Schizophrenia Treatment: Understanding the Condition and the Path Toward Healing

Schizophrenia is a chronic mental health condition marked by disruptions in thought, perception, emotion, and behavior. It is considered a psychotic disorder because the symptoms can include episodes of psychosis when a person becomes detached from reality. According to the National Institute of Mental Health (NIMH), approximately 0.25% to 0.64% of people in the US suffer from schizophrenia.[1]

Schizophrenia is not a personality disorder and is different from having a split personality. Schizophrenia is a distinct mental health condition with its own clinical profile, separate from personality disorders or dissociative conditions. Schizophrenia typically emerges in early adulthood, often between the late teens and mid-30s, and tends to appear earlier in men than in women.

Researchers agree that schizophrenia develops from the interaction of genetic, biological, and environmental factors.[2] Differences in brain chemistry, particularly involving the neurotransmitters dopamine and glutamate, are thought to play a significant role in how the condition develops. Having a family history of schizophrenia or another mental health disease increases the likelihood of developing schizophrenia. Exposure to certain substances during pregnancy and early-life exposure to stressors also increase susceptibility.

Symptoms of schizophrenia are categorized into three groups: positive symptoms, negative symptoms, and cognitive symptoms.[3] Understanding these classifications can assist families and individuals in identifying the need for a professional assessment.

Positive symptoms refer to experiences that are added to a person’s baseline, meaning things that occur that would not otherwise be present. These symptoms are commonly related to psychotic symptoms:

• Hallucinations (hearing, seeing, or feeling something that isn’t actually there)
• Delusions (having firm beliefs that aren’t true, such as believing one is being followed or has special powers)
• Disorganization of thinking or talking
• Abnormal motor function (highly disorganized movement)
• Self harm

Negative symptoms represent a decrease or lack of typical behavior and emotions. These could consist of:

• Decreased emotional expression
• Lower motivation
• Social withdrawal
• Fewer feelings of enjoyment
• Limited talk

Negative symptoms are often less dramatic than a psychotic episode but can be just as disabling over time.

Cognitive dysfunction is an essential aspect of schizophrenia that is often overlooked. People can have problems with memory, attention, rate of processing information, and executive function. Cognitive impairments can make it difficult for a person to perform job duties; maintain responsibility; and participate fully in treatment without the right support.

Witnessing someone you love dealing with schizophrenia can be extremely difficult emotionally. It is perfectly acceptable to be fearful, unclear, or unsure about what to do. The most important thing to know is that your involvement matters. Research consistently shows that individuals with schizophrenia who have strong family support tend to have better long-term outcomes.[4]

Educating yourself about schizophrenia as a medical condition rather than a personal failure is a meaningful first step. Learning to distinguish symptoms from the person allows for more compassionate communication.

When your loved one has both schizophrenia and substance abuse, finding integrated dual-diagnosis treatment instead of addressing only one condition will benefit your loved one’s welfare.

You don’t have to go through this journey alone. There are mental health professionals at schizophrenia treatment centers who can help with symptom management, medical care, and more.

Co-occurrence of schizophrenia and addiction is very common. Studies suggest that almost fifty percent of individuals diagnosed with schizophrenia have met diagnostic standards for a substance use disorder at some point in their lifetime.[5] The co-occurrence of these conditions is described as either dual-diagnosis or co-occurring disorders. When both conditions are present, treating only one without addressing the other is rarely effective. An integrated approach that targets both simultaneously leads to better outcomes, including reduced hospitalizations, improved medication adherence, and greater quality of life.[6]

Several factors explain why schizophrenia and addiction are so often intertwined. Some individuals use substances as a means of self-medicating in order to alleviate distressful psychosis or emotional numbness resulting from negative symptoms. Many others started using substances prior to experiencing symptoms of schizophrenia and found that drug or alcohol use made their condition worse over time. Finally, social factors including isolation and less availability of ongoing mental health care also account for the relationship between these diseases.

One of the most frequent inquiries asked by families and individuals diagnosed with schizophrenia is “can substance abuse create schizophrenia?” The answer is complicated and will require careful consideration. Substance abuse has a bidirectional relationship with schizophrenia, meaning one influences the other.

Research suggests that drug abuse does not directly cause schizophrenia in people who have no underlying vulnerability. However, heavy substance use can significantly increase the risk of triggering a psychotic episode or accelerating the onset of the condition. Cannabis use specifically has been examined widely regarding this issue. In 2019, a study published in Lancet Psychiatry showed that consuming high-potency cannabis regularly increased the chance of psychosis five times more than non-users.[7]

Stimulants such as methamphetamine and cocaine can induce psychotic states resembling schizophrenia. At times, these induced psychotic states can persist long after the substance has left the body. Therefore, determining if psychotic symptoms exist due to substance abuse or schizophrenia requires accurate diagnosis from a psychiatrist evaluating for substance-induced psychosis or a diagnosable primary mental health condition.

Although drug abuse cannot independently cause schizophrenia, it represents an important risk factor for those with an intrinsic predisposition. Furthermore, drug abuse will certainly negatively impact the course of the disease for those who have been previously diagnosed with schizophrenia.