What is Schizophrenia? Why is this Condition So Misunderstood?

What is Schizophrenia? Schizophrenia is a serious mental health condition that most people in American society do not understand. Why? I believe that the fear, myths and stigma that surround this condition keep most people from truly understanding it. We tend to fear and judge what we do not understand.

For example, many people think that people living with Schizophrenia are:

  • Very dangerous. My response: In my experience (and research backs me up on this), they are no more violent than the average population, unless they are also actively using drugs. However, even here, I need to point out that MANY PEOPLE who use certain types of drugs are more violent than average, with or without Schizophrenia. So while persons living with may exhibit what we'd call very odd behavior, rarely do they behave in a way that is dangerous to others.
  • Drug addicts and/or alcoholics. Response: While many individuals with this condition do self-medicate, many do not. Besides, how can one judge someone for using substances if they are living with delusions, visions, and/or voices? If I experienced those symptoms, I'm not sure what I would do to cope; it's hard for me to imagine, even after working with hundreds of individuals living with Schizophrenia. 
  • Homeless and begging for your change. Response: While it is certainly true that the nature of the condition makes one more vulnerable to losing stable housing, with proper support the vast majority of people can  live independently, some of them with little or no support. Our society often doesn't provide the proper level of support for someone struggling with a persistent mental health condition. Make no mistake, this is a major systemic problem we have in terms of how we treat persons living with mental illnesses!
  • Have multiple personalities. Response: No. That’s a totally different condition, known as Dissociative Identity Disorder (formerly Multiple Personality Disorder). Yet, according to WebMD (2018), 64% of Americans believe that Schizophrenia involves a split personality.
  • Had bad parents. Response: Mothers in particular get blamed. Genes, trauma, drug abuse, and other factors are all causal. Being a poor (or ill-equipped) parent does NOT cause Schizophrenia in someone.
  • Are not very smart. Response: Simply not true. Persons with this condition are on average every bit as smart as the mainstream, and sometimes smarter.
  • Not fit to live in mainstream society. Response: Says who? I’ve seen many persons with this condition live independently, and many others who’ve lived independently with regular support from a case manager or advocate. The level of resources and social supports makes a huge difference for someone living with a mental health diagnosis that's on the Schizophrenia Spectrum. 
  • Unable to hold a job. Response: I spent about 18 months as a supported employment specialist at a local social services agency called ShelterCare, and saw dozens of individuals diagnosed with Schizophrenia engage in competitive employment.
  • Never going to get any better. Response: Not true. My first-hand experience has shown me that many individuals living with this condition are able to reduce their symptoms and become more engaged in an active life. Many of these individuals were helped considerably by medication, but some improved without meds. (NOTE on medication for Schizophrenia and other related disorders: they tend to have significant side effects, leaving the individual with an unpleasant choice--Do I continue the medication and suffer severe side effects such as Tardive Dyskenesia or weight gain, OR do I go off the meds and have a major increase in symptoms and loss of mental stability? What a horrible choice to make!).

In any case, the bullet points above are a list of many (but not all) of the most common myths surrounding Schizophrenia. During my 13 years as a counselor and coordinator at ShelterCare, I had the experience of working with many individuals who live with Schizophrenia. I’ve found that people living with this condition are some of the most stigmatized and misunderstood people in our society.

Now we know what it isn’t. So...what is Schizophrenia?

Okay, so what is schizophrenia? For sure, it's one of the most misunderstood mental health conditions, maybe THE most misunderstood.

It’s important to understand that Schizophrenia, like most other mental health conditions, is best thought of on a spectrum (based on intensity, frequency, duration, and impact on one’s functioning). Don’t think of people as either having Schizophrenia or not. Furthermore, some people who have delusions or auditory/visual hallucinations do not suffer from Schizophrenia or any of it’s closely related conditions--Schizoaffective Disorder, Schizophreniform Disorder, and more. There are medical reasons, extreme stress responses, and other factors that may explain these symptoms for some people. 

Having said that, there are a few key features to the condition known as Schizophrenia. In order for someone to meet the diagnostic criteria, there must be the presence of two or more of these active symptoms

  • Delusions. For example, thinking that the radio broadcaster is actually talking to you, or believing that one is the King of an Ancient Empire
  • Auditory or Visual Hallucinations
  • Disoriented thinking and speech (frequent incoherence or inability to stay on one coherent topic)
  • Furthermore, these symptoms are not better explained by alcohol, drugs or a medical condition
  • While the actual diagnosis of Schizophrenia requires ‘the continuous presence of the disturbance for at least six months’ (DSM-5, 2013), it is important to note that several other conditions on the Schizophrenia Spectrum require less duration. For more detail on the specifics of diagnosis, click here

In addition, the following ‘Negative Symptoms’ include

  • Social Withdrawal
  • Extreme Apathy
  • Lack of Initiative
  • Emotional Unresponsiveness

The term negative symptoms refers to conditions that imply the absence of something. Notice that the four symptoms above all have this in common.

Also, I must emphasize that this is a list of possible symptoms. No one person has the same set of symptoms. If you were to meet ten people who were in an active phase of Schizophrenia, you would see ten different presentations. Just like any other group, persons living with this condition are very individual, one from another. The question of 'What is Schizophrenia?' has no simple answer. 

For more information on what constitutes the condition we call Schizophrenia, and what differentiates it from other somewhat related conditions, check out this link at Mental Health America

How Does Schizophrenia Affect People?

Well, consider what it would be like trying to work at a job (or go to school, or have an intimate relationship) while hearing voices or believing that the radio is talking to you specifically. This would be terrifying by itself, but imagine having to function in society with a condition like this! To state that it would be difficult is an understatement (although many people are able to do it to some degree).

Would you call such a person crazy? I would call such a person brave and resilient. 

For some anecotes from persons living with the condition, click here

For Loved Ones of Persons Living with Schizophrenia

Needless to say, having a loved one who suffers from this condition can be very hard. You are worried about your loved one’s condition, but possibly also having a very difficult time living harmoniously with him/her. It’s very important to not take things personally, even if the behavior is directed at you. A wonderful resource for family members of people living with Schizophrenia (and other mental health issues) is the National Alliance on Mental Illness. Known as NAMI, this wonderful organization is found nationally and here in Lane County at the local level, and provides education, advocacy, and active support for individuals living with Schizophrenia and their families.

One thing I've seen consistently over the years is this: the support of family and friends can make or break someone's ability to cope with Schizophrenia. If your loved one has Schizophrenia or another mental health condition on the Schizophrenia Spectrum, any support and love you can give is important. At the same time, try to focus on what you can control, and understand that you cannot make someone be better, healthier, or whatever you might want them to be. Consider getting support for yourself, or by all means go to NAMI! 

For more information for family members and loved ones, click here.

Notice that I do not describe people with this condition as….

….schizophrenics. Think about it. Someone living with Schizophrenia could be a parent, a son or daughter, an artist or construction worker, a Christian or Buddhist, etc. The person is more than their condition. Language is important. That’s why I do not call someone a schizophrenic. I encourage you not to as well.

Coping with Schizophrenia and Substance Abuse?

Are you (or your loved one) self-medicating with drugs or alcohol in order to cope with delusions and/or hallucinations? Wondering where to start to get help for yourself or your loved one? Is it better to start by dealing with the mental health issue or the substance abuse?

These are all normal questions to ponder.

My experience tells me to encourage people to start with whatever issue they feel most ready to address. There are numerous resources for mental health and alcohol/drug treatment. If you live in Lane County, consider using this link in order to access a good list of services.

In addition, WhiteBird’s Little HELP book is an excellent online resource with valuable information on the help provided by most social services agencies in Lane County.

AN IMPORTANT NOTE: If you are in a mental health crisis in Lane County contact the WhiteBird Crisis Line at 541-687-4000. If you are having major medical issues such as acute withdrawl, detox, or severe intoxication from drugs or alcohol, call 911, as this is a medical emergency!

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More about Schizophrenia

What is Schizophrenia? I hope that this page has helped you to learn more about this and related conditions, and inspired you to find out more about this and all conditions on the Schizophrenia Spectrum (Schizoaffective Disorder, Delusional Disorder, and other conditions listed in the DSM-5 manual).

Check out this link for more excellent information about this condition.

Another great link within WebMD, one that addresses the myths and facts in more detail can be found here.

How common is Schizophrenia? According to the National Institute of Mental Health, the prevalence of Schizophrenia in the USA is about 2.2 million people. 

Worldwide, it is estimated that about 51 million people suffer from this mental health condition (according to Schizophrenia.com). 

What is Schizophrenia? It’s a very serious mental health condition, but one that people can live with. There is hope….and speaking of hope, I hope that the information on this page has created a desire for you to learn much more about this condition. The more we know, the more we can support those suffering from this difficult condition and fight the stigma that surrounds it. 

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