I want to talk about a disorder called schizophrenia, and I will also explain another related disorder called schizoaffective disorder. Schizophrenia is a mental disorder that interferes with a person’s ability to think clearly, make decisions, manage emotions, and relate well with other people. When someone has schizophrenia, it is not just that they are “confused.” It is deeper than that. It affects how the mind organizes reality. It affects how a person understands what is real and what is not. It affects how they interpret other people’s intentions. It affects how they express feelings. It affects how they function in daily life.
One thing many people do not know is that schizophrenia mostly begins in young people. It often appears in the teen years, the twenties, and the early thirties. It is rare to find someone being diagnosed with schizophrenia when they are below the age of twelve, and it is also rare to find a first diagnosis after the age of forty. So this disorder is mainly a young person’s disorder in the way it begins, and that is important because it means families, teachers, friends, and communities should watch early signs instead of dismissing them as “youthful behavior” or “stubbornness.”
When we come to symptoms, schizophrenia can show itself in many ways. One symptom is isolation. A person withdraws from other people. They stop socializing. They stop interacting. They may prefer to stay alone. Sometimes they avoid family. Sometimes they avoid friends. They may even avoid places they used to enjoy. It can look like the person is “just quiet,” but when it becomes persistent, it is a warning sign.
Another symptom is serious sleep problems. With schizophrenia, sleep can become extremely disrupted. A person may stay awake for long periods—sometimes two days without sleep—then sleep only a few hours. Others may sleep only one hour in an entire day and remain awake for the rest of the twenty-four hours. This kind of extreme sleep disruption affects the brain further and makes symptoms worse.
Another major symptom is hallucinations. We have discussed hallucinations before, but here they are very important. Hallucinations are when a person experiences something as real when it is not actually present. They may hear voices that other people cannot hear—this is auditory hallucination. They may see things that other people cannot see—this is visual hallucination. Some people talk as if they are having a conversation with someone invisible. Some respond to voices. The person is not acting for attention. In their mind, the experience is real.
Another major symptom is delusions. Delusions are false beliefs that a person holds strongly, even when there is evidence that the belief is not true. A person may say, “I am the president.” Or “I am a celebrity.” Or “I have special powers.” And even when you try to explain, they may not accept correction because, to them, the belief feels true. Delusions can also involve fear—believing others are plotting against them—or believing they are being watched or targeted. These beliefs can make the person live in constant fear and suspicion.
Another symptom is emotional flattening. This means the person may appear as if they have no emotion. Their face may look blank. Their reactions may be minimal. They may not smile when something is funny. They may not cry when something is sad. It is not that they are heartless. It is that the illness interferes with emotional expression.
Another symptom is difficulty starting activities and completing them. You may see a person struggle to do even simple tasks. They may begin something and not finish. They may want to make a sandwich and fail to complete the steps. They may struggle with basic routines like bathing, dressing, cleaning, cooking, or organizing. It can look like laziness from the outside, but it is not laziness. It is a real functional problem caused by the disorder.
Another symptom is disorganized thinking. This is where the person’s thoughts are not systematic. They may jump from one topic to another without connection. They may speak in a way that does not follow a clear flow. They may answer questions in a confusing way. Sometimes the listener feels like they cannot “follow” the person’s mind. That is part of the disorder.
Schizophrenia also affects relationships. A person may have difficulty connecting emotionally. They may not maintain friendships. They may not talk about partners or family relationships. They may struggle to trust others. Sometimes the illness creates distance, and the person becomes isolated even when people care about them.
When we talk about causes, schizophrenia is linked to several factors. Genetics can play a role. It can run in families, meaning a person may inherit vulnerability. Environmental factors can also play a part. This includes stressful life situations, trauma, and challenges in development. Brain chemistry also matters. This disorder is connected to changes in how the brain functions and how certain brain chemicals communicate. Something shifts in the brain’s system, and the symptoms begin to appear.
There is also something very important I want to speak about clearly, especially for young people: psychoactive drugs. These are drugs that affect the nervous system and the brain. Hard drugs like cocaine, meth, LSD, and similar substances can trigger serious mental health problems, including psychosis and schizophrenia-like symptoms. This is one reason schizophrenia is often seen in younger ages—because younger people are more exposed to experimenting with substances. And sometimes people think, “It is just fun,” or “It is only one time.” But the brain is not a toy. Once certain conditions are triggered, you cannot simply reverse the consequences by wishing.
And I want to be honest about something that people rarely consider: the cost of living with schizophrenia can be heavy. Treatment is not always simple. Some people require long-term medication, including long-acting injections. I know of someone who receives an injection (Invega Sustenna) that costs thousands of dollars per month. So when someone plays with hard drugs, the question is not only, “Will it feel good today?” The question is, “Can I afford the outcome tomorrow—financially, emotionally, socially, and physically?”
Treatment for schizophrenia often involves antipsychotic medication. These medications help reduce hallucinations, delusions, and disorganized thinking. Treatment can also include psychotherapy, where the person is supported in understanding symptoms, improving coping skills, and staying connected to reality. People also develop self-management strategies—ways they calm themselves, ways they handle triggers, ways they reduce stress. Some people take walks. Some keep routines. Some use grounding techniques. Some avoid overstimulation. The goal is stability and support, not shame.
Now, I also want to mention another disorder related to schizophrenia, called schizoaffective disorder. Schizoaffective disorder is like schizophrenia, but with an additional mood disorder component. This means a person has the psychotic symptoms of schizophrenia—hallucinations and delusions—but also experiences mood episodes like bipolar disorder. So it becomes like two categories of disorder in one: psychosis plus mood disturbance.
In schizoaffective disorder, the person can experience schizophrenia symptoms, and on top of that experience mania and depression. They may have periods of high energy, elevated mood, and increased activity, and then periods of deep sadness, withdrawal, hopelessness, and depression—while still dealing with hallucinations or delusions. That is why it becomes more complex and more complicated to manage.
The treatment approach is similar in structure: medication for psychotic symptoms, medication for mood symptoms, psychotherapy, and self-management strategies. But because it combines more than one major symptom group, it often requires careful monitoring, long-term follow-up, and support from family or caregivers.
And that brings me to something I keep repeating because it matters: people living with someone who has schizophrenia or schizoaffective disorder should observe patterns carefully. How did the person wake up today? How was their mood through the day? Were they sleeping? Were they eating? Were they withdrawn? Were they speaking to voices? Were they suspicious? This information is very valuable because it helps mental health specialists customize medication and care. Without observation and accurate reporting, it becomes harder to provide the best support.
So this is what I want people to remember from this chapter. Schizophrenia is real. It affects thinking, emotions, decision-making, and relationships. It often begins in young adulthood. It can be triggered or worsened by hard drugs. Treatment exists, and there is hope, but early support matters. If you notice these characteristics in yourself, seek help early. If you notice them in someone else, don’t stigmatize them. Don’t label them. Encourage them to seek support early, before the condition become extreme.
One thing many people do not know is that schizophrenia mostly begins in young people. It often appears in the teen years, the twenties, and the early thirties. It is rare to find someone being diagnosed with schizophrenia when they are below the age of twelve, and it is also rare to find a first diagnosis after the age of forty. So this disorder is mainly a young person’s disorder in the way it begins, and that is important because it means families, teachers, friends, and communities should watch early signs instead of dismissing them as “youthful behavior” or “stubbornness.”
When we come to symptoms, schizophrenia can show itself in many ways. One symptom is isolation. A person withdraws from other people. They stop socializing. They stop interacting. They may prefer to stay alone. Sometimes they avoid family. Sometimes they avoid friends. They may even avoid places they used to enjoy. It can look like the person is “just quiet,” but when it becomes persistent, it is a warning sign.
Another symptom is serious sleep problems. With schizophrenia, sleep can become extremely disrupted. A person may stay awake for long periods—sometimes two days without sleep—then sleep only a few hours. Others may sleep only one hour in an entire day and remain awake for the rest of the twenty-four hours. This kind of extreme sleep disruption affects the brain further and makes symptoms worse.
Another major symptom is hallucinations. We have discussed hallucinations before, but here they are very important. Hallucinations are when a person experiences something as real when it is not actually present. They may hear voices that other people cannot hear—this is auditory hallucination. They may see things that other people cannot see—this is visual hallucination. Some people talk as if they are having a conversation with someone invisible. Some respond to voices. The person is not acting for attention. In their mind, the experience is real.
Another major symptom is delusions. Delusions are false beliefs that a person holds strongly, even when there is evidence that the belief is not true. A person may say, “I am the president.” Or “I am a celebrity.” Or “I have special powers.” And even when you try to explain, they may not accept correction because, to them, the belief feels true. Delusions can also involve fear—believing others are plotting against them—or believing they are being watched or targeted. These beliefs can make the person live in constant fear and suspicion.
Another symptom is emotional flattening. This means the person may appear as if they have no emotion. Their face may look blank. Their reactions may be minimal. They may not smile when something is funny. They may not cry when something is sad. It is not that they are heartless. It is that the illness interferes with emotional expression.
Another symptom is difficulty starting activities and completing them. You may see a person struggle to do even simple tasks. They may begin something and not finish. They may want to make a sandwich and fail to complete the steps. They may struggle with basic routines like bathing, dressing, cleaning, cooking, or organizing. It can look like laziness from the outside, but it is not laziness. It is a real functional problem caused by the disorder.
Another symptom is disorganized thinking. This is where the person’s thoughts are not systematic. They may jump from one topic to another without connection. They may speak in a way that does not follow a clear flow. They may answer questions in a confusing way. Sometimes the listener feels like they cannot “follow” the person’s mind. That is part of the disorder.
Schizophrenia also affects relationships. A person may have difficulty connecting emotionally. They may not maintain friendships. They may not talk about partners or family relationships. They may struggle to trust others. Sometimes the illness creates distance, and the person becomes isolated even when people care about them.
When we talk about causes, schizophrenia is linked to several factors. Genetics can play a role. It can run in families, meaning a person may inherit vulnerability. Environmental factors can also play a part. This includes stressful life situations, trauma, and challenges in development. Brain chemistry also matters. This disorder is connected to changes in how the brain functions and how certain brain chemicals communicate. Something shifts in the brain’s system, and the symptoms begin to appear.
There is also something very important I want to speak about clearly, especially for young people: psychoactive drugs. These are drugs that affect the nervous system and the brain. Hard drugs like cocaine, meth, LSD, and similar substances can trigger serious mental health problems, including psychosis and schizophrenia-like symptoms. This is one reason schizophrenia is often seen in younger ages—because younger people are more exposed to experimenting with substances. And sometimes people think, “It is just fun,” or “It is only one time.” But the brain is not a toy. Once certain conditions are triggered, you cannot simply reverse the consequences by wishing.
And I want to be honest about something that people rarely consider: the cost of living with schizophrenia can be heavy. Treatment is not always simple. Some people require long-term medication, including long-acting injections. I know of someone who receives an injection (Invega Sustenna) that costs thousands of dollars per month. So when someone plays with hard drugs, the question is not only, “Will it feel good today?” The question is, “Can I afford the outcome tomorrow—financially, emotionally, socially, and physically?”
Treatment for schizophrenia often involves antipsychotic medication. These medications help reduce hallucinations, delusions, and disorganized thinking. Treatment can also include psychotherapy, where the person is supported in understanding symptoms, improving coping skills, and staying connected to reality. People also develop self-management strategies—ways they calm themselves, ways they handle triggers, ways they reduce stress. Some people take walks. Some keep routines. Some use grounding techniques. Some avoid overstimulation. The goal is stability and support, not shame.
Now, I also want to mention another disorder related to schizophrenia, called schizoaffective disorder. Schizoaffective disorder is like schizophrenia, but with an additional mood disorder component. This means a person has the psychotic symptoms of schizophrenia—hallucinations and delusions—but also experiences mood episodes like bipolar disorder. So it becomes like two categories of disorder in one: psychosis plus mood disturbance.
In schizoaffective disorder, the person can experience schizophrenia symptoms, and on top of that experience mania and depression. They may have periods of high energy, elevated mood, and increased activity, and then periods of deep sadness, withdrawal, hopelessness, and depression—while still dealing with hallucinations or delusions. That is why it becomes more complex and more complicated to manage.
The treatment approach is similar in structure: medication for psychotic symptoms, medication for mood symptoms, psychotherapy, and self-management strategies. But because it combines more than one major symptom group, it often requires careful monitoring, long-term follow-up, and support from family or caregivers.
And that brings me to something I keep repeating because it matters: people living with someone who has schizophrenia or schizoaffective disorder should observe patterns carefully. How did the person wake up today? How was their mood through the day? Were they sleeping? Were they eating? Were they withdrawn? Were they speaking to voices? Were they suspicious? This information is very valuable because it helps mental health specialists customize medication and care. Without observation and accurate reporting, it becomes harder to provide the best support.
So this is what I want people to remember from this chapter. Schizophrenia is real. It affects thinking, emotions, decision-making, and relationships. It often begins in young adulthood. It can be triggered or worsened by hard drugs. Treatment exists, and there is hope, but early support matters. If you notice these characteristics in yourself, seek help early. If you notice them in someone else, don’t stigmatize them. Don’t label them. Encourage them to seek support early, before the condition become extreme.
