Schizophrenia is one of the most difficult mental illnesses and requires a clear understanding of the condition and its symptoms so that we can contain it and understand how to interact with and treat someone affected by it. Many people confuse schizophrenia with split personality or classify it as a type of madness. To settle these questions, this article examines the causes, symptoms, types, and treatment of schizophrenia. It also answers whether schizophrenia is a mental or psychological illness and explains the difference between schizophrenia and split personality.

Because awareness is lacking among most people, many equate the word “madness” with mental illness, which is a serious mistake. The word “madness” has no clear medical meaning, and there is no condition in psychiatry or mental medicine called madness. It is a general word that refers only to behavior and thinking that fall outside what a society’s traditions consider normal. Some societies therefore regard madness as close to genius, while others protect these individuals and believe they have a sacred quality worthy of respect. Other societies reject them as followers of devils surrounded by evil spirits, while elsewhere they are imprisoned or treated in hospitals. We should therefore abandon this word when discussing psychotic illnesses scientifically.

What Are the Symptoms of Schizophrenia?

1. A clear disturbance in behavior that differs from the person’s usual nature.
2. A change in the original personality.
3. Adopting habits, customs, and behavior that differ from the original personality.
4. Confusion in thoughts and in the way they are expressed.
5. Psychotic disturbances characterized by withdrawal from reality.
6. Inappropriate affect.
7. The patient has an unusual way of speaking and thinking, as well as abnormal motor symptoms.

Learn more about the symptoms of schizophrenia in this article.

Causes of Schizophrenia:

Scientifically, the direct cause of schizophrenia has not been identified. However, a combination of genetic, biological, and environmental factors may contribute to its development. These include:

1. Genetic factors: Having a family history of schizophrenia increases your likelihood of developing it sixfold.
2. Environmental factors: Environmental factors may include living and being raised in a home where violence and harshness are the basis of parenting, or the mother experiencing poor nutrition or taking medications that may affect the brain’s chemical composition. 
3. Biological factors: A dysfunction in the brain’s chemical composition that leads to neurotransmitters working incorrectly, or taking medications to manage psychological changes during adolescence that may affect brain function.

Is Schizophrenia a Mental or Psychological Illness?

Schizophrenia is classified as a chronic mental psychotic illness whose symptoms affect how the person thinks and behaves. Because schizophrenia is a psychotic illness, it may lead the affected person to create ideas and characters unrelated to reality, which are classified as hallucinations and delusions. The person may either live with them, believe they are conspiring against them, or feel that someone is pursuing them. This happens because the patient cannot distinguish between ideas created because of schizophrenia and events occurring in reality.

As a result, schizophrenia is a psychological disorder that can disrupt the course of the patient’s life because of the hallucinations and numbers that pursue them, occupy their thoughts, and leave them unable to perform daily duties or interact with the people around them.

Types of Schizophrenia:

The term schizophrenia has been used to refer to a particular number of subgroups of disturbances. We now recognize that a single classification has been used to define more than one type because it is easier, not because practical necessity requires it. There may therefore be other types, with the name schizophrenia indicating similarity in symptoms without necessarily implying similarity in the causes of the illness. In fact, there is evidence for two types of schizophrenia:

1. Process schizophrenia: This follows the traditional pattern, which includes psychological trauma, a poor home environment, an unstable personality before the illness, and then severe deterioration.
2. Reactive schizophrenia: This term is used for patients who grew up in stable family circumstances, showed suitable social adjustment during adolescence, then suddenly developed psychosis, displayed relatively mild symptoms, and generally had a stronger prospect of recovery.

The distinction between these two types gave rise to a theory that process schizophrenia, or developmental schizophrenia, represents the traditional pattern: an organic hereditary illness that begins mildly and continues to worsen toward deterioration. Reactive schizophrenia, by contrast, may be an entirely different and nonspecific illness because of its sudden acute onset, limited symptoms, and good response to treatment. Until a more useful system is developed, the two groups of patients must continue to be combined based on their shared symptoms.

Today, different patterns of disturbance are recognized among the types of schizophrenia:

1. Simple schizophrenia
2. Hebephrenic schizophrenia
3. Catatonic schizophrenia
4. Paranoid schizophrenia
5. Childhood schizophrenia

Kraepelin is credited with being the first to group the schizophrenic disturbances together after recognizing a shared characteristic among them: madness following progressive deterioration. He distinguished between the preceding three types. Later, Bleuler proposed adding the simple type to the preceding three and favored the term early madness, dementia praecox.

Bleuler used dementia to indicate mental deterioration and praecox to indicate its appearance at an early age. Bleuler did not believe that early madness necessarily led to madness and argued that the illness was principally characterized by a splitting of the personality. At his suggestion, the new term schizophrenia—schiz, meaning to divide or split, followed by phren, the Greek word for mind—replaced Kraepelin’s old name.

Can Schizophrenia Be Cured Permanently?

Unfortunately, treating schizophrenia requires a lifelong treatment plan without interruption, even when symptoms improve noticeably. It is also preferable for both medication treatment andpsychotherapy sessionsto be included in the patient’s treatment plan to reduce the severity of symptoms. In some cases, symptoms are so severe that the patient needs to receive treatment in a hospital.

Medication is given priority in schizophrenia, with the doctor aiming to reduce the severity of symptoms. The doctor uses antipsychotic medications at different doses to achieve a better outcome. When a patient resists or refuses treatment, or avoids taking the medication because it causes side effects, doctors may administer it by injection instead of tablets. 

As for psychotherapy, it is preferable for the patient to attend psychotherapy sessions with a psychiatrist who specializes in psychotic illnesses or is experienced in treating schizophrenia, given the difficulty and particular nature of schizophrenia, which require specialized treatment.

In conclusion, schizophrenia in its various forms is one of the most serious major psychiatric disorders. Between 30% and 32% of those admitted to mental hospitals are diagnosed with schizophrenia. Schizophrenia attracts attention because it may begin very early in a person’s life, usually during their twenties, and may remain resistant to recovery throughout the rest of the patient’s life. A truly troubling fact is the length of hospitalization required to treat schizophrenia, which reaches 13 years—a period equal to the sentence imposed on perpetrators of major crimes.

Although the proportion of people with schizophrenia admitted to hospitals compared with admissions for all conditions is one fifth, half of the patients in a mental hospital at any given time are people with schizophrenia. This is because these patients tend to accumulate due to the slow rate of recovery. Schizophrenia also places a heavy burden on both the patient and society. As grave as rates of schizophrenia are, they do not fully represent humanity’s losses or the degradation inflicted upon human dignity.