It\u2019s often been said that depression is the \u201ccommon cold\u201d when it comes to psychiatric disorders, while schizophrenia is likened to \u201ccancer.\u201d\u00a0\u00a0 While those metaphors may be oversimplified, they\u2019re not far off the mark in many ways. Schizophrenia is one of the most serious -- and often one of the most disabling -- types of mental illness. \u00a0About 1% of the adult population suffers from it. Due to its severity, psychiatric inpatient units are a frequent stop for many individuals who live with this chronic, complex and challenging psychiatric disorder.\u00a0 Some people diagnosed with schizophrenia are able to manage their symptoms well enough -- usually with the lifelong use of powerful antipsychotic medication and a strong support system -- to function quite well and live a fulfilling life. Far too many, though, are relegated to a difficult life that includes bouts of homelessness, institutionalization, and \/ or regular and lengthy hospital stays and seemingly endless trials of yet one more medication. \u00a0Many schizophrenic individuals also have to endure the frequent whispers, snickers, pointed fingers, taunts and stares of ignorant or cruel individuals who cross their paths. Who Develops Schizophrenia? Like almost all types of mental illness, schizophrenia knows no boundaries with regard to gender, race, or socioeconomic status. Both men and women develop the disorder in about equal numbers. Although schizophrenia has been known to develop in young children and older adults, the symptoms most frequently begin to emerge between late adolescence to the mid- to late-20s.\u00a0 As a general rule, males tend to develop the disorder at a younger age than females. Heredity is believed to play a role in the development of schizophrenia, although it can develop in individuals who have no family history of the disorder. \u00a0Individuals with the greatest risk are those in which both biological parents are schizophrenic, followed by those with only one biological parent.\u00a0 Causes Years ago, the symptoms of schizophrenia were attributed to everything from poor mothering to demonic possession.\u00a0 Although most old myths have been dispelled, experts still don\u2019t know exactly what causes schizophrenia.\u00a0 Autopsies and brain scans have revealed differences in the brain structure of schizophrenics compared to individuals without the disorder.\u00a0 Recent research suggests that the absence of certain genes \u2013 causing the brain to be \u201cwired\u201d incorrectly \u2013 may also play an important part in the development of schizophrenia. Diagnosis Schizophrenia is frequently diagnosed initially when the first \u201cpsychotic break\u201d or psychotic episode occurs.\u00a0 The individual begins to act increasingly bizarre, paranoid, withdrawn, and \/ or disorganized.\u00a0 They may say things that don\u2019t make sense or appear to be having conversations even though there\u2019s no one responding.\u00a0 School or work performance begins to decline.\u00a0 Someone close \u2013 a family member or spouse, close friend, or coworker or employer - usually notices that something is seriously wrong and gets the person in to see a medical or mental health professional for an evaluation. There\u2019s no specific diagnostic test for schizophrenia. Rather, the diagnosis comes from a combination of interviewing and \/ or observing the patient and information obtained from family, friends, or others who know the patient.\u00a0 The patient is typically screened for drugs that might be causing the psychotic symptoms before being given a diagnosis of schizophrenia. When schizophrenia is diagnosed, one of five types is specified: \tParanoid \tDisorganized \tCatatonic \tUndifferentiated \tResidual Symptoms One of the often confusing aspects of schizophrenia is that there are actually five types or subtypes of the disorder.\u00a0 So, the symptoms of someone with catatonic schizophrenia can be notably different than those observed in an individual with paranoid schizophrenia. Schizophrenia is classified as a \u201cpsychotic disorder\u201d by clinicians.\u00a0 Psychosis can be difficult to define, but it essentially means that a person is out of touch with reality.\u00a0 Determining what\u2019s real and what\u2019s not can be very difficult to completely impossible in the throes of a psychotic episode. Hallucinations and Delusions Hallucinations and delusions are two of the most common symptoms of schizophrenia, especially paranoid schizophrenia. Hallucinations may involve any of the senses (i.e. sight, hearing, touch, taste, or smell).\u00a0 For example, the person believes he is seeing or smelling that isn\u2019t actually there. With schizophrenia, hallucinations are most often \u201cauditory\u201d in nature and involve hearing one or more voices - even though no one else is present or actually talking.\u00a0 The voices may give commands, comment on the individual\u2019s actions, or say harsh, hurtful things.\u00a0 Command hallucinations can be dangerous if the voices are instructing the person to hurt himself or others.\u00a0 Auditory hallucinations can be very distressing, especially when they occur for hours on end or say troubling things. Delusions involve a firmly and persistently held belief that isn\u2019t realistic, true, and \/ or possible.\u00a0 Delusions may be bizarre (e.g. the belief one\u2019s brain has been surgically removed and replaced with an alien brain) or non-bizarre (e.g. a woman insists she is pregnant despite medical proof that she\u2019s not).\u00a0 When someone is delusional, it\u2019s impossible to convince them that what they believe is not true or couldn\u2019t possibly happen.\u00a0 (It should be noted that a belief is not considered a delusion if it is normal for that person\u2019s particular religion, culture, etc.) Delusions typically involve themes.\u00a0 The most common types of delusional themes involve paranoia (e.g. conspiracies), persecution (e.g. someone is harassing them or trying to harm them), grandiosity (e.g. the person has special powers), erotomania (e.g. someone famous is in love with the person), or something somatic (e.g. having some rare disease).\u00a0 Another fairly common type of delusion involves the belief that a person\u2019s thoughts are being controlled by someone else. Disorganization The disorganization in individuals with schizophrenia may involve their thoughts and speech, and \/ or their behavior.\u00a0 Someone with disorganized speech may frequently jump from one topic to the next, say things that have no relevance whatsoever to the current conversation, or speak gibberish in which nothing they say makes any sense at all.\u00a0 In order to qualify as a symptom of schizophrenia, the disorganized speech must be severe enough to interfere with their ability to communicate. \u201cGrossly disorganized behavior\u201d is a clinical term that includes a variety of things.\u00a0 Examples include becoming agitated for no reason, bizarre or extreme silliness, problems carrying out goal-directed tasks, refers to the person\u2019s inability to initiate and carry out basic or simple tasks, and neglecting personal hygiene. Catatonic Behavior Some individuals with schizophrenia become catatonic.\u00a0 Catatonic behavior can include extreme obliviousness to one\u2019s surroundings (stupor), holding a rigid stance or bizarre posture, resistance to being moved or being told to move, or excessive, excited movement that serves no purpose. Negative Symptoms All of the above symptoms of schizophrenia are called positive symptoms.\u00a0 Negative symptoms \u2013 which involve a deficit of some sort \u2013 include lack of emotional expression (\u201cflat affect\u201d \u2013 the person has no response, facial movement, or eye contact), alogia (very limited speech), and avolition (the inability to initiate and follow through with a task.\u00a0 The negative symptoms of schizophrenia can be particularly debilitating. They are also the most difficult to treat effectively. Related Disorders Although other psychotic disorders, such as delusional disorder, share some similarities with schizophrenia, there are two disorders that are particularly closely related: \tSchizoaffective Disorder \tSchizophreniform Disorder Schizoaffective disorder involves significant mood symptoms \u2013 depression, mania, or a mixed mood \u2013 along with the psychotic symptoms.\u00a0 Very specific criteria help clinicians distinguish between schizophrenia and a co-occurring mood disorder or schizoaffective disorder. Schizophreniform disorder is often a precursor to schizophrenia.\u00a0 The differences between the two lie in 1) the length of occurrence (between 1 and 6 months for schizophreniform disorder) and 2) social and \/ or occupational impairment isn\u2019t required for a diagnosis in the former (although it may occur). Treatment Because schizophrenia is generally regarded as a life-long disorder, ongoing treatment is often required.\u00a0 In many cases, the first psychotic episode leads to hospitalization - for safety as well as stabilization.\u00a0 Future hospitalizations are often necessary if the patient stops taking medication and becomes severely symptomatic. Medication is often the primary treatment for schizophrenia.\u00a0 Antipsychotic medications, such as Risperdal or Zyprexa, help to alleviate or reduce psychotic symptoms and improve the person\u2019s ability to function.\u00a0 Many individuals with schizophrenia must take medication on an ongoing basis in order to thwart future psychotic episodes. Unfortunately, antipsychotic medications often have undesirable side effects.\u00a0 This leads some individuals to stop their medication (against their doctor\u2019s advice) because they hate the way it makes them feel.\u00a0 Of course, when the medication is working and the patient starts feeling good, he may also stop taking it because he believes it\u2019s no longer necessary.\u00a0 It\u2019s not uncommon for individuals with schizophrenia to end up back in the hospital not long after they discontinued their meds. Medication doesn\u2019t always work.\u00a0 When it does, its effectiveness may be limited or minimal.\u00a0 However, it\u2019s considered necessary by many mental health professionals if a patient wishes to keep psychotic episodes at bay or at least significantly reduce their severity when they do occur. Treatment for schizophrenia may also include any combination of the following: \tEducation (for the patient as well as those close to him) \tIndividual, couples, and \/ or family therapy \tGroup therapy \tDay treatment (in which the patient goes to treatment for several hours each day and returns home in the evening) \tVocational training \tLife skills training \tSupport groups Additional Issues Because schizophrenia is such a challenging disorder, it often triggers the development of other disorders or life choices that compound the issue.\u00a0 For example, many people with schizophrenia become depressed due to the stress of the disorder.\u00a0 While self-harm may occur due to command auditory hallucinations, it may also occur \u2013 in the form of a suicide attempt \u2013 as the result of depression and feelings of hopelessness. Substance abuse is also a fairly common problem for individuals with schizophrenia. Many individuals turn to alcohol or drugs to quiet the voices and alleviate other symptoms \u2013 or to simply escape from the pain and stress caused by living with a serious, chronic disorder. Homelessness is another dilemma for many individuals with schizophrenia.\u00a0 Many fall through the cracks of the mental health system and end up on the streets.\u00a0 Family members may try to help, but the challenges of the disorder can take a significant toll.\u00a0 Issues like substance abuse or an unwillingness to take medication as prescribed can lead to alienation from family. Without a strong support system or sufficient resources, an individual with schizophrenia will have an especially hard time navigating the system and end up not getting the treatment they need. No Cure\u2026Yet Sadly, there is still no cure for schizophrenia.\u00a0 Research has led to significant progress, and new medications are constantly being developed.\u00a0\u00a0 While there is very little in life that is more frightening than parents discovering that their precious child, teen, or young adult has schizophrenia, hope should not be lost.\u00a0 As mentioned previously, with proper treatment, many individuals with this difficult disorder are able to lead fulfilling lives.\u00a0 And as science moves forward, we may yet discover a cure for \u2013 or a far better and more effective way of treating \u2013 this dreaded mental illness.