Schizophrenia is not a rare mental illness. About one person in 100 has it, worldwide. Yet, people hardly know about it and there are many prejudices. Some people think it means "split personality", which isn't the case at all. Many believe schizophrenics are more violent than others, which isn't the case either.

I am susceptible to this illness, and it is an important part of my life. That is why I would like to tell you about it.


Schizophrenia is a mental illness with various different symptoms. Not everybody suffering from that illness has the same symptoms, and some people are suffering much more severe symptoms than others. I was lucky, my symptoms are very mild.

The first symptoms of schizophrenia usually start in adolescence, and are not typical: Depression, anxiety, extreme mood shifts, extreme sensitivity, generally awkward feelings without reason. Since these symptoms are "normal" in adolescence, to some degree, for most people, the illness is usually not recognized yet. Either the symptoms are considered common puberty symptoms, or a wrong diagnosis is made, like "depression" or "anxiety disorder".

In my case, these symptoms started when I was 16. I didn't really know what's wrong with me, I just knew I felt horrible without apparent reason, would suddenly get panic attacks, and generally be very sensitive. A doctor diagnosed depression and gave me anti-depressant medication, which made me feel a little better, but did not really make those symptoms go away.

At some point, when I was 18, school had become unbearable for me. I felt paranoid, whenever someone was laughing, I thought they were laughing about me. I felt everybody hates me. That I had been the "class nerd" before (I used to be more mature than most of my classmates, and also easily got good grades, without ever doing much work for that, especially in history and German literature) didn't make it better. So I just stopped going to school. Of course my parents were worried, but I kept refusing going to school.

These symptoms kept going on for a few years, but the lesser stress I had, the better they were. I worked in a retirement home, which was a rather stable routine for me, and the symptoms were almost gone. It was not before I was 24, when I finally learnt the reason for my feelings:

In a moment of severe stress (I had just moved into a new flat, my gf had broken up with me, I had money problems because a friend couldn't pay me back and then, additionally, the washing machine broke and set the whole bathroom under water), a psychosis started.

A psychosis is a mental state, usually lasting a few weeks up to a few months, where there are very severe symptoms. Until a schizophrenic person suffers from such a schizophrenic or schizotypic paranoid psychosis, he or she is usually not diagnosed as "schizophrenic" -- because only when these extreme symptoms start, doctors realize it's schizophrenia.

Among the symptoms of a schizophrenic psychosis, there are delusions and paranoia. Often, there are also auditory hallucinations -- the concerned start hearing voices which aren't there. My symptoms were relatively mild, I did not hear voices. But I was delusional and paranoid -- it started in subway, when I had the impression people were all watching me in disgust, as if I had some stigma, was dirty or such. And soon, I believed to see secret hidden allusions in everything people said. Even when it was in radio or TV. I believed there was a huge conspiracy against me, because I interpreted every bit of information in a wrong way, saw hidden messages and allusions everywhere. I believed the conspirators were tapping my computer and phone, to know every single step I do. When I saw a car parking on the street in front of my window, I thought they belong to "them" to control me. And soon I was convinced someone is out there with the intention to kill me. I was convinced I would suffer a very painful death soon, when, in the end, "they" would get me.

Fortunately, my parents realized something was wrong with me and sent me into a hospital. There, I got medication, and after two weeks, I suddenly woke up one morning, as if I had woken up from a bad dream. I could not believe myself what I had been thinking the past weeks. The psychosis was gone.


Schizophrenia is very different for each person concerned. There are roughly three groups: About one third of schizophrenics suffer a psychosis only once in their lives, and it will never come back, when medicated. They have a rather good prospect and can live a relatively normal life. Another third will see "calm" periods, but every few months or years, such a psychosis with extreme symptoms as described above, comes back. A normal life is difficult for them, because they have to interrupt whatever they do, time and again, because of that psychosis which makes them incapable of functioning normally. And the last third of schizophrenics is worst off: In their case, the psychotic symptoms never vanish again. They stay paranoid and delusional for the rest of their lives.

Fortunately, I am in the lucky third. At least I hope so -- this psychosis of mine lasted only very short, for 5 weeks only, and this was more than three years ago. The extreme paranoid and delusional symptoms have never come back since. My doctor says I am probably lucky, he believes my prospects are very good and the illness is not likely to come back. Especially since I get anti-psychotic medication as prophylaxis.


But that does not mean I am completely healthy. Even when a schizophrenic is not in a psychosis, not suffering the extreme symptoms, he or she is suffering from so called "comorbid symptoms": Even a non-psychotic person susceptible to schizophrenia is much more sensitive to stimuli than "normal" people. Emotional reactions, both good and bad, are very strong. There are extreme mood shifts, often without apparent reason, and symptoms such as genuine depression and/or anxiety disorder may appear. Also, schizophrenics are very susceptible to stress: When too stressed, these symptoms become stronger. There are days with complete lot of motivation to anything, and it's very hard to get up and do anything, even if that's just getting dressed.

So although my prospects are good and it's not likely I will ever suffer delusional or paranoid psychotic symptoms again, my life is very much influenced by this illness -- I am not as resistant to stress as others, and often need some time for myself, to regenerate. For example, when I am in a room where a large number of people is speaking, like a large cafeteria or canteen, I feel extremely stressed and anxious, I cannot stay there for long but need to leave it soon. There are often days when I feel like complete ****, extremely anxious, for no apparent reason. Sometimes, there are panic attacks out of the blue. On the other side, there are some days when I am very happy, almost euphoric, for no apparent reason either.

So I am lucky, although I am susceptible to schizophrenia, I can live a normal life, as long as I take my daily medication. But there is no cure; only the symptoms can be suppressed, but I will have to live with the minor side-symptoms, the "comorbid" symptoms. But since I was diagnosed with schizophrenia, I am also relieved -- I no longer have to think I am just "different" like all the others, "awkward" or "sick", but I know it's because of the illness, and it's relieving to know I am not the only one, that there are others who feel the same.


The worst thing, though, is that I cannot just explain to others easily what's wrong with me. Hardly anybody knows about that illness, so it's very risky to tell people you are "schizophrenic" -- they immediately think "oh, a psycho", or "oh, better take care, he's crazy and violent", or "split personalities? what a sicko". So better you don't tell people you are suffering from that illness.

Other minorities are accepted already. In most places, for example, you can just tell people you are "gay", or suffering from a certain illness, like "strong allergy", "diabetes" and so on -- and people will be understanding. They have heard about those minorities already, know a few things about it, and don't take it the wrong way.

I really wish for the day schizophrenia will be just as known and accepted. It would be an immense relief for me, if I could just tell people "see, that's the reason", when I suffer symptoms again, and they would be understanding and helpful.

Movies like "A Beautiful Mind" with Russel Crowe have already made a first step of increasing awareness of this illness. But as a concerned person, I have to say that this movie is actually very bad at depicting the illness -- you just see the illness from the outside, and only the most extreme symptoms during a psychosis, so many viewers will believe schizophrenics are just crazy and impossible to deal with. It's just a lurid Hollywood flic for a mass audience, at best suited to evoke interest for the topic, but not remotely a movie capable of explaining the illness.


I would not have written this posting if I didn't believe most of you here on this board are tolerant and understanding, and avoid prejudices and condemnation. So I hope some of you will find this posting interesting; if you have further questions, I'll be happy to answer them. :)

It's true that Schizophrenia is very misunderstood and I think that's why people react so negatively to it.

Thank you for having the courage to be open and share this with us, Sim.

Hmm... very enlightening. Ok, is this a result of your envoronment? How you were raised? Is there a trend to say who gets it and who doesn't?

Interesting read.

My familiarity with schizophrenia begins and ends with 'A Beautiful Mind'. While I have friends with most of the major psychological issues (ADD, ADHD, general anxiety, clinical depression, obsessive compulsive disorder), I don't know anyone well who's had a documented psychotic episode--at least one that they've told me about.

Schizophrenia has very strong genetic and environmental components. If you have an identical twin who is schizophrenic, your risk of being diagnosed with it is 50% higher. The Irish in Ireland (not descendants of Irish immigrants in America) have the highest rate of schizophrenia in the world, which suggests a strong envirnomental component.

I have to say Sim, that my own understanding of schizophrenia has been very uninformed. Thanks for opening my ideas up about it.

Science is still uncertain about the reasons. But there is agreement both genetic and environmental factors do play a role.

It's not an entirely genetic hereditary illness, but it seems at least the susceptibility for that illness is partly genetic: Monocygotic, identitcal twins, who are genetically 100% identical have a 40% chance of developing the illness, when the sibling has it. If it was entirely genetic, this number would be 100%. When one of your parents has it, the chance of the child developing the illness is 5% to 10%, which is higher than average (1%).

There are also clues suggesting early childhood/birth complications play a role: When there were complications during pregnancy or birth, the rate rises. And in fact, I was a 7-moth-child and had to spend the first weeks of my life in an incubator. There are theories connecting schizophrenia to problems regarding the development of the central nervous system.

But environmental factors play a role as well: People living in cities have a higher rate, than people living in silent, rural areas. Also, it is always a high level of stress that triggers a psychosis, so burdening situations in life, like loss, play a role too.

But in the end, science has not found a solid theory for the reasons yet, nor has science really understood yet what exactly is going on in the brain during the illness. It has just been found that there are much higher levels of the transmitter dopamine in the brains of those with schizophrenia, and glutamate receptors are more numerous. But the exact mechanism is still unknown.
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A good friend of mine has ADD, was recently diagnosed with it. That was a huge relief for him, because he had always figured something was wrong with him, and finally, he knows the reason. He now gets meds against it (ritaline), which help him a lot.

We sometimes joked we have the opposite kind of illnesses, because with ADD, the dopamine level is very low, while in case of schizophrenia, it is very high. And it also seems my perceptions sometimes seems the opposite to him -- while he is very easily distracted by something random, like a bird on the field or someone walking by on the street, and cannot focus at all, I am most of the times so much focused on a particular thing, even if it's just on my mind, that I don't even realize these random events, I have a strong "tunnel vision". I often don't even take notice of friends walking by, greeting me, because I'm so focused on something. ;)

But I assume it's scientifically and medically inaccurate to claim "schizophrenia is the opposite of ADD". ;)

Sim, how exactly does anti-delusional medication work, if you have such knowledge?

Sometimes, I've seriously wondered if I have it myself. Really. I've had a few episodes where I've found myself paranoid of everything, thinking that the world around me is just snickering behind my back at every turn. I had a bad episode almost a year ago where I got severely anxious, broke up with my girlfriend because of it (we got back together an hour or so late basically because I was freaking out for no reason), and shook for basically the rest of the day.

But like Kaz mentioned, I don't like the sound of medication. How does it work?

I'm not an expert, but I know all anti-psychotic meds (called "neuroleptics") work by pushing down the unnaturally high dopamine levels in the brain. This doesn't entirely "cure" the illness, because dopamine is probably not the only reason, but just another symptom, of the illness -- but they are very sufficient at suppressing the extreme symptoms, such as delusions, hallucinations and paranoia.

Especially older neuroleptics, the "first generation" ones, had severe side effects, like motor-driven problems similar to Parkinson syndrome, blurred vision, dizziness. But there are newer meds which are much better, which hardly have side effects.

When suffering an acute psychosis, though, the harder meds are used, because they are more potent -- I suffered weight gain (extreme appetite) and extreme fatigue in the hospital (sleeping up to 18 hours per day), after I was given Zyprexa. But when the worst symptoms were gone, my doctor switched to Amisulpride, which is slightly less potent, but has no side effects on me whatsoever.


Constantine, I hope you are not suffering from that illness, but maybe you should better have a look on it, if the symptoms regularly come back. Maybe you indeed are susceptible, and there has just not been a stressful event yet which triggered a psychosis.

In case that happens, it is important you have loving people around you, who know what to do. Because you yourself will lose all capacities whatsoever to critically look on yourself -- you will be 110% convinced what you see is true, and no argument or reasoning will suffice to get you off the delusions.

Also, you should be careful with drugs, namely hallucinogenics and marihuana/pot: Those may trigger a psychosis as well, if you are susceptible. Amphetamines as well, in high dosage, because they increase the dopamine level as well (which is why ADD people like them so much).

If you want to know more, just ask me, I'll answer gladly. :)