A chronic brain disorder that affects less than one percent of the U.S. population.

Sheeraz Qurban

The combination of high achievement and severe mental illness is not mutually exclusive, but most people don't know much about schizophrenia outside of media portrayals of violence, failure, or deviance.

Schizophrenia is a lifelong, psychotic ailment that affects fewer than 1% of the U.S. population, but is one of the most stigmatized cognitive illnesses. It influences how individuals think, feel and act; and is most commonly characterized by delusions and hallucinations, impaired cognitive thinking, and difficulty socializing with others, which can make it difficult for some — but not all — to access treatment or maintain employment and housing. - Elyn Saks

As an expert in mental health policy, Elyn Saks is highly accomplished in her field. She graduated from Yale Law School, teaches law, psychology, and psychiatry at the University of Southern California Law School, and is a recipient of many honors, including a prestigious MacArthur fellowship. She also lives with schizophrenia – a diagnosis she revealed in her memoir, "The Center Cannot Hold: My Journey Through Madness."

Do you really know what schizophrenia is? Most people don't. Schizophrenia is a chronic, psychotic disorder characterized by delusions and hallucinations affecting less than 1% of the U.S. population. Jenna Ryu in her article highlights the importance and misconceptions about Schizophrenia.

Schizophrenia can lead to substance abuse, homelessness, social isolation, and even suicide if left untreated. Researchers have also connected it with mass violence and shootings in past. It is important to note, however, that schizophrenia and violence are rarely causally related. However, psychologists warn the relationship between schizophrenia and violence is often oversimplified and rarely ever causal.

"While there is a relationship between mental illness and violence, it's not the best predictor. Other risk factors come into play but are often cherrypicked out (of reports)," says Patrick Corrigan, a professor of psychology at the Illinois Institute of Technology.

Other predictors include gender, age, substance use history, and history of legal problems, but "when we focus solely on mental health, it adds to the stigma and fear."

The reality is that many people can manage the disorder to lead fulfilling lives.

"A common misconception is that we're unable to care for ourselves and that's not true," Saks says. "For some people it is, but not for all of us. We can have relationships –romantic and friendships. But we often don't see that (in the media) because of the emphasis on sensationalism and 'othering' us."

What is schizophrenia?

Often, when people think of schizophrenia, they envision erratic behavior, "talking to yourself and saying nonsense," Corrigan says. But what is it actually and factually?

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling. -mayoclinic.org

Schizophrenia is a chronic brain disorder that affects less than one percent of the U.S. population.

When schizophrenia is active, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking, and lack of motivation. However, with treatment, most symptoms of schizophrenia will greatly improve and the likelihood of a recurrence can be diminished.

There is no clear explanation for the exact cause, which is likely a combination of genetics and environmental factors. But, People with schizophrenia often experience delusions and hallucinations, which cause them to hear or see things that deviate from reality.

In her own experience, Saks "would sometimes have the belief that I killed hundreds of thousands of people with my thoughts" or "had hallucinations of a man standing in front of me with a raised knife in the middle of the night."

Hallucinations, experts say, include seeing or hearing things that don't align with reality. Delusions involve persisting, false beliefs.Photo byImage by Gerd Altmann from Pixabay

Some people may suffer from negative symptoms, such as anhedonia (the inability to experience pleasure), flat affect (the inability to express emotions), or withdrawal from relationships and work. The treatment of these symptoms tends to be more challenging.

"People who meet the criteria for schizophrenia likely have several different things going on, and it's not always uniform across all people," says William Carpenter, a psychiatrist and professor at the University of Maryland School of Medicine whose research focuses on schizophrenia.

"Some will have trouble with cognition. Others will have impaired motor symptoms. But what's shared among them is they, in some way, have false belief systems that lead to this diagnosis."

Can schizophrenia be cured?

Though there is no cure for schizophrenia, many patients do well with minimal symptoms. Certain treatments have been proven to help keep symptoms at bay. Antipsychotic medications can reduce hallucinations and delusions, while therapies and rehabilitations can address specific concerns, like teaching cognitive techniques or enhancing social skills to interact with others.

Psychological treatments such as cognitive behavioral therapy or supportive psychotherapy may reduce symptoms and enhance function, and other treatments are aimed at reducing stress, supporting employment, or improving social skills.

'The stigma is very real and it can be very deadly.' What needs to be done?

As a successful professional with schizophrenia, Saks says the need to debunk myths about mental illness is crucial in understanding the complex disorder and encouraging treatment and social support.

A 2012 study found that a majority of characters with schizophrenia across 41 movies displayed violent behavior, with a third of those characters displaying homicidal tendencies.

While it's true that some may exhibit aggression or unpredictability when their symptoms go untreated or when combined with substance use, research has supported that most are not actually violent: Serial killers are more likely to exhibit antisocial personality disorders (such as sociopathy or psychopathy), according to the American Psychiatric Association, and those with schizophrenia are at increased risk of becoming victims, rather than perpetrators, of violence.

"The stigma is very real and it can be very deadly," says Carpenter, who worries it can exacerbate feelings of hopelessness and isolation. "When there are so many misconceptions about what schizophrenia really is, then large numbers are treated improperly or in ways devoid of the therapeutic techniques that are available."

Psychologists fear that the stigma, which often depicts schizophrenia as violent and unpredictable..Photo byImage by Gerd Altmann from Pixabay

Proper education is key to combatting these issues and treating schizophrenia. But the next, and "most important" step is making psychosis more approachable and understandable. Mental illness can pose real-life limitations, but Saks wants people to know their experiences should be depicted as multi-faceted and unique, rather than demonized as something to be feared.

"Putting a human face on this mental illness does reduce stigma," she urges. "And people with schizophrenia should be able to come forward with their stories without being afraid of jeopardizing their work life or relationships."

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