Schizophrenia is a serious form of psychosis. In schizophrenia, you may have difficulty distinguishing between fantasy and reality, and your thinking may be affected. You may also have difficulty coping with your daily routine.
The symptoms of schizophrenia include hallucinations (often in the form of voices) and delusions, problems to express yourself, as well as apathy, withdrawal and a flattened emotional life.
Schizophrenia is a long-term illness, and therefore your doctor will only diagnose schizophrenia when your symptoms have been present for at least a month.
Schizophrenia affects about 1 percent of the population in Finland. It is usually diagnosed at the age of 20–32, in men often a few years earlier than in women. However, the disease can break out already in childhood or only in middle age.
Symptoms of schizophrenia
There is great individual variation in the symptoms of schizophrenia and also in the same individual during different stages of the disease.
Sometimes the first symptom is a sudden and intense psychotic episode, whereas sometimes the symptoms develop slowly over weeks or months.
A delusion means that you are firmly convinced that things are a certain way, even though other people around you knows that it is not true. Misconceptions can be, for example, that you think you are someone else, are under outside control, feel persecuted or think you have been chosen for a special purpose. The delusions can also be of a religious nature, for example, you may feel that you have a divine mission. Experiences of being monitored via camera or microphone are common.
The most common of the delusions is that you hear voices that no one else hears. These voices can be accusatory or angry, and they can be the voices of loved ones or strangers. Sometimes, over time, the voices may become softer.
In addition to, or instead of, hearing voices, schizophrenia may also include other kinds of sensory hallucinations. People suffering from schizophrenic symptoms may feel different kinds of objects or creatures on their body, or see, taste or smell things that do not really exist.
Hearing voices does not always mean that it is a matter of schizophrenia. People may hear voices in connection to, for example, upsetting situations, intense stress or excessive substance use. It is estimated that quite a few Finns hear voices at some point in life. For some it is a one-time event, while others hear voices for a long time.
People suffering from long-term auditory hallucinations have an association of their own, Suomen Moniääniset, which operates under The Finnish Central Association for Mental Health, the national organisation of people with lived experience of ill mental health.
In addition, people suffering from psychotic depression or bipolar affective disorder can hear voices.
Impaired thinking leads to difficulties in planning and focusing on things or to remember at all what is important in daily life. It feels like thoughts are falling apart and it is difficult to communicate with other people.
In schizophrenia you may experience lack of motivation and apathy, which makes it difficult to perform a particular task or to perform anything, basically. Daily routines, such as bathing, can become incredibly difficult.
Flattening of emotions
Your emotional life may become flattened or blunted. You may find that you have no feelings. Sometimes others may find that your feelings are misplaced and inappropriate in the social context, which may make them confused.
Schizophrenia can lead you to withdraw from socializing or that you isolate yourself in your home. This can be due to, for example, your hallucinations, thought disorders or lost social skills or fear of social contacts.
Self-care in schizophrenia
Although the disease is long-lasting, it often gets milder with age. Self-care can help you live a normal life like anyone.
It is important to have supportive social contacts and meaningful daily activities. Peer support is important, and it is good for you to participate in various activities that offer peer support. Daily activities, part-time work or work with support is good for your recovery.
A healthy lifestyle with good diet and sleep habits also facilitate as the disease has a tendency to lead to addictions and depression. Exercise is important both for your mood and for your physical health. You should avoid alcohol and drugs, which often aggravate the symptoms.
Treatment of schizophrenia
Antipsychotic medication and other treatment can help you live a full and independent life if initiated in time. If your symptoms remain untreated, they can cause serious problems for you, both at work and in personal relationships. It is important that you do not interrupt your treatment on your own initiative.
Treatment of schizophrenia is a long-term process that is based on a combination of different forms of treatment and takes into account your own needs and involves your family. In addition to antipsychotic medication, the treatment of schizophrenia also includes learning more about psychoses (psychoeducation), cognitive psychotherapy and cognitive rehabilitation, family conversations and other forms of psychosocial support. Psychotic drugs are effective and prevent relapse, but they also have side effects.
The care and treatment aims to relieve the symptoms, strengthen the social skills, learn to keep the disease under control and live with it, and to support your family and other relatives. The care and rehabilitation takes place mainly in outpatient care. Vocational rehabilitation and support at work are important parts of care.
Also your family and loved ones can benefit from support and psychoeducation.
Causes of schizohrenia
Research shows that genetic factors and disturbances in the early development of the central nervous system increase the risk of schizophrenia. Various stressors can then lead to the onset of the disease. For example, trauma during childhood or adolescence, migration and social exclusion, or drug use, especially cannabis, can trigger schizophrenia if early disruptions of brain development have made you vulnerable.