Schizophrenia
Common symptoms and causes of schizophrenia, misconceptions about schizophrenia, getting support and ways you can look after yourself.
This content discusses trauma and anxiety, which some people may find triggering.
Summary
Experts often describe schizophrenia as a type of psychosis. This means you might be unable to tell the difference between your thoughts and reality. It’s becoming more common for the term ‘psychosis’ to be used to describe schizophrenia, so you may be given a diagnosis of psychosis rather than schizophrenia. NICE, the organisation that produces guidelines for healthcare professionals, uses 'psychosis' as an umbrella term covering a range of conditions including schizophrenia and groups them together in its guidance.
What are the symptoms of schizophrenia?
During an episode of schizophrenia, the way you see and understand the outside world is disrupted. Symptoms are often described in two groups.
Positive symptoms are things you experience that wouldn’t usually be there — such as:
- losing touch with reality
- seeing or hearing things that are not there
- holding irrational, paranoid or unusual beliefs not based on reality
- behaving in ways that may seem unusual to others, because you are responding to these experiences
Negative symptoms are things that may be reduced or absent — such as motivation, emotional expressiveness, speech and the ability to engage socially. Negative symptoms can be harder to recognise but often have a significant impact on everyday life, relationships and work.
Schizophrenia is one of the most common serious mental health conditions. Around 1 in 100 people will have one episode of schizophrenia, and two-thirds of these will go on to have further episodes. Schizophrenia usually starts in your late teens or early 20s. Some people need a great deal of help in managing the symptoms of schizophrenia. Others find ways to cope with experiences such as hearing voices and don’t necessarily want to receive any treatment.
What causes schizophrenia?
The exact cause of schizophrenia is unknown, but most experts think it’s linked to genetic and environmental factors. Stressful experiences and some recreational drugs can also trigger an episode in vulnerable people.
Traumatic experiences, particularly adverse experiences in childhood, are also recognised as an important factor. Research consistently shows that childhood adversity is associated with significantly increased odds of developing psychosis, with some forms of abuse showing particularly strong associations. It’s common for people with schizophrenia or psychosis to have experienced significant trauma, and this may need to be addressed as part of treatment and recovery.
Psychosis affects less than one in a hundred adults in England in any given year, a rate that has remained broadly stable over time. However, rates are notably higher among people living in the most deprived neighbourhoods, those experiencing problem debt, and those who are economically inactive — reflecting the significant role that social and economic circumstances play in mental health.
Schizophrenia usually starts in your late teens or early 20s. For some people schizophrenia involves a single episode; for others it is a longer-term condition requiring ongoing support. Some people need a great deal of help in managing the symptoms of schizophrenia. Others find ways to cope with experiences such as hearing voices and don’t necessarily want to receive any treatment.
Common misconceptions about schizophrenia
There are many common misconceptions about schizophrenia.
- Myth: schizophrenia means ‘split personality’
Fact: People with schizophrenia don’t have a split personality or multiple personalities. The name was meant to describe the ‘split’ from reality you can experience with psychosis. - Myth: people with schizophrenia are dangerous
Fact: Most people with schizophrenia are not violent. Research consistently shows that people with severe mental illness are substantially more likely to be victims of violence than perpetrators, including domestic, community and sexual violence. Women with severe mental illness face particularly elevated risks. People with schizophrenia are also more likely to harm themselves than others. - Myth: schizophrenia can’t be treated
Fact: People with schizophrenia may need long-term support, but the condition can be treated. Some people find that most of their symptoms get better, while others find they stop for a long time or never return. Some people find ways to live with the condition long-term.
Getting treatment and support
Schizophrenia is often treated with a combination of talking therapy and medication: usually cognitive behavioural therapy (CBT) and antipsychotic medication. You may also receive help from social services or a community mental health team.
If you are experiencing psychosis for the first time, speak to your doctor. They should refer you to an early intervention in psychosis service. These are specialist teams that offer a full range of psychological, social, occupational and medical support. Access should be available regardless of your age or how long you have been experiencing symptoms.
For some people, symptoms don’t respond adequately to initial treatment. If this happens, it’s important to continue working with your care team to explore other medication options, review psychological support, and consider whether there are other factors, such as substance use or a coexisting condition, that may be affecting your recovery.
Talking therapy
Different talking therapies can help with schizophrenia.
Different talking therapies can help with schizophrenia.
Different talking therapies can help with schizophrenia.
- CBT can help you manage symptoms such as hearing voices or delusions. It can also help normalise psychosis and make it less frightening – for example, by explaining that hearing voices is common or that there are times when we can all feel paranoid. Normalising these experiences can reduce your stress and remove any stigma you may feel.
- Art therapy can help you express how you feel and come to terms with traumatic experiences you may have faced.
- Family intervention can help you and your family cope better with your condition. It can help you all learn more about your symptoms, improve your communication and help you support each other.
Medication
Antipsychotic medication can help reduce the symptoms of schizophrenia. You should work with your doctor to find the right antipsychotic. They can cause side effects, and you should tell your doctor if they become severe. There may be a different antipsychotic you can try or other medications you can take to help with the side effects. You may take antipsychotics for a short time or need to take them long-term.
Physical health monitoring
Antipsychotic medication can affect physical health, including weight, blood sugar and cardiovascular indicators. Your care team should monitor these regularly, particularly in the early stages of treatment. People with schizophrenia or psychosis have higher rates of some physical health conditions, so this monitoring is an important part of your care, not an optional extra.
Support for carers
If you have family members or carers who are closely involved in your life, they should also be offered support. This includes access to information about schizophrenia and its treatment, as well as carer-focused education and support programmes. Good communication between you, your carers and your care team is an important part of managing the condition well.
Living with a diagnosis
Receiving a diagnosis of schizophrenia or psychosis can affect your life in ways that go beyond the symptoms themselves. Many people experience stigma - negative assumptions or attitudes from others, including sometimes from people within health and social care services. This can make it harder to seek help, maintain relationships, or feel confident in other areas of life.
Discrimination: discrimination linked to a mental health diagnosis can affect access to employment, housing and other services. People with severe mental illnesses including schizophrenia and psychosis have significantly lower rates of employment than the general population. Research using linked health and census records in England found economic inactivity affecting more than three quarters of people with a severe mental illness diagnosis. This is not simply a reflection of symptoms. Stigma from employers, gaps in support during the transition back to work, and the side effects of some treatments can all play a role. Under the Equality Act 2010, a mental health condition that has a substantial and long-term effect on your daily life is recognised as a disability, meaning you have legal protections against discrimination in employment and elsewhere.
People from some ethnic minority communities are significantly more likely to be diagnosed with schizophrenia than White British people in England, with particularly pronounced differences for Black African and Black Caribbean communities, and elevated rates also seen in South Asian, Mixed Ethnicity and White Other groups. People from ethnic racially minoritised communities are also more likely to have contact with mental health services through crisis routes or compulsory treatment rather than through early, voluntary support. Research also suggests that Black African, South Asian and other Black groups are more likely to be economically inactive following a severe mental illness diagnosis. These patterns reflect broader and long-standing inequalities in how mental health services identify and engage with different communities, and communities and remain an active area of concern within the sector.
Self-stigma: internalising negative beliefs about yourself because of your diagnosis — is also common and can affect self-esteem and recovery. Peer support, lived experience communities and talking therapies can all help with this.
Ways you can look after yourself
Be aware of the warning signs
Learning to spot the early signs of becoming unwell can prevent you from having a relapse. Signs can include losing your appetite, not sleeping well or feeling anxious. You may develop mild symptoms such as hearing quiet voices, feeling suspicious, or finding it hard to concentrate. Tell someone you trust or your doctor or support worker if you notice any early signs so that you can get help to avoid a relapse.
Plan ahead
When you’re unwell, it may be difficult or impossible to tell people how you’d like to be treated. It can help to plan by writing an advance statement to help friends, family, and medical professionals make decisions on your behalf. You could also make a crisis card, a small document you can carry in your pocket or wallet explaining what to do and who to contact if you’re unable to communicate.
Look after your physical health
Try to eat well, exercise, get enough sleep, stop smoking and avoid stress where you can.
Work and daily activities
If you want to find or return to work, you should be able to access supported employment programmes. If employment isn’t currently realistic, other occupational or educational activities can also support recovery and wellbeing. Your care plan should include a record of your daytime activities and any occupational goals.
Find peer support
Peer support – where you talk to other people with the same diagnosis or symptoms as you – can help you feel less alone, increase your self-esteem and share ways of coping. Ask your doctor for recommendations of local peer support groups.
Resources
The Hearing Voices Network offers support groups and resources for people who hear voices, see visions or have other unusual sensory experiences. It takes a lived experience approach, meaning it is rooted in the perspectives of people who have these experiences themselves, rather than purely a clinical view. Many people find this a valuable complement to, or alternative to, formal treatment, particularly if they want to explore ways of living with their experiences rather than solely focusing on eliminating them. www.hearing-voices.org
NHS has further information and resources: nhs.uk/mental-health/conditions/schizophrenia/living-with/
References
- National Institute for Health and Care Excellence (2014, updated 2025). Psychosis and schizophrenia in adults: prevention and management. Clinical guideline CG178. https://www.nice.org.uk/guidance/cg178
- Morris, S., Hill, S., Brugha, T., McManus, S. (Eds.). (2025). Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4. NHS England. DOI: 10.13140/RG.2.2.24367.39840. https://digital.nhs.uk/data-and-information/publications/statistical/ad…
- Equality Act 2010. UK Public General Acts. https://www.legislation.gov.uk/ukpga/2010/15/contents
- Hearing Voices Network. About us. https://www.hearing-voices.org/about-us/
- Zhou, L., Sommer, I., et al. (2025). What do four decades of research tell us about the association between childhood adversity and psychosis: an updated and extended multi-level meta-analysis. American Journal of Psychiatry. https://doi.org/10.1176/appi.ajp.20240456
- Cybulski, Ł., Dewey, M.E., Hildersley, R., Morgan, C., Stewart, R., Wuerth, M., et al. (2024). Health, disability, and economic inactivity following a diagnosis of a severe mental illness: cohort study of electronic health records linked at the individual-level, to census from England. Schizophrenia Bulletin. https://doi.org/10.1093/schbul/sbae195
- Halvorsrud, K., Nazroo, J., Otis, M., Brown Hajdukova, E., & Bhui, K. (2019). Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses. Social Psychiatry and Psychiatric Epidemiology. DOI: 10.1007/s00127-019-01758-y
- Khalifeh, H., Johnson, S., Howard, L.M., Borschmann, R., Osborn, D., Dean, K., Hart, C., Hogg, J., & Moran, P. (2015). Violent and non-violent crime against adults with severe mental illness. British Journal of Psychiatry, 206(4), 275–282.
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