal, active, and residual.

Prodromal Phase

Prodromal phase is the first stage of schizophrenia. It’s a stage that occurs before more intense experiences like hallucinations and delusions begin to take over.

The difficulty with getting help for those going through the prodromal phase is that the symptoms mimic many other diseases and disorders as well. There is very little evidence to support that these specific symptoms will lead to schizophrenia.

Some of the symptoms of the prodromal phase include:

• anxiety

• social isolation

• neglecting personal hygiene

• irritability

• lack of motivation

• difficulty concentrating

The prodromal phase can last months and sometimes even years. About 70% of schizophrenia cases will occur with the prodromal phase.

Cognitive impairments can also become more present and troublesome.

During this period of time, those with schizophrenia might seek out help but they are typically seeking health for conditions like depression or anxiety.

Unfortunately, this is the time where most schizophrenia patients struggle with suicidal ideation. 47% reported at least 27 suicide attempts between them out of 16 patients.

Attempts have been made to find resources and screenings that will help detect and protect those with prodromal symptoms from developing into full schizophrenia. A lot more work in this field needs to be accomplished before we can begin using testers and screenings reliably.

Active Phase

In the active phase of schizophrenia, individuals begin experiencing the symptoms and experiences that lead to active bouts of psychosis. These symptoms are much more obvious to family, friends, and doctors that the illness has progressed.

During the active phase of schizophrenia is the time when most individuals are diagnosed with schizophrenia.

During this phase, there is a more aggressive nature with positive, negative, and cognitive symptoms. This is typically when the patient will begin to develop full-blown psychosis.

Psychosis is the presentation of symptoms that affect the mind and leads to loss of contact with reality. During this loss of reality, thoughts and perceptions can be severely disrupted, causing the patient to not understand the difference between reality and their illness.

Studies show that is can be common for an individual to experience psychosis for up to a year before they begin receiving treatment. Reducing the time in between the start of symptoms and when the individual receives professional help is critical - earlier interventions can often times mean an earlier recovery. It should be recognized that there is no cure or full recovery with a schizophrenia diagnosis.

Recovery usually means remission of the illness or the next stage, Residual Phase.

Residual Phase

Although this part of the schizophrenia diagnosis is no longer included in the DSM-5-TR for diagnosis, it is still a very valuable and noteworthy part of the illness to talk about.

During the residual phase of schizophrenia, patients begin to experience fewer and less intense symptoms than they experienced during the active phase. Positive symptoms are usually the symptoms that are seen to be less consistent and easier to manage.

The residual phase is really similar to the prodromal phase.

Cognitive symptoms and negative symptoms can still be debilitating for the patient.

The residual phase is sometimes what happens as people get older, but not everyone reaches the residual phase. Some stay in the active phase for the rest of their lives.

Conclusion

Schizophrenia is a life-long illness and cannot be cured.

Although those with schizophrenia can go into remission from their illness, most still experience a lot of every day perceptual oddities. A description of this can be found in my post on the EASE and EAWE, Self-Disorder in Schizophrenia.

If any of you have experience with schizophrenia. please add to my description by offering your own experiences in the comments below!