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When a person is diagnosed with schizophrenia, often they or their family wonder “How can this be happening? What did I do?” Over the centuries, the causes of schizophrenia have been debated, and many theories have emerged, most of them wrong.

It appears that there is a combination of things that contribute to schizophrenia, with none of them being the sole cause. For example, if schizophrenia were completely genetic, when a person who is an identical twin has schizophrenia, his or her twin also would, which is not always true. If it were completely environmental, it wouldn’t make sense that schizophrenia runs in some families, across generations and situations.

So what is it? Researchers have found evidence that some people have a genetic susceptibility to developing schizophrenia, but that other things are involved, including life stress, emotional intensity of families, and the mother having a certain virus while pregnant (which virus hasn’t been pinned down yet.)

One theory that has been clearly discredited, however, is the “schizophrenogenic mother,” in which a mother’s parenting style causes schizophrenia. There is nothing any one person can do to cause schizophrenia. Without the genetic and other neurological factors present, schizophrenia doesn’t emerge. So, if you or a loved one has schizophrenia, please don’t blame yourself.

We may not know yet exactly the constellation of causes that come together for schizophrenia, but we know it’s a lot more complicated than just one thing. More helpful is to focus on recovery, there are more answers to recovery than to causes.

It would be ideal if everyone understood mental illness and had no prejudices against people with them, but this just isn’t the case.

Bias, stereotyping, and mistreatment still occur, and sometimes you might decide it’s best not to share your diagnosis with some people. But how to decide?

First off, you don’t have to. You have the right to keep your medical status private. In addition, federal law usually prevents employers from asking you if you have a history of mental illness when you apply for a job (there are exceptions for certain jobs, like law enforcement and armed services). Employers can ask you about drug/alcohol abuse, but not about legitimate use of prescription medications.

A job interview is not usually the best time to tell people. If you get the job, then you can get to know the people and the situation, then decide if it’s in your best interest to tell them.

Some questions that might help you make your decision are:

• Is there a reason for them to know? If you need special accommodations, like a flexible schedule at work so you can see your therapist, etc., this could be a good reason to tell your employer. You cannot be fired for telling them of your illness, though employers have the right to ask for a letter from your doctor or other documentation. (The employer has to keep this information confidential, they aren’t allowed to tell your coworkers.)
• Is the person likely to find out anyway?
• How understanding do I think they would be?
• Will it make things easier for me if they know?
• Have I known them long enough to tell them this kind of personal information?
• What are the risks of my telling the person? What could go wrong?
• How well can I handle it if the person judges me as a result of telling them?
• If I don’t want to tell them, do I think I can continue to maintain it as a secret, even if I have to lie?

You may want to ask someone you know and trust what their opinion is of whether they think you should talk about your illness.

When you approach the conversation about your illness, decide how specific you want to be:

• very general: refer to a “medical condition” or “illness”
• a little specific: refer to a “neurological problem,” a “brain disorder,” or “difficulty with stress”
• more specific: mention “mental illness” or a “mental disorder”
• most specific: give them your exact diagnosis

Pick a quiet time without a lot of distractions if possible. Tell them you want to talk briefly about something important. Think about what information will be helpful for them to know. Use that to help you decide what details you want to tell them.

You might want to make a comparison to diabetes–it can be well-treated with medications. Finally, remember to remind them of who you are as a person–this will help them remember that you are not your illness.

It’s not a bad idea to practice this, to do a role-play with a friend or family member who already knows about your illness so you can try it out.

Introduce the topic with something like, “I wanted to let you know about a challenge I have. I have a mental illness. It’s not like in the movies, I’m not a criminal or scary or anything. But sometimes the symptoms of my illness get more severe, and then (you might notice I’m very quiet/I might have to take some sick leave/I might have a harder time getting things done).”

Tell them as much as you’re comfortable with and as much as they need to know. Be ready to answer questions, and be ready to refuse to answer questions if they get too personal for you.

Schizophrenia is often portrayed in the media (TV, movies, the web) as a violent person who looks “different” and doesn’t fit in with the rest of society. These images are false and offensive.

Occasionally, the illness is depicted more accurately, but even then it’s usually pretty simple—hallucinations or delusions. The actual disorder is much more complicated than that, and has some positives associated with it (creativity, for example) as well.

“Always remember that you are a person first and foremost. A mental health label does not define you. You are not ‘depression’ or ‘schizophrenia’ or ‘bipolar.’ You are a person. A person with cancer does not call himself or herself ‘cancer,’ so why should you limit yourself to a label?”
-David Kime, artist, writer, floral designer, in recovery from bipolar disorder since age 15
(from the Illness Management and Recovery workbook)

If you or a loved one has schizophrenia* it might be helpful to learn about the range of details that can be associated with this illness. Below is a summary.

• sensitivity (physical and emotional)–can be a positive or a negative
• filtering problems–good at noticing things, good at details, easily distracted, easily overstimulated in crowded places
• creativity–many people with schizophrenia are very artistic
• often skilled at accepting others for who they are
• can be easy to get along with, sometimes to the point of lack of assertiveness
• a thought disorder–feeling compelled to examine and interpret many things others see as neutral or without meaning; having many thoughts go on in one’s head at once; being easily confused when one has complicated input, such as conversations; problems combining senses like watching and listening at the same time; thoughts getting jumbled up; thought-blocking, where thoughts get “stuck” in one’s mind
• hallucinations–hearing/seeing things (also feeling, smelling, tasting things); sense of smell etc. being stronger (smells are stronger, colors are brighter); things looking psychedelic or deformed, voices sounding unusual; sometimes, feeling pain or heat/cold is less strong than in others; distortions of the body (feeling like a zombie, feeling like one’s body is changing size, etc)
• delusions–false ideas that seem very real to the person, but not to others; paranoia is a kind of delusion where a person thinks they are being watched, persecuted, attacked, laughed at, recorded, etc.; other examples of delusions are believing that one is an important person to the government, the radio is sending messages directly to the person, the person believes that she/he is 900 years old, that he/she is Jesus
• easily overwhelmed by stress–stress can trigger symptoms, people with schizophrenia are often more easily stressed and more affected by stress
• emotions–trouble expressing your emotions on your face, being strongly bothered by conflict, emotions being less strong than they used to be, depression, inappropriate emotions, trouble interpreting what others’ emotions are
• trouble getting motivated and getting things started
• trouble making decisions
• disorganized behavior–doing things that seem pointless to others and get nothing accomplished, that seem important to you (moving everything from one room to another for no reason)
• catatonic behavior–sitting in one place, not moving, for very long periods of time, without apparent reason
• movement–slowness in movement, clumsiness
• problems with concentration–too many thoughts at once, being easily distracted, voices interrupting your concentration
• problems with communication–trouble organizing thoughts into words and sentences, trouble saying what you want to say, voices telling you not to say certain things
• negative symptoms–problems getting things started, not following through with plans, not being interested in things you used to like, trouble expressing emotions, trouble getting everyday tasks done, difficulty with hygiene, thought-stopping, difficulty speaking, still face, poor eye contact
• can’t see your symptoms for what they are, feeling nothing’s wrong or that he/she doesn’t have symptoms when everyone else disagrees
• social–hard time making friends, trouble with assertiveness
• memory problems
• having trouble working full-time

Schizophrenia affects about 1%, or one out of every 100 people, all over the world. This means that in the Greater Twin Cities area, there are around 30,000 people with schizophrenia.

Schizophrenia is not contagious, it is not mental retardation, it is not multiple personality disorder, it is not a personal weakness or a result of bad parenting. It’s no one’s fault.

WHAT CAUSES SCHIZOPHRENIA?

Chemical imbalances in your brain. Scientists believe that some people’s genes (which are part of them from before they are born) make them vulnerable to schizophrenia, and that vulnerability combined with stress can cause the symptoms to appear. However, our understanding of the causes of schizophrenia still isn’t very good.

Schizophrenia often has episodes of more intense symptoms, followed by times of less intense symptoms. Some people have less severe cases than others.

*”Schizoaffective Disorder” involves both schizophrenia and depression or bipolar episodes, this list covers the schizophrenia part of this disorder

The word “schizophrenia” often conjures up fear or apprehension because of misinformation in the movies and on TV/the web about the disorder.

People with schizophrenia are generally portrayed as disheveled, scary, violent people who yell at no one. In actuality, people with schizophrenia are not more violent than anyone else and look “regular.”

An outsider may see only someone ‘out of touch with reality.’ In fact we are experiencing so many realities that it is often confusing and sometimes totally overwhelming.”
(anonymous client quoted in Surviving Schizophrenia, by E. Fuller Torrey)

Think about it, how many people are you acquainted with? One hundred? More? Schizophrenia disorders occur in roughly 1% of the population, so for every one hundred people you know or even see walking around, one has schizophrenia. As medications have improved, so have the lives of people with schizophrenia. They look like anyone else, they work, they have hobbies, and they live in our neighborhoods. They are people who struggle, but aren’t we all? Below are some basic facts about schizophrenia that might help dispel any misconceptions.

FACTS ABOUT SCHIZOPHRENIA

• Schizophrenia is a brain disorder. When schizophrenia symptoms get high, changes in behavior and thinking often are a result. They can involve: hearing voices, seeing visions, false and scary beliefs (like “people are out to get me”), strange behavior, seeming slow, poor grooming, and outbursts of irritation (not usually violence)

“The vast majority of people with schizophrenia are not violent and do not pose a danger to others.”
–The Mental Health America Resource Center

• It is not mental retardation or multiple personality disorder.
• Schizophrenia affects males and females in equal rates, and about 1 out of every 100 people in America and around the world have schizophrenia.
• Schizophrenia is a treatable illness. The symptoms can go up and down, and often people are able to do pretty well when their symptoms are not severe. Many people are completely “normal” when their symptoms are not severe. You probably can’t tell they have schizophrenia at those times.
• There are many things that are thought to be involved in the development of schizophrenia, such as genetics, brain anatomy, and illness in the womb, but no single cause of schizophrenia has been found.

“Schizophrenia is not caused by childhood experiences, poor parenting, or lack of willpower.”
–The Mental Health America Resource Center