Schizophrenia: An Altered Experience of Reality


Schizophrenia is a serious mental illness, but one that is often mischaracterised as causing multiple personalities by the general public. Thanks to the lack of general knowledge about the condition, people with schizophrenia are also frequently stigmatised as being unbalanced, dangerous and violent.  People with schizophrenia do not have split or multiple personalities and the vast majority are not violent.

What is Schizophrenia?

Schizophrenia is a chronic psychiatric issue that affects the way people perceive reality, potentially causing delusions, visual and aural hallucinations, disorganised thinking and disordered movement. Around 1% of the population experiences schizophrenia worldwide and the condition most commonly develops between the ages of 15 and 35. The condition may also develop later in life and is more commonly seen developing in women later in life.

Around 150,000 - 200,000 people in Australia live with schizophrenia with the severity of symptoms between these people varying wildly. Around 20% - 30% of people with schizophrenia only experience a few intermittent episodes, while for others the condition is chronic and ongoing. Unfortunately, around 10% of people with schizophrenia globally commit suicide.

Symptoms of Schizophrenia

Schizophrenia  associated symptoms are broken into two roughly defined groups - positive and negative. It may appear that the symptoms are classified as good or bad, but this isn’t the case. Positive symptoms refer to those that are expressions of new affect or activity and negative refer to those that evince a lack of normal behaviour.

Positive Symptoms

Delusions - More than 90% of people with schizophrenia experience delusions. These are characterised by a strongly held belief that persists regardless of evidence produced to the contrary or how illogical or bizarre the idea may be. Delusions are broken down into a number of categories, including:

Control - Delusions of control refer to the belief that an individual’s actions are being controlled by an outside force. This control varies from delusion to delusion, but there are commonalities when it comes to the overall methodology of “control”. Delusions of control commonly revolve around either the insertion or withdrawal of thought and ideas by an outside force like aliens or a shadowy government agency. 

Grandeur - Delusions of grandeur refer to a person’s belief that they are special or important in an exaggerated way, such as being an important historical or religious figure (like Julius Caesar or Jesus), or have abilities that put them above normal people, such as telepathy or the ability to fly.

Persecution - Delusions of persecution revolve around the firmly held belief that “they” are out to get you. The delusion may be personal, focussing on a family member or colleague, but commonly the delusions are based around convoluted and outlandish conspiracies. 

Reference - Someone with delusions of reference believes that they are being sent direct messages through a common medium,and that they are the only ones that can understand. Common examples include the belief that a TV show or radio program is talking directly to you.

Hallucinations - Any of the five senses can be affected by hallucinations, but the most commonly experienced by people with schizophrenia are visual and aural. Visual hallucinations can take many forms but are often personal for those that experience them, such as people, characters or images of special importance to the individual. Visual hallucinations are more often experienced alone than in company. 

Aural hallucinations are also commonly personal in nature, with the person experiencing the hallucination hearing the voices of people or characters they know. Aural hallucinations are often critical, cruel, vulgar or abusive in nature. 

Disorganised Speech - Schizophrenia can make it difficult for a person to concentrate or maintain a train of thought, and this can manifest in speech. Disorganised speech can take many forms, including rapid topic changes, even within a single sentence, frequent use of made up words, repetition of words or meaningless rhyming. 

Disorganised Behaviour - Schizophrenia can affect a person’s ability to take care of themselves, work, achieve goals or interact with others. This can manifest in a number of ways including a lack of inhibition or impulse control, unstable or unpredictable emotional responses or the exhibition of bizarre or erratic behaviour.

Negative Symptoms

Symptoms of schizophrenia can also display in an absence of typical behaviours. A lack of typical emotional expression can appear as a flat vocal affect, a lack of or limited facial expressions or an absence of eye contact. A lack of  enthusiasm or interest can display as a lack of self-care, motivation or withdrawal from society. 

Negative symptoms vary from person to person and in some cases may only be truly noticed by someone familiar with their earlier “typical” behaviour. 

Causes of Schizophrenia

As with many mental conditions, the exact cause of schizophrenia is unknown, but it is believed to have biological, environmental and genetic roots. Having a family history of schizophrenia increases the chance of a person developing the condition, as does having an inflammatory or autoimmune disease. Evidence shows that heavy use of psychoactive (mind-altering) drugs, such as regular marijuana use can increase the chance of developing schizophrenia. High stress and exposure to toxic chemicals may also play a part.  

Treatments for and Living With Schizophrenia

Schizophrenia is a lifelong disorder that requires treatment or medication to control the severity of symptoms and reduce their frequency. Antipsychotic medications are often used to treat or stop hallucinations and delusions. Therapy and vocational rehabilitation (including occupational therapy) are often also required to help the person with schizophrenia lead a normal life.

Although no replacement for medication and therapy, there are a number of lifestyle behaviours a person with schizophrenia can practice to aid in their treatment, including getting plenty of sleep, eating balanced and healthy meals, getting regular physical exercise, trying to minimise or otherwise manage stress, avoiding non-medical drugs (including nicotine and alcohol) and most importantly, surrounding themselves with an understanding support network. 

Both people with schizophrenia and those caring for them need support, and that’s where groups like SANE Australia and Mind Australia are very useful. SANE Australia can be accessed through the website or via their hotline on 1800 18 7263, and offers information and support for people with schizophrenia and their carers or family. Mind Australia is dedicated to the practicalities of living with a mental condition, so can assist with home assessments, carer support, financial support and other aspects of aid covered by the NDIS.

If you have a loved one who is showing abnormal behaviour, or are caring for a person with schizophrenia and need some support, the easiest and most convenient way to find and book an appointment with a mental health professional is through MyHealth1st. The team at MyHealth1st believes in early intervention and continuity of care, so people can have any problem diagnosed quickly, allowing for the best possible outcome.


Clinical Advisor

Dr. Ross Walker

Consultant Cardiologist; Media Health Presenter; Author; Professional Speaker. Dr Walker’s new radio show Healthy Living airs on the Macquarie Radio Network nationally each Sunday for 2 hours at 7PM

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