As a psychology student, when given the opportunity to choose my subject matter for research papers, my focus was always severe mental illnesses (SMI). I wanted to be able to understand and approach the most stigmatized mental illnesses in a calm and curious manner while bringing compassion and informed thought into my research.

Schizophrenia comes in many forms: paranoid, hebephrenic, catatonic, undifferentiated, residual, simple, and unspecified. For greater ease, I will only be discussing a very basic form. Are you ready to wonder wisely?

Let’s unearth schizophrenia and its working parts.

In the DSM-V criteria for schizophrenia (295.90) is as follows:

• Delusions (false beliefs, they may think they are a god or John Lennon reincarnated)
• Hallucinations (hearing, seeing, smelling things others cannot)
• Disorganized speech (word salad)
• Completely disorganized behavior (cognition on the fritz)
• Diminished emotional expression (no affect, hard core poker-face)

These symptoms of schizophrenia usually first appear in later teenage years or in young adults. To meet the criteria to be diagnosed with schizophrenia bulleted points 1-3 must be moderately to mostly present for 6 months or longer along with the other bulleted points sprinkled in.

Sometimes people with schizophrenia have anosognosia, meaning that they lack the awareness to know they have the disorder. This makes treatment so much more difficult, as you can imagine.

I understand if you’re reading this and you’re thinking, “holy shit, this sounds scary!” Well, your feelings are valid. Humans are hard-wired to become alert in unusual territory, worry is a sign of a healthy noodle trying to protect you.

Rest assured though, schizophrenia can be managed through therapy (ex: cognitive behavioral therapy), medication, and community/familial support.

You might be thinking at this point, “how does schizophrenia even happen?” Great question!

Schizophrenia occurs through either one or a combination of:

• Genetics (not just one gene, but several, and those genes must be environmentally stimulated)
• Environment (in utero)
• Brain chemistry (defunct neurotransmission)
• Substance abuse (starting young with increased use and variety)

Schizophrenia usually occurs in tandem (comorbidity) with other mental health issues. This is not unusual in the mental health realm. Often people have more than one mental health issue and that’s okay, but this means the traits can exacerbate the other qualities making existence much less enjoyable.

Comorbidities are cyclical or triangulate, they are legit, do not ignore them. Comorbidities can also allow for misdiagnoses, so if you are speaking with a mental health professional please be as honest and straightforward with your experiences as you possibly can.

Schizophrenia occurs (or is diagnosed) in less than 1% of the population. That isn’t to say it isn’t more widespread (remember anosognosia).

Treating individuals with schizophrenia can be rather difficult due to their symptoms being a preventative source for seeking care. Schizophrenia may be complex in nature and its complicated presentation is perfect for misrepresentation.

It is super important to convey most people with schizophrenia do not present a greater potential for violence than anyone else. However, they do experience homelessness and hospitalizations more than the average person, due to lack of widespread care facilities. Therefore, familial support is of the utmost importance. Compassion is key.

All my best,

Tricia Rembold

Great sources for more information or assistance:

The American Psychological Association (2021) https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Spaulding, Silverstein, and Menditto (2017). The Schizophrenia Spectrum. Hogrefe Publishing Corporation

Call the NAMI Helpline at

800-950-NAMI 

Or in a crisis, 

text “NAMI” to 741741