Frequently Asked Questions About Schizophrenia

Schizophrenia is a highly misunderstood mental illness. Part of the reason is the incorrect way it’s portrayed in movies and television. The media, too, muddles things harmfully when it equates schizophrenia to violence. The word itself is also misused, which makes people question what it really means. Have you ever heard someone refer to another as “schizophrenic” as a put-down?

People, though, are questioning whether these portrayals are accurate (Schizophrenia Movies, Films and Documentaries). When we as a society ask questions, it means we want to understand each other. That’s a very good thing. Questions about schizophrenia lead to understanding and empathy.

Here, then, are answers to some frequently asked questions about schizophrenia.

Is Schizophrenia Real?

Yes. Schizophrenia is a real illness that affects real people (not just characters in movies). It’s rare, though, with just under 1% of the population living with the disorder.

Are People with Schizophrenia Dangerous?

Typically, no. This is a common misconception. Violent behavior isn’t a symptom of schizophrenia, and it’s not an effect, either. The idea of voices telling someone to kill isn’t a realistic one. Sometimes, if someone has what’s known as persecutory delusions (the belief that people are out to get him), he might lash out in what he thinks is self-defense. It’s almost always limited to hostility and aggression, and random assaults aren’t common. No other hallucinations or delusions have been shown to cause any kind of violence.

Repeated research studies have shown that when schizophrenia is linked to violent behavior, one (or both) of two things contributes to it: substance use, and a childhood history of conduct disorder or, if that wasn’t diagnosed, generally aggressive and destructive behavior.

The DSM-5 indicates that people with schizophrenia are far more likely to be victims of violence than to commit it.

Is Schizophrenia a Mental Illness?

Yes. Schizophrenia is a brain-based mental illness with specific symptoms and characteristics. It’s part of the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5), which is the encyclopedia of the mental health professions.

Is Schizophrenia a Personality Disorder?

No. A personality disorder isn’t a disorder of the brain itself. In mental illness, things go wrong with the brain either structurally, at the neurological and neurochemical level, or both.

Personality disorders aren’t brain-based. They involve persistent, long-term patterns of behavior that are outside of typical behavior in one’s culture.

While this might sound like it describes schizophrenia, schizophrenia is brain-based and thus isn’t a personality disorder.

Does Schizophrenia Get Worse with Age?

Usually, the symptoms of schizophrenia begin gradually and slowly worsen over time. How long they worsen before stabilizing varies from person to person.

The symptoms of schizophrenia behave differently. The psychotic symptoms (hallucinations and delusions) tend to lessen over time. Negative symptoms (diminished emotional expression, lack of motivation, apathy, and more) seem to remain the same, while cognitive symptoms remain the same or worsen. According to the DSM-5, about 80% of people with schizophrenia don’t have a good prognosis; the disorder isn’t likely to improve over time. Beyond this basic understanding, it’s difficult to predict what will happen to someone with schizophrenia as he grows older.

Why Do People with Schizophrenia Hear Voices?

Researchers are working very hard to answer this very question, for when they can pinpoint precisely what is happening in the brain that causes hallucinations like hearing voices, they’ll be much better able to treat it.

Right now, knowledge is limited, but we do have a basic understanding. In schizophrenia, hearing voices happens because something isn’t working right in the brain. Part of it seems to be problems in the way neurons are transmitted. Also, neurotransmitters, especially glutamate, dopamine, serotonin, and GABA, are imbalanced in the brain afflicted with schizophrenia.

The more we all—researchers, doctors, patients, families, and society as a whole—ask questions, the better we will understand. We’ll understand schizophrenia better, yes, but even more importantly, we’ll develop deeper understanding and empathy for those who live with it.