“Schizophrenia cannot be understood without understanding despair.” – R. D. Laing 

Schizophrenia is a mental disorder that makes it hard to tell the difference between real and unreal experiences, to have normal emotional responses, to think logically, and to behave normally in social situations.  Often wrongly referred to as ‘split personality’, schizophrenia is a chronic, severe, debilitating mental illness that affects about 1% of the population, corresponding to more than 2 million people in the United States alone, resulting in some combination of disorganized thinking, speech and behavior, hallucinations (most often hearing voices) and delusions (a persistent false belief), and most often requiring lifelong treatment.  Paranoia, social withdrawal, sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia.  Sadly, it is the most disabling of the major mental illnesses, and the ability of people with schizophrenia to function normally and to care for themselves frequently tends to decline over time.

Although the term schizophrenia has only been in use since the early 1900s, its symptoms have been described throughout written history.  There is no known single cause of schizophrenia as it appears to be the result of a complex group of genetic, psychological and environmental factors.

In men, symptoms of schizophrenia usually start in the teens or 20s.  In women, schizophrenia symptoms typically begin in the 20s or early 30s.  These are the critical years in a young adult’s social and vocational development.  Although possible, it is uncommon for children to be diagnosed with schizophrenia and rare for those older than 40.  People suffering from this disorder oftentimes have difficulty maintaining a job and keeping friends.  They also are at increased risk of having a number of other mental health conditions such as anxiety, depression, and suicidal thoughts and behaviors

Signs and symptoms of schizophrenia generally are divided into three categories — positive, negative and cognitive.

Positive symptoms reflect an excess or distortion of normal functions and include:

• Delusions – a persistent belief not based in reality
• Hallucinations – hearing or seeing things that do not exist
• Thought disorder – difficulty speaking and organizing thoughts
• Disorganized behavior – can range from childlike silliness to unpredictable agitation

Negative symptoms refer to a lessening or absence of characteristics of normal function and include:

• Loss of interest in everyday activities
• Appearing to lack emotion
• Reduced ability to plan or carry out activities
• Neglect of personal hygiene
• Social withdrawal
• Loss of motivation

Cognitive symptoms involve problems with thought processes and include:

• Difficulty paying attention
• Memory problems

The main treatment of schizophrenia is antipsychotic medications, which have been found to be most effective in treating the positive symptoms, often in about 7-14 days, in combination with psychological and social supports.  Psychosocial treatments include education of family members, social skills training, supported employment, and cognitive behavioral therapy.  There is some strong evidence that regular exercise has a positive effect on the physical and mental health of those with schizophrenia.

Schizophrenia is a chronic condition that requires lifelong medication and psychosocial treatment, even when symptoms have subsided, in order to effectively manage the disorder.  During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.  A psychiatrist experienced in treating schizophrenia usually guides the treatment team which often includes a psychotherapist and possibly a case manager to coordinate care.

Coping with an illness as serious as schizophrenia can be challenging, both for the person with the condition and for friends and family.  You can receive help and referral assistance by contacting the National Alliance on Mental Illness (NAMI) which is a grassroots, patient and family self-help support and advocacy organization dedicated to improving the lives of people with severe mental illnesses such as schizophrenia.  The Santa Barbara County Chapter of NAMI can be contacted at:

NAMI – Santa Barbara County
617 Garden St., 2nd Floor
Santa Barbara, CA 93101

Phone: 805-884-8440