Schizophrenia was identified more than a century ago. Still, it remains one of the most misunderstood and stigmatized illnesses today. Some aspects of schizophrenia are well-known to researchers, including the most common types of schizophrenia, their causes, and the connection between schizophrenia and addiction.
Symptoms of schizophrenia are usually categorized as positive symptoms or negative symptoms. Positive symptoms are where an action occurs, either through erratic behavior, hearing voices, or other external expressions of symptoms. Negative symptoms are when the person appears to withdraw and so no interest in anything.
Paranoid schizophrenia is the most common type of schizophrenia, characterized by schizophrenia symptoms like delusions and hallucinations. It does not involve disorganized speech, catatonic behavior, or a lack of emotion.
Disorganized schizophrenia is characterized by disorganized behavior and nonsensical speech. A person with disorganized schizophrenia may also have inappropriate emotional responses or lack of any emotional response.
Residual schizophrenia is used to describe a person who showed symptoms of the illness in the past but who currently has lingering negative symptoms or none at all. Some of the lingering symptoms may include poor attention, some mental disorganization, and emotional withdrawal.
A person who does not fit into any of these other classifications of schizophrenia may have undifferentiated schizophrenia. They may be showing symptoms for more than one kind.
There is not one single cause for the onset of the different types of schizophrenia. It is a combination of genetic and environmental factors that contribute to the development of schizophrenia.
Research suggests that almost 80% of the likelihood of having schizophrenia may be genetic.1 Although only 1% of people have schizophrenia, children or siblings of people with schizophrenia are ten times more likely to develop the disease.2 Immediate relatives of people with schizophrenia can exhibit milder versions or traits associated with the disorder, but not to the extent that requires treatment. Experts are confident that many different genes increase the risk of developing schizophrenia. Still, no single gene causes the disorder by itself.3
Scientists believe that different brain structures, functions, and interactions between neurotransmitters may contribute to the onset of schizophrenia. People with schizophrenia have been found to have differences in the volumes of specific brain components, neurotransmitters, and how regions of the brain are connected and work together. During puberty, changes in the brain may trigger psychotic episodes due to genetics, environmental exposures, or brain structure differences.
Environmental factors like exposure to certain viruses in infancy might increase the likelihood of schizophrenia. The use of some drugs, such as marijuana, may trigger psychosis in highly susceptible individuals. Other environmental factors include living in poverty, stressful surroundings, and nutritional problems before birth.
Addiction is a physical or psychological urge to do, take or use something, even though it could be harmful to you. The most common type of addiction is drug addiction, also known as substance use disorder. It’s also possible to be addicted to various activities, such as gambling, eating, or working.
According to studies, peer influences and family environment are the most important factors influencing using addictive substances. Genetic factors and psychopathology play a more critical role in the transition to problematic use.4
Childhood experiences can significantly affect physical and emotional health. Events such as sexual abuse, parental separation, verbal abuse, or witnessing violence may lead to physical and emotional difficulties.
Environmental factors can also contribute to the development of addictions. Some environmental factors include social pressure, poor coping skills, exposure to addictive substances, parental drug use, and poor parental supervision.
Stress is a well-known risk factor in developing an addiction. Some examples of stressors include interpersonal conflict, loss of a relationship, death of a close family member, and loss of a child. Although stress, on its own, does not cause addiction, in combination with other factors such as genetics, it can undoubtedly lead to the development of an addiction.
Schizophrenia and addiction often co-occur. People with schizophrenia may start abusing various substances in a misguided attempt to self-medicate or alleviate feelings of anxiety and depression. Although substance abuse can not cause schizophrenia on its own, it can act as an environmental trigger. Substances such as marijuana, cocaine, and amphetamines can aggravate the symptoms of schizophrenia and worsen their severity.
In fact, around 50% of people with schizophrenia have a history of substance abuse.5 Up to 64% of people who have experienced an episode of psychosis (FEP) have used cannabis.6 Almost one-third of people with schizophrenia develop an alcohol use disorder.7
Cocaine abuse among people with schizophrenia is common. Cocaine abuse and schizophrenia are co-occurring disorders. Cocaine can worsen the positive symptoms of schizophrenia, such as abnormal motor behavior, delusions, and disorganized thinking. Cocaine use can make schizophrenia harder to treat. It’s common for a dual diagnosis of cocaine addiction and schizophrenia to require inpatient treatment.
According to recent research, daily smoking of high-potency marijuana can increase the chances of developing psychosis by nearly five times compared to people who have never used marijuana.8 People who have schizophrenia and use marijuana may experience a worsening of symptoms.
Alcohol use disorder is common among people with schizophrenia. One cause for the high co-occurrence of schizophrenia and alcohol use disorder is dysfunction in brain reward circuitry.9 Alcohol is known to make symptoms of schizophrenia worse.
Cigarette smoking is linked with many disorders, including schizophrenia. It has been found that cigarette smoking in individuals with psychotic disorders is 2-3 times greater than in those without. Studies have also found that cigarette smoking may be causally related to a risk of psychosis, possibly through a shared genetic liability to smoking and psychosis.10
Delusional thinking is called a positive symptom of schizophrenia, meaning it occurs in people with schizophrenia but not in the general population. Delusional thinking, together with hallucinations, are the hallmarks of the illness.
Delusions are firmly held beliefs not supported by objective facts. For example, a person may become paranoid that others are “out to get them” or believe that the television, radio, or internet are broadcasting special messages that require some response.
Hallucinations are false sensory experiences. Symptoms of schizophrenia may include hallucinations, such as hearing voices or seeing things that aren’t there.
A person with schizophrenia may be unable to form coherent or logical thoughts, resulting in disorganized speech. They may leap from one topic to another, and their speech may be garbled and impossible for someone else to understand.
Disorganized or catatonic behavior can vary in a person with schizophrenia. Their behavior can change from being childlike to violent and aggressive. These symptoms may also involve not listening to instructions and freezing in place.
Schizophrenia also has negative symptoms. These qualities include lack of emotion, decreased motivation, or delayed speech. There are cognitive symptoms as well, such as difficulty concentrating, remembering information, and making decisions.
Experts believe that the negative symptoms of schizophrenia are tied to too little dopamine in some areas of the brain.
According to studies, schizophrenia reduces the overall life span by ten years. The leading causes of death among individuals with schizophrenia are self-harm and suicide. The rate of attempted suicide ranges from 10 to 50%. Also, around 40 to 79% of individuals with schizophrenia reported suicidal ideation at least once during the course of illness. Suicidal ideation and self-harm increase the likelihood of eventual death by suicide.11
The symptoms of schizophrenia and addiction can be persistent and disabling if left untreated. A range of treatments is available, including detox, CBT, and antipsychotic medication. Effective treatment can treat symptoms of schizophrenia and addiction to increase your engagement in school, work, and enjoy personal relationships.
Detox involves cleansing the body from all substances. It is the first step in dual diagnosis treatment. The body must be clear of any substances before a clinical team can address the schizophrenia symptoms and advise on the best course of treatment.
Cognitive-behavioral therapy is another effective treatment for schizophrenia. A combination of CBT with other behavioral therapies such as motivational interviewing and antipsychotic medication is common. CBT teaches how to improve coping skills and deal with the everyday challenges of the illness. With proper treatment, you can pursue goals, such as attending school, working, or forming relationships. Participating in regular treatment can also lead to a lower risk of relapse and hospitalization.12
Motivational interviewing is an evidence-based approach that encourages positive self-talk to make life changes. This therapy involves active engagement including, deciding which behaviors to change, analyzing the reasons for making the change, and deciding on a plan.
Antipsychotics can be a very effective treatment for schizophrenia, especially when combined with other therapies such as behavioral therapy. Antipsychotic medications are dopamine receptor blockers, helping with symptoms of schizophrenia. People who have schizophrenia usually take the medication daily in pill or liquid forms. Some antipsychotic drugs are given as injections once or twice a month. Sometimes, when symptoms do not improve with antipsychotic medication, you may be prescribed clozapine. Some possible side effects of the antipsychotic medication include weight gain, dry mouth, restlessness, and drowsiness.
DSM-5 is the standard classification of mental disorders used by clinicians, researchers, and public health officials in the United States. It serves as the principal authority for diagnosing mental health disorders, including schizophrenia.
Symptoms must fit the criteria outlined in the DSM-5 for there to be a diagnosis of schizophrenia. You must meet two of the five symptoms, with one being in the first three criteria.
This information should not replace a visit to a doctor or treatment center. If you are concerned that you or a loved one might be suffering from schizophrenia and addiction, ask for professional help today.