Schizophrenia is a serious mental illness that changes how a person thinks, feels, and behaves. For many, it involves episodes of psychosis, where reality becomes distorted and symptoms like hallucinations or delusions interfere with daily life. Although it is a severe mental illness, early recognition, consistent schizophrenia treatment, and strong support can help people manage symptoms and live fulfilling lives.¹
What Is Schizophrenia?
Schizophrenia is one of several psychotic disorders. These also include schizoaffective disorder, schizophreniform disorder, delusional disorder, and brief psychotic disorder. All involve disruptions in thought, perception, and behavior, but schizophrenia is often more persistent and disabling.
Most people are diagnosed between ages 16 and 30.1 Many experience a first episode of psychosis during this time, though subtle changes in motivation, mood, and social connection often appear earlier. Detecting these early warning signs can improve long-term outcomes.
The lifetime risk of developing schizophrenia is about 1%.1 Men tend to develop symptoms earlier, while women often have later onset but sometimes better long-term functioning.²
Schizophrenia symptoms
Schizophrenia symptoms are usually grouped into three major categories:
- Positive symptoms: Added experiences such as hallucinations, delusions, and disorganized thinking. Hearing voices is one of the most common symptoms.
- Negative symptoms: Reductions in usual abilities, such as lack of motivation, reduced emotional expression, limited speech, or social withdrawal. These negative symptoms can have a major impact on independence and daily life and are often more resistant to treatment.
- Cognitive symptoms: Problems with attention, memory, and executive functioning. These challenges can make it hard to focus at work, follow conversations, or plan daily tasks.
Both positive and negative symptoms are central to understanding and treating schizophrenia, since they affect quality of life in different ways.
Causes and risk factors
There is no single cause of schizophrenia. Research shows it develops from a mix of genetic vulnerability, brain changes, and environmental influences.
- Genetics: Twin and family studies suggest about 80% of the risk is inherited.² No single gene causes schizophrenia, but many genetic variations combine to increase risk.
- Brain chemistry and structure: Dysregulation in dopamine and glutamate systems, along with reduced gray matter volume in certain brain regions, are linked to the condition.²
- Environment: Obstetric complications, maternal malnutrition, childhood trauma, poverty, and urban living all increase risk. Growing evidence also shows that heavy or early cannabis use raises the chance of developing schizophrenia.²
Schizophrenia treatment
Schizophrenia treatment is most effective when it combines medication, therapy, and supportive services tailored to each person’s needs.
Medication
- Antipsychotics are the primary treatment, helping reduce positive symptoms like hallucinations and delusions.
- Both first-generation and second-generation medications are available.
- Treatment resistant schizophrenia is diagnosed when two or more antipsychotic trials fail. In these cases, clozapine is recommended and has the strongest evidence for effectiveness, with about 40% of patients responding.²
- Long-acting injectable medications may be used for people who struggle to take daily doses.
Therapy and psychosocial support
- Therapy for schizophrenia can include cognitive behavioral therapy for psychosis (CBTp), which helps people manage distress and reduce relapse risk.
- Family therapy improves understanding of symptoms, builds healthier communication, and provides tools for loved ones to offer effective support.
- Coordinated specialty care is now the recommended model for early psychosis. It combines therapy, medication, case management, employment or education support, and family therapy.
Community and recovery support
- Assertive community treatment provides intensive, team-based support for people at risk of frequent hospitalizations or homelessness.
- Supported employment and education programs help individuals re-enter daily life.
- Addressing co-occurring conditions, like substance use or depression, is critical to long-term stability.
Living with schizophrenia
Schizophrenia is a lifelong condition, but with early and consistent care, many people experience meaningful recovery. Positive symptoms often improve with medication, while negative symptoms and cognitive challenges may require ongoing therapy and social support.
Early treatment after a first episode of psychosis leads to better chances of long-term success. With access to therapy, medication, and family therapy, many people with schizophrenia are able to live independently, pursue education or work, and maintain meaningful relationships.
Get in touch with NEHS
Northeast Health Services is here to help you manage your mental health, including schizophrenia and psychotic disorders. For existing clients, please click here and find your office location to contact your office directly.