Living with schizophrenia can be a challenging and confusing journey. It may be one of the most misunderstood and stigmatized mental health conditions that affects less than one percent of the U.S. population. 

Until just decades ago, the majority of people diagnosed with schizophrenia spent their lives inside psychiatric hospitals. With the development of antipsychotic medications in the 1950s, treatment for schizophrenia has radically improved.

Contrary to inaccurate portrayals in TV, films, and the media, many people with schizophrenia live full and empowered lives. 

While there is no cure for schizophrenia, integrative treatment which often includes medication, psychoeducation, cognitive-behavioral therapy, and psychosocial tools can reduce symptoms and help people diagnosed with schizophrenia achieve stability and fulfillment. 

We sat down with Christina Kozlowski, LMHC to learn more about what schizophrenia is and what treatment for schizophrenia involves. 

Christina spent many years working with individuals diagnosed with schizophrenia in acute settings, and provides effective psychotherapy and psychosocial therapy to guide individuals in a collaborative way toward connection, healing, and growth.

What is Schizophrenia?

Schizophrenia is a chronic and severe mental health condition that affects less than one percent of the U.S. population, according to the American Psychiatric Association. 

When schizophrenia is active, an individual may experience symptoms such as delusions, hallucinations, disorganized speech, impaired memory, trouble thinking, and lack of motivation. 

While there’s no cure for schizophrenia, most symptoms will greatly improve with treatment.

How is Schizophrenia Diagnosed:

Psychiatrists or psychiatric mental health nurse practitioners diagnose schizophrenia based on a person’s symptoms and behaviors. A diagnosis will be given after they’ve spent time with the individual, collected information, and considered other possible causes.

What are Some Myths and Misconceptions Around Schizophrenia?

“There’s a big misconception that people with schizophrenia are violent. Anyone can be violent and diagnosis of schizophrenia doesn’t make someone a threatening or harmful person,” says Christina. 

“The same prejudice can be made from calling someone with schizophrenia ‘crazy’ or ‘insane,’” Christina adds. “The fact is, people with mental health conditions are much more likely to be victims of violence than to create violence themselves.”

Symptoms of Schizophrenia Include:

The symptoms of schizophrenia (listed below) affect how a person thinks, feels, behaves, and interacts with the world and the people around them. 

Christina Kozlowski, LMHC explains that symptoms of schizophrenia typically appear during teenage years or into someone’s twenties. The changes often appear gradually and may be disruptive to a person’s learning, work, and social relationships. 

Early symptoms of schizophrenia may include: 

• Drop in grades
• Tumultuous relationships or changes in social circle
• Sudden loss of interest in activities or classes
• Disrupted sleeping
• Loss of motivation or interest in activities

Once people have developed schizophrenia, they will often experience an array of different symptoms.  

It’s important to note that everyone’s experience with schizophrenia is different. Just like with any mental health condition, not everyone with schizophrenia will experience the following symptoms:

Negative symptoms of schizophrenia:

“Negative symptoms” are associated with disruptions to a person’s mood or behavior. Negative refers to the absence of behaviors, such as: 

• Lack of pleasure or enjoyment
• Loss of motivation or interest in activities
• Social withdrawal
• Flat affect (reduced expression of emotions via facial expression or voice tone) 
• Reduced speaking 
• Difficulty beginning or sustaining activities

Positive symptoms of schizophrenia:

“Positive symptoms” are also known as psychotic behaviors associated with schizophrenia. These symptoms are less common, but are typically more active and intense if they do occur: 

• Changes to senses (seeing, hearing, smelling, tasting) 
• Unusual thinking
• Disorganized speech
• Delusions (paranoia) 
• Hallucinations (seeing things or hearing voices) 
• Altered sense of reality
• Altered sense of self
• Movement disorders 

Cognitive symptoms of schizophrenia:

“Cognitive symptoms” of schizophrenia are associated with learning, reasoning, and remembering: 

• Memory difficulties 
• Difficulty focusing or paying attention
• Inability to use information immediately after learning it
• Easily distracted
• Difficulty making decisions

What is Psychosis and How Does it Relate to Schizophrenia?

Psychosis and schizophrenia are often used in conjunction, however, while these two terms are related, they describe two different conditions. 

Psychosis refers to a collection of symptoms when someone has lost touch with reality. It’s one of the many “positive symptoms” of schizophrenia (listed above), but people can also have psychosis without schizophrenia. 

There is no singular case of psychosis: resulting from a complex combination of exposure to stressors or trauma, substance use, genetic risk factors, mental health conditions, and differences in brain development.

The two main types of psychosis include:

Hallucinations: Describe when someone hears, sees, or feels things that aren’t occurring outside of their mind. For instance, someone experiencing psychosis may hear voices when no one is around. 

Delusions: Describe intense, false beliefs that aren’t shared by others. For instance, a person with psychosis may believe that other people are conspiring against them when all evidence points to the contrary.

How is Schizophrenia diagnosed:

What Does Treatment for Schizophrenia Involve?

Treatment for schizophrenia typically involves a combination of psychotherapy, antipsychotic medication, and emotional and family or peer support. 

• Medication 

Medication is often the first treatment for schizophrenia. 

A psychiatric mental health nurse practitioner or a psychiatrist will work with individuals to create an individualized medication plan. Clients will understand their medications’ purposes, how to take them safely, and what side effects to watch out for. 

• Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy aims to help people with schizophrenia gain awareness of their thoughts, feelings, and behaviors in the present moment, and as a result become more intentional with their thoughts and reactions to situations. 

“I’ll often offer cognitive-behavioral therapy (CBT) to help clients with schizophrenia identify and change any negative thoughts or behaviors, such as delusions or hearing voices, that are making their life difficult,” says Christina. 

“When a client says that they’re hearing voices or experiencing hallucinations, I don’t tell them that they are wrong or convince them that these voices aren’t real. I offer strategies for changing the way they think about their symptoms which can reduce the stress these symptoms cause,” Christina adds. 

Research also suggests that adverse experiences such as stress and acute trauma increase the likelihood of someone developing schizophrenia. 

“CBT also may help individuals understand and work through lingering effects of trauma, such as stress, anxiety, and depression, to improve symptoms and functioning,” says Christina.

• Psychoeducation 

Psychoeducation helps people with schizophrenia and their family members understand the nature of the condition, treatment options, coping mechanisms and tools to reduce symptoms, and services that can help. 

Other forms of treatment for schizophrenia may include peer support, medical care, physical activity, and dietary approaches depending on the individual and their symptoms.

What To Do When a Loved One Has Schizophrenia:

Knowing how to support your loved one with schizophrenia can make a drastic difference in their recovery. Here’s how: 

1. Talk to your loved one with schizophrenia the same way you would talk to anyone else. 
2. Don’t tell your loved one who’s experiencing hallucinations or delusions to “just stop listening,” to them and don’t tell them that they’re “not real.”
3. If your loved one is hospitalized, be there to support them. 
4. Work with your loved one to create a plan if they’re continuously forgetting to take their medication, don’t just tell them to take it. 
5. Understand if your loved one refuses to accept treatment for schizophrenia, and be there for them regardless. 

Start Working with a Therapist in Massachusetts for Schizophrenia Today:

If you or your loved one is living with schizophrenia and doesn’t have a therapist, or is seeking a new therapist to work with in Massachusetts, our team of providers are here to help. 

At Handel Behavioral Health, we offer effective and convenient treatment for schizophrenia online in Massachusetts or in-person from our offices in Amherst, Franklin, West Springfield, Natick, and Wilbraham. 

Our licensed therapists and psychiatric mental health nurse practitioners are here to help you develop a treatment plan, and learn how to manage your symptoms as soon as possible. 

To start working with one of our licensed providers, please contact us today at (413) 343-4357.

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