Schizophrenia is a serious mental health condition and psychotic disorder. It is characterized by hallucinations, delusions, and cognitive disturbances.

Schizophrenia is potentially debilitating to those who live with it. Knowing how it relates to depression can help you understand the diagnosis and treatment options. The following list details some of the most important things to know about this condition.

1. Schizophrenia Has Both Environmental and Genetic Risk Factors

According to a 2016 study across 195 countries and territories, schizophrenia affects approximately 0.28 percent of the population worldwide. There are several risk factors for developing schizophrenia, some genetic and some environmental. Environmental risk factors for schizophrenia include infections, drug use, stress, and complications during the prenatal period and birth.

Infectious Diseases

Research suggests that developing certain infections while in utero and during childhood and before adulthood may cause a person to later develop schizophrenia. This link may be related to inflammation in the brain caused by infections during these critical periods of development.

Complications During the Prenatal Period and Delivery

Complications of the prenatal period other than infections have been linked to schizophrenia. For instance, a person has a greater risk of later developing schizophrenia if they had a low birth weight or experienced malnutrition in utero. Some cardiovascular congenital anomalies — heart abnormalities developed before birth — are also associated with the development of schizophrenia.

Stress

Research suggests that stress during developmentally critical periods, such as between the ages of 10 and 19, increases a person’s vulnerability to schizophrenia.

Seasonal Birth

Studies have linked being born during winter and early spring (between January and May for those in the Northern Hemisphere) to the development of schizophrenia later in life. This may, in part, be due to factors such as:

• Temperature
• Humidity
• Daylight duration
• Infections
• Changes of maternal hormones
• Other factors that may affect a baby in the womb

Genetics

Studies of families and twins have shown that schizophrenia is strongly driven by genetics. Not only does schizophrenia run in families, but twin studies provide particularly compelling information about genetics by comparing the schizophrenia rates in twins who are monozygotic (identical) against twins who are dizygotic (not identical). Research shows that the likelihood of both monozygotic twins developing schizophrenia is 33 percent, while in dizygotic twins this rate is only 7 percent. From this data, researchers can conclude that genes have a strong (but not total) influence in the development of schizophrenia. Several genes have now been linked to schizophrenia in scientific research.

2. Hallucinations Are Just One Symptom of Schizophrenia

People tend to most closely associate schizophrenia with hallucinations, but the symptoms can be much more complicated than that. The symptoms of schizophrenia can be classified into three broad categories:

• Positive symptoms
• Negative symptoms
• Cognitive symptoms

Positive Symptoms

Positive symptoms, which are also called psychotic symptoms, usually involve an altered sense of reality. Examples of psychotic symptoms of schizophrenia include:

• Hallucinations — Seeing, hearing, feeling, smelling, or tasting things that aren’t real
• Delusions — False beliefs, typically in relation to feeling important or persecuted
• Thought disorder — Includes disorganized thinking or speaking

Negative Symptoms

Negative symptoms refer to a decrease or cessation of behaviors that are normally present. For instance, a person with schizophrenia might:

• Lack motivation
• Feel less pleasure in everyday life
• Be unable to express emotions as vividly (also called “flat affect”)
• Talk less than usual

Cognitive Symptoms

Cognitive symptoms might affect a person’s ability to remember, process information, or focus on something. The degree to which cognitive symptoms affect someone with schizophrenia can vary greatly from person to person.

3. Schizophrenia Shares Symptoms With Depression and Bipolar 1, Making It Difficult To Diagnose

Schizophrenia is usually diagnosed by a psychiatrist or clinical psychologist after a thorough review of an individual’s personal history, including an analysis of their current symptoms. A doctor may also perform physical tests to rule out other diseases.

Schizophrenia is typically diagnosed during early adulthood — most commonly in the early 20s and a few years before for men and the late 20s to early 30s for women, according to the National Alliance on Mental Illness. This is when symptoms, such as psychosis, begin to manifest.

Diagnosing schizophrenia can be difficult because psychosis can also occur in the context of depression and bipolar 1 disorder. The use of amphetamines and hallucinogenic drugs can also cause symptoms similar to those seen in schizophrenia.

4. Schizophrenia Can Be Managed With Medications and Therapy

Treatment for schizophrenia is lifelong, and there currently is no cure for this disorder. However, symptoms can be managed through the use of medications and different forms of therapy.

The main drugs used to treat schizophrenia are a class of pharmaceuticals called antipsychotics — specifically, the newest group of antipsychotics called “second-generation.” Antipsychotics are typically taken orally (by mouth), although sometimes long-lasting antipsychotics can be administered via injection.

Some antipsychotics used today include:

• Aripiprazole (sold as Abilify)
• Clozapine (Clozaril and Versacloz)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa)
• Olanzapine and samidorphan (Lybalvi)
• Paliperidone (Invega)
• Quetiapine (Seroquel XR)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)

A class of drugs called antidepressants may also be used for treatment in people with both schizophrenia and depression.

Whereas medications are usually the first-line treatment for symptoms of schizophrenia, psychotherapy or talk therapy can also help. Research has shown that a form of psychotherapy known as cognitive behavioral therapy (CBT) can help individuals with schizophrenia better manage their symptoms. CBT led by a mental health professional is a form of psychotherapy that focuses on being aware of, and changing, thought and behavior patterns. Often, CBT teaches specific skills and techniques, such as acceptance or problem-solving.

5. Depression Can Be a Symptom of Schizophrenia or a Distinct Condition

The connection between schizophrenia and depression can be complicated. Depression is often a symptom of schizophrenia itself. However, people with schizophrenia can also experience symptoms of major depression, a distinct condition. In one study of 90 individuals with stable schizophrenia, 31 percent were found to have clinically relevant symptoms of depression.

Having multiple conditions can complicate treatment. Research shows that people living with both schizophrenia and major depression have a lower quality of life than those with schizophrenia alone.

If you have been diagnosed with depression or schizophrenia, it is important to stay aware of your thoughts, feelings, and mood. Be open and honest with your doctor and therapists about your experience, so they can help you manage the symptoms of your condition.

Be particularly vigilant about the increased risk for suicidal behaviors among people with both schizophrenia and depression. Reach out to your doctor or health care team immediately if you have any thoughts of self-harm.

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

Talk With Others Who Understand

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