Schizophrenia: What It Is and Is Not

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COVID-19, which is continuing to impact all areas of our lives, has led to an increased focus on our mental health. It is good that people are developing more understanding and sensitivity to mental illness. It has been a long time coming. However, on any given day, the mental health information we receive tends to focus on trauma, stress, depression, anxiety, and narcissism. While these certainly are important issues, it seems that little, if any, attention is given to the severe mental illnesses such as psychosis and schizophrenia.

There are so many myths and misunderstandings about schizophrenia that it is understandable why most people do not know what it truly is and the impact it has on the individual and their family. Many people become fearful when they hear that someone is schizophrenic. The person with schizophrenia’s way of behaving and perceiving the world is so foreign to others that it is hard for them to understand, be sympathetic, or supportive. In Psychology Today’s diagnosis dictionary, schizophrenia is described as

a disabling mental illness that affects more than 1 percent of the world’s population. Individuals afflicted with this thought disorder experience hallucinations, disorganized thinking and are prone to false and paranoid beliefs. These and other symptoms often render the individual fearful, withdrawn or difficult to interact with.¹

Most of the misunderstanding and fear about schizophrenia can be traced back to the late 1890s when it was first named and identified as a psychiatric disorder. As its etiology was not understood, many theories were proposed to explain the disorder. It is some of these false beliefs that continue in the public domain that stigmatize schizophrenia. It is important to know not only what schizophrenia is but also what it is not. Perhaps dispelling some of the most misunderstood aspects of the disease will make it easier to be supportive of these individuals and their families.

• Myth 1: Those with schizophrenia tend to be violent and dangerous. Historically, literature and cinema had a new villain in the person with schizophrenia who was portrayed as a deranged, crazed killer. The truth is that those with schizophrenia tend to be loners and are more likely to be the victims of violence rather than the perpetrators. They are also more prone to harm themselves than others as there is a high rate of suicide (10 percent) in those with this diagnosis.²
• Myth 2: Schizophrenia is a result of bad mothering. In early attempts to find the source of this disorder, some psychoanalysts believed that schizophrenia was caused solely by the “schizophrenogenic mother.” Mothers were villainized while fathers and other family members were not even mentioned.³ As we know, there are many people involved in a child’s life that might have a deleterious effect on them. We know now that schizophrenia is a brain disorder and not the cause of “bad” parenting. Additional factors found to contribute to the development of schizophrenia include viral infections, changes in brain chemistry, birth trauma, and genetics.
• Myth 3: Schizophrenia is the same as “split-personality disorder” or as it is referred to today as dissociative identity disorder. I have found this belief to be most common among a wide range of people regardless of educational level. It seems to stem from several sources. The word schizophrenia is from the Greek words for splitting and mind. Many take it to mean split personality. Schizophrenics do not have two different personalities. They do however experience delusions, hallucinations, and disordered thoughts. Their behavior on and off medication may also lead some to think they have two personalities. Dissociative disorders are much less common than schizophrenia. In addition, those with dissociative disorders do not have psychotic symptoms.⁴
• Myth 4: If you have schizophrenia, you will never get better. Today, with the advent of more effective medications with fewer side effects, those with schizophrenia can become more stable and functional. Early intervention, compliance with medication, and other psychosocial treatments are important in stabilization. Compliance is often problematic, as many with the disorder do not understand or believe there is anything wrong with them. Anosognosia, as it is referred to, is a neurological deficit and not denial. According to the National Alliance of Mental Illness, about half of Americans with schizophrenia can improve significantly.⁵

Living with schizophrenia can be very challenging for the individual and their family. However, things are not hopeless. Perhaps having a better understanding of what schizophrenia is and is not may help to change some of the stigma attached to it. It is also important to recognize and acknowledge the struggles and impact on the family when a loved one is schizophrenic.