What are the symptoms of schizophrenia?

The symptoms of psychosis vary from person to person and even between one episode and another. These symptoms may seem to appear suddenly, but they often follow a time of gradual changes to a person's behaviour and personality when "something is not quite right". Doctors call this lead-up period a "prodrome". The more obvious psychotic symptoms may only appear after some months or years and include: Thought disturbance: A person may believe that their thoughts are being interfered with. They may believe that others can read their mind, for instance, or that their thoughts have been put there by other people or as a result of telepathy. They may believe that others are telling them what to think. These disturbances make it hard for a person to "think straight", concentrate, remember things or have a conversation that makes sense to others. This can make other people feel so uncomfortable they tend to leave the person alone - and this can make them socially isolated. Delusions: Having delusions means that you believe something that isn't true. Delusional beliefs are unshakeable, and there is no point in trying to argue someone out of them. A person with delusions may believe they're being watched by aliens, stalked by supernatural beings or controlled by other people or forces. People with schizophrenia often have paranoid delusions - meaning they believe that they are being watched or followed by people or beings that mean them harm. Having these delusions can affect the way a person behaves. They can also be very frightening to the person experiencing them - fearing that others may want to harm them can make some people suicidal. Hallucinations: One of the most common hallucinations associated with schizophrenia is hearing voices that no one else can hear. Although some people hear them only occasionally, others hear them every day and they can be very distressing. Sometimes these voices are abusive, threatening, or tell people what to do. It can be hard to tell whether something is said by a real person or by a hallucinatory voice. People sometimes shout back at their voices, or even make conversation with them. Some people may also experience hallucinations of taste, touch, smell or sight - tasting, feeling, smelling or seeing things that are not there. These symptoms can sometimes reinforce each other - having a taste hallucination, for instance, can convince someone that their food is poisoned, building on their delusion that others want to harm them. Hallucinations, like delusions, seem very real to the person who has them - so it's no surprise that these symptoms can make someone agitated, distressed, and sometimes hostile to others. Some people describe the experience of psychosis as having a dream or a nightmare while you're still awake. Low motivation: The effects of psychotic symptoms can make it very hard for a person to get on with their life and put thoughts and plans into action. Doing everyday things like getting out of bed or washing up can seem like an enormous effort. This is why some people with schizophrenia become lethargic, lying in bed or watching television all day. This can be very irritating to family and friends. But while it's good to encourage the person to be more active, remember that what seems like laziness may be the effect schizophrenia has on the part of the brain that helps with motivation. Changed feelings: One effect of schizophrenia is to "flatten" a person's emotions. This doesn't mean they don't feel anything. He or she may be very emotional, but be unable to express this. It can be difficult to know how to respond appropriately to emotions. Sometimes symptoms of schizophrenia are referred to as "positive" or "negative". Doctors call disordered thinking, hallucinations and delusions "positive" symptoms because they are something "added" to the person's normal experience. Low motivation and changed feelings are called "negative" because they take something away from the person. As well as episodes of acute illness, people with schizophrenia commonly experience long-term effects from these symptoms, which affect their ability to live an everyday life. This can cause them to have difficulty in relating to other people, looking after themselves and working, for example. People are affected by psychiatric disability by varying degrees. This information on schizophrenia is from the Sane Australia Guide to Schizophrenia 2005, produced with a grant from Bristol Meyers Squibb Pharmaceuticals. The source is gratefully acknowledged - www.sane.org.