It is correct to say that no mental disorder is more shrouded in mystery, misunderstanding, and fear than schizophrenia. “The modern equivalent of leprosy”, is how renowned research psychiatrist E. Fuller Torrey, MD, refers to schizophrenia in his excellent book, Surviving Schizophrenia: A Handbook for Families, Patients, and Providers.
While 85 percent of Americans acknowledge that schizophrenia is a disorder, only 24 percent are actually familiar with it. And according to a 2008 survey by the National Alliance on Mental Illness (NAMI), 64 percent either can’t recognize their symptoms or believe the symptoms include a “split” or multiple personalities. (They don’t do it.)
Ignorance aside, images of the aggressive and sadistic “schizophrenic” are abundant in the media. Those stereotypes only increase more the stigma and squash any sympathy for people with this disease, Dr. Torrey writes. Stigma has a number of negative consequences. It has been associated with reduced housing and employment opportunities, decreased quality of life, low self-esteem, and increased symptoms and stress (see Penn, Chamberlin, & Mueser, 2003).
So it’s bad enough that people with schizophrenia are affected by such a terrible disease. But they also have to deal with the confusion, fear, and disgust of others. If your loved one has schizophrenia or would like to know more, gaining a better understanding of it helps demystify the illness and is a boon to those who suffer from it.
Below are some of the widespread myths – followed by real facts – regarding schizophrenia.
1 . People with schizophrenia have the same symptoms
First of all, there are different types of schizophrenia. Even people diagnosed with the same subtype of schizophrenia often look very different. Schizophrenia is “A big, huge variety of people and problems,” said Robert E. Drake, MD, Ph.D, a professor of psychiatry and of family and community medicine at Dartmouth Medical School.
Part of the reason that schizophrenia is so mysterious is because we are unable to put ourselves in the shoes of a person with the disorder. It’s just hard to imagine what having schizophrenia would be like. Everyone experiences sadness, anxiety, and anger, but schizophrenia seems so far outside our realm of feeling and understanding. It can help adjust our perspective. Dr Torrey writes:
“Those of us who have not had this disease must wonder, for example, how we would feel if our brains began to play tricks on us, if invisible voices were yelling at us, if we had lost the ability to feel emotions, and if we had lost the ability to reason logically.”
2. People with schizophrenia are dangerous, unpredictable, and out of control
“When the illness is treated with medications and psychosocial interventions, people with schizophrenia are no more violent than the general population,” said Dawn I. Velligan, Ph.D, professor and co-director of the Division of Schizophrenia and Related Disorders in the Department of Psychiatry at the U.T. Health Science Center in San Antonio. Furthermore, “People with schizophrenia often tend to be victims rather than perpetrators of violence despite untreated mental illness and substance abuse often increasing risk for aggressive behavior,” said Irene S. Levine, Ph.D., psychologist and co-author of Schizophrenia for Dummies.
3 . Schizophrenia is a character flaw
Lazy, unmotivated, lethargic, easily confused…and the list of “qualities” of individuals with schizophrenia seems to be infinite. However, the idea that schizophrenia is a character flaw “Is no more realistic than suggesting that someone could prevent his epileptic seizures if he really wanted to or that someone could ‘decide’ not to get cancer if he ate the food adequate. What often appear as character flaws are the symptoms of schizophrenia,” writes Levine and co-author Jerome Levine, MD, in Schizophrenia for Dummies.
4. Cognitive deterioration is an important symptom of schizophrenia
Apparently unmotivated individuals are more likely to experience cognitive difficulties in problem solving, attention, memory, and processing. They may forget to take their medication. They can ramble and it doesn’t make sense. They may have a difficult time organizing their thoughts. Once again, these are the symptoms of schizophrenia, which have nothing to do with character or personality.
5. There are psychotic and non-psychotic people
The public and doctors alike see the psychosis as categorical – either you’re psychotic or not – rather than symptoms that reside on a continuum, said Demian Rose, MD, Ph.D, medical director of the University of California, San Francisco PART Program and director of the UCSF Early Psychosis Clinic. For example, most people will agree that individuals are not simply depressed or happy. There are gradients of depression, from mild one-day blues to deep, disabling clinical depression. Similarly, the symptoms of schizophrenia are not fundamentally different brain processes, but are on a continuum with normal cognitive processes, said Dr. Rose. Auditory hallucinations may seem remarkably different, but how many times have you had a song stuck in your head that you can hear very clearly?
6. Schizophrenia develops quickly
“It’s very rare to have a big drop in running,” said Dr. Rose. Schizophrenia tends to develop slowly. The initial signs often show during adolescence. These signs typically include school, work and social decline, managerial relationship difficulties and problems with organizing information, he said. Again, the symptoms are on a continuum. In the early stages of schizophrenia, a person cannot hear voices. Instead, he can hear whispers, which he can’t stop. This “prodromal” period – before the onset of schizophrenia – is the perfect time to intervene and seek treatment.
7. Schizophrenia is purely genetic
“Studies have shown that in pairs of identical twins (who share an identical genome) the prevalence of developing the disease is 48 percent,” said Sandra De Silva, Ph.D, psychosocial treatment co-director and director of outreach at the Staglin Music Festival Center for the Assessment and Prevention of Prodromal States (CAPPS) at UCLA, departments of psychology and psychiatry. Because other factors are involved, it’s possible to reduce the risk of developing the disease, she added. There are several prodromal programs that focus on helping at-risk teens and adults.
Along with genetics, research has shown that stress and family environment can play a role in increasing a person’s susceptibility to psychosis. “While we can’t change genetic vulnerability, we can reduce the amount of stress in someone’s life, develop coping skills to improve how we respond to stress, and create a low-key, calm, protective family environment without a lots of conflict and tension in the hope of reducing the risk of disease progression,” De Sliva said.
8. Schizophrenia is untreatable
“Although schizophrenia is not curable, it is an eminently treatable and manageable chronic illness, like diabetes or heart disease,” Levine said. The key is to get the right treatment for your needs.
9. Sick people need to be hospitalized
Most people with schizophrenia “Live well in the community with outpatient treatment,” Velligan said. Again, the key is proper treatment and adherence to that treatment, especially taking medication as prescribed.
10. People with schizophrenia cannot lead productive lives
“Many people are able to lead happy and productive lives,” Velligan said. In a 10-year study of 130 individuals with schizophrenia and substance abuse – co-occurring in nearly 50 percent of patients – from the New Hampshire Dual Diagnosis Study, many gained control over both disorders, reducing their episodes of hospitalization and homelessness, living on their own, and achieving a better quality of life (Drake, McHugo, Xie, Fox, Packard, & Helmstetter, 2006). Specifically, “62.7 percent were controlling schizophrenia symptoms; 62.5 percent were actively achieving substance abuse remissions; 56.8 percent were in independent living situations; 41.4 percent were competitively employed; 48.9 percent had regular social contacts with non-substance abusers, and 58.3 percent expressed general satisfaction with life.”
11. Medicines make zombie sufferers
When we think of antipsychotic medication for schizophrenia, we automatically think of adjectives like lethargic, apathetic, disinterested, and vacant. Many believe that medication causes these types of symptoms. However, more often these symptoms are either from schizophrenia itself or due to overmedication. Those reacting like zombies are “Relatively less, compared to the number of patients who have never received adequate treatment of available medications,” according to Dr. Torrey in Surviving Schizophrenia.
12. Antipsychotic medications are worse than the illness itself
Medications are the mainstay of treatment for schizophrenia. Antipsychotic medications effectively reduce hallucinations, delusions, confused thinking, and bizarre behavior. These agents can have serious side effects and can cause death, but this is rare. “Antipsychotic drugs are one of the safest groups of drugs of common use and are the greatest advance in the treatment of schizophrenia to date,” Dr. Torrey writes.
13. People with schizophrenia cannot regain a normal life
Unlike dementia, which gets worse over time or doesn’t get better, schizophrenia appears to be a problem that is reversible, Dr. Rose said. There is no line that once crossed means there is no hope for a person with schizophrenia, she added.
Drake, R.E., McHugo, G.J., Xie, H., Fox, M., Packard, J., & Helmstetter, B. (2006). Ten-Year Recovery Outcomes for Clients With Co-Occurring Schizophrenia and Substance Use Disorders. Schizophrenia Bulletin, 32, 464-473.
Penn, D.L., Chamberlin, C., & Mueser, K.T. (2003). The effects of a documentary film about schizophrenia on psychiatric stigma. Schizophrenia Bulletin, 29, 383-391.