Schizophrenia is a lifetime disorder that affects about one percent of the United States population. According to the World Health Organization, it is one of the ten most debilitating diseases to affect people. It is more common than both Alzheimer’s disease and multiple sclerosis. And while a common misconception is that schizophrenia refers to multiple personalities, in reality, the disorder affects the way a person perceives reality.

Schizophrenia is a mental illness that makes it difficult to separate reality from fantasy, causing delusions, and even hallucinations. Decision-making and emotions are also compromised. A person will often hear voices, become paranoid and terrified, or not make any sense during a conversation. Symptoms for schizophrenia often start around age 15.

There is no known cause for schizophrenia, but it is believed that a person’s genetics, environment, and even brain chemicals such as neurotransmitters have a role in its development.

Because schizophrenia is a disease with no cure, it must be monitored and treated for a lifetime. A combination of medication, rehabilitation, and psychotherapy are aimed at reducing the symptoms, preventing symptomatic flare-ups, and giving support to an individual.

The most commonly prescribed drugs for schizophrenia are antipsychotic medications. Antipsychotic drugs handle many symptoms of schizophrenia, including hallucinations, delusions, disorganized thinking, and aggressive behavior. The drugs work by interacting with neurons in the brain. When information travels through a neurotransmitter, it passes from cell to cell through receptors. When too much information travels from cell to cell, it can disrupt activity and lead to diseases such as schizophrenia. The antipsychotic drugs block specific receptors such as serotonin and dopamine, allowing activity to function closer to normal.

Typical Antipsychotics

Typical antipsychotics are considered an “older” medication. They have been around since the 1950s and are effective at controlling symptoms. Typical antipsychotics must be taken regularly. However, they have both mild and potentially serious side effects, which include fatigue, stiffness, weight gain, tremors, and a disease known as tardive dyskinesia. Tardive dyskinesia causes involuntary movement of the arms, legs, and lips. Another serious illness associated with typical antipsychotics is neuroleptic malignant syndrome. This causes confusion, high blood pressure, fever, and muscle rigidity.

Typical antipsychotics include chlorpromazine, haloperidol, perphenazine, and fluphenazine.

Atypical Antipsychotics

Newer versions of antipsychotic medication arrived in the 1990s, now called atypical antipsychotics. They treat many of the same symptoms of typical antipsychotics, including hallucinations. The benefit of atypical antipsychotics is they come with lower risks of severe side effects.

One atypical medication, clozapine, is particularly effective for people who do not respond to antipsychotic drugs. Clozapine does come with the risk of seizures and the loss of white blood cells. Because of this, a person must have their white blood cell count measured weekly for several months to monitor their progress. Other side effects for atypical antipsychotics include drowsiness, rapid heartbeat, weight gain, blurred vision, and sensitivity to the sun.

Atypical antipsychotics include risperidone, apripprazole, clozapine, olanzapine, quietiapine, and ziprasidone.

Mood Stabilizers

Schizophrenia symptoms can often affect a person’s line of thinking and emotions. Loss of interest, odd emotional reactions to situations, and even disturbed thoughts are all possible. Mood stabilizers regulate mood swings. The first mood stabilizer to be developed was lithium, which is still considered highly effective at controlling the symptoms of mood swings. Lithium works by interrupting dopamine receptors in the brain. Side effects include weight gain, uncontrollable tremor, and nausea. In the long-term, lithium can affect the thyroid and kidneys.

The remaining mood stabilizers are anticonvulsants. Lithium generally takes up to 10 days to become effective, so often an anticonvulsant is prescribed in the interim because it works faster. They can be prescribed if lithium is found to be ineffective.  Originally, anticonvulsants were used to treat seizures until it was discovered they were also affecting mood. The reason for this is still unclear, but it reduces excitement in the brain.

One of the most difficult parts of schizophrenia treatment is maintaining the strict lifelong commitment to taking medication. Various therapies and treatments allow a person to stay on track and manage their illness, while at the same time helping him or her to develop skills necessary to lead a normal life 

Rehabilitation Therapy

Rehabilitation therapy helps a person adjust to their surroundings and function properly in daily life. This type of therapy can focus on job counseling, money management, communication skills, and how to act in public. The goal is to allow a person to properly perform at their jobs and in social settings.

Cognitive Behavior Therapy

Cognitive behavior therapy deals with symptoms unaffected by medication. This can include hearing voices and having difficulty with memory. This type of therapy trains a person with schizophrenia to make distinctions between reality and fantasy. It can effectively lower symptoms and prevent relapses.

Substance Abuse Treatment

People with schizophrenia often have trouble with substance abuse. Aside from the usual dangers, substance abuse can exacerbate schizophrenia symptoms. Substance abuse treatment for people with schizophrenia is different than regular substance abuse programs. Generally, programs for schizophrenia and substance abuse are done at the same time, to deal with the special needs associated with schizophrenia.

Family Education Therapy

Those with schizophrenia are not the only ones affected by the illness. Family members must be well informed and supportive. Family education therapy allows a therapist to teach coping and problem solving to family members dealing with a schizophrenia patient. They can also help the patient monitor their medication, making the process easier. 

Illness Management

The personal responsibility for people with schizophrenia is even more important than family support. A person must know as much as possible about the illness and treatment. This cooperation will go a long way in the management of schizophrenia, helping a person take their medication, react properly to a relapse, and learn important life skills.

A therapist is an important part of treatment. Therapists can help a person with schizophrenia deal with their feelings, understand the importance of medication, and help them adjust to a normal life.

Finding the right therapist requires research. Getting a recommendation from friends, family, or health care provider can ensure you will be directed to a trusted source. Be sure to find out the therapist’s availability, and if they have treated schizophrenia in the past. Finally, a person should make sure they are comfortable with the therapist they choose.