schizophrenia and addiction

Breaking the Cycle: Identifying the Connection Between Schizophrenia and Addiction

Schizophrenia is a misunderstood and often misdiagnosed disorder that can cause those that suffer from it to self-medicate with illicit substances. Learn how to help break the cycle. 

Understanding Schizophrenia

Schizophrenia is one of the most misunderstood and potentially harmful brain disorders that there is. Although research is constantly being done to better understand what causes schizophrenia and what can be done to help those who have it, there is still a lot that the medical community doesn’t know about it. Over time, research has uncovered the link between schizophrenia and addiction.   

One thing that has become clear in recent years is that there is a direct correlation between a patient having schizophrenia and an increased risk of addiction. That addiction can appear in many forms including substance and drug abuse, alcohol abuse, and opioid abuse.1 

There are many reasons why a person with schizophrenia may become addicted to certain substances such as nicotine, cocaine, cannabis, and alcohol. Many times, they may be seeking an escape from their symptoms or reality, looking for something to help with insomnia, or trying to silence their mind for a time.  

Unfortunately, by using these substances, these individuals are more likely to exacerbate their symptoms. Their medications may stop being effective and they may experience increased periods of psychosis. To prevent psychotic occurrences and relapses, effective, affordable, and available treatment options must be implemented to help people with schizophrenia when they need it most.        

What is Schizophrenia?

schizophrenia and addiction

Schizophrenia is a chronic brain disorder for which there is no cure. It is a severe mental health condition that causes episodes of psychosis, delusional beliefs, hallucinations, and difficulty determining what is real from what is not. Although it is commonly referred to as a mental illness it is more accurately a family of neurological disorders that alter the way that a person perceives reality.2 

In most cases of schizophrenia, cognitive function is impaired as well which leads to memory difficulty, learning disabilities, and problems with concentration. The delusional beliefs, hallucinations, and altered thinking can cause significant shifts in personality and can cause those who have schizophrenia to lash out and act in ways that can cause themselves or others harm.    

Delusional Thinking 

These delusions are often terrifying and may present as auditory, visual, or other sensory hallucinations. It can be incredibly difficult for an individual to tell what is real from what is not. As such, many people with schizophrenia are especially prone to other co-existing conditions such as anxiety and depression. 

It is important to note that although there are some cases of schizophrenia causing a person to become violent, most patients with schizophrenia never become violent. There is, however, a high correlation between untreated schizophrenia and hospitalization, homelessness, and unemployment.  

The Stigma Surrounding Schizophrenia

Because this disorder is so misunderstood, both by the people that it affects and society at large, many stigmas surround schizophrenia. This stigma causes those that it affects to be resistant to seek help for their disorder. Instead, they often try to mask it with the aid of drugs, alcohol, nicotine, or other substances.3 

In addition, the stigmas surrounding schizophrenia, as well as the many false beliefs such as that it is synonymous with multiple personality disorder, cause many people to go undiagnosed and untreated for a large portion of their lives. When left untreated, schizophrenia becomes a serious disorder that can ruin lives.  

Although there is no cure for schizophrenia, there are multiple treatment options that can reduce the severity of symptoms and can prevent patients from relapsing. Depending on the type of schizophrenia that a person has, there are different and more effective options for treatment, including but not limited to antipsychotic medications, therapy, and temporary hospitalization. 

With proper schizophrenia treatment, patients with schizophrenia typically experience a reduction in symptoms and severity of their disorder as they get older.    

Psychotic Symptoms

Schizophrenia causes several symptoms including both physical and psychological effects. These early signs typically manifest between the ages of sixteen and thirty years old, and they often occur in males at an earlier age than in females.  

Schizophrenia symptoms always come in phases. There are no signs of schizophrenia that are constant or that always remain present. It is unlike other mental health conditions such as anxiety, depression, or bipolar disorder in which symptoms will typically persist for at least six months.  

Due to the transient nature of symptoms, people who are experiencing schizophrenia may at first attribute the signs to stress, lack of sleep, or being overworked. Many people may not realize that they are experiencing psychotic episodes until someone else witnesses the symptoms and tells them.   

There are many different types of schizophrenia, although all schizophrenia symptoms fall into three separate categories: positive symptoms, negative symptoms, and disorganized symptoms.4   

Positive Symptoms  

Positive symptoms of schizophrenia are identified by the presence, rather than absence, of certain symptoms. These include:

  • Hallucinations: Schizophrenia causes people to experience things that no one else does. These hallucinations may be auditory (such as voices in their heads), visual (seeing people, lights, or patterns), olfactory (smelling things that aren’t there), gustatory (things taste wrong and someone may believe that they are being poisoned and refuse to eat), and tactile (they may feel like things are touching them or crawling on them when nothing is there). 
  • Delusions: Schizophrenia causes people to believe things that are not true and have no evidence of being true. These beliefs are not real but they feel as if they are true. Some examples include believing that someone is in love with you, believing that you are famous, or believing that someone is out to harm you.
  • Movement Disorders: These issues can include jumpy, repetitive movements, or catatonic states where a person doesn’t move for hours at a time. 

Other positive symptoms include trouble concentrating, confused thought, and disorganized speech.

Negative Symptoms 

Unlike positive symptoms, negative symptoms are defined by the inability of a person to perform normally.5 These are often misdiagnosed as symptoms of depression, as they share many signs in common. The most common negative symptoms are: 

  • Poor hygiene: Not brushing one’s teeth, showering, or taking care of one’s appearance. 
  • Lack of emotion: May not make eye contact or show interest in things. 
  • Social withdrawal: May lose interest in things that they once cared about, may not wish to go outside, visit friends, or communicate like they once did.  
  • Cognitive Disturbances: This symptom often includes significant difficulty with remembering things in their short-term memory, or in performing multiple tasks at once.   

Disorganized Symptoms 

These symptoms can be some of the most apparent and may be the most obvious signs that something is wrong or that a person needs help. These symptoms include:

  • Unusual speech patterns 
  • Difficulty performing day-to-day tasks
  • Inappropriate emotions such as laughing at a funeral 
  • Facial expressions that do not match their emotions or words 
  • Difficulty understanding concepts or struggling with education 
  • Showing no emotion at all 

What is Living with Schizophrenia Like?

Approximately .25% to .64% of Americans will be diagnosed with schizophrenia at some point in their lives.6 Most commonly, this diagnosis is made between the ages of sixteen to thirty years old. It is significantly more difficult to diagnose schizophrenia in teens, though, as they often do not experience the most recognizable symptoms of schizophrenia such as delusions or hallucinations.  

Officially, there are five distinct types of schizophrenia. Of these, paranoid schizophrenia is the most well-known, the most demonized, and most incorrectly portrayed by the media. The five types of schizophrenia are:  

  • Paranoid schizophreniaLike psychosis, this type is characterized by hallucinations and delusional thoughts that someone is trying to hurt you or is out to get you.  
  • Schizoaffective Disorder: This type occurs when a patient is diagnosed with both schizophrenia and another mental health disorder, most commonly depression or bipolar disorder. 
  • Catatonic SchizophreniaThis type causes someone to act as if they are in a stupor and to be unresponsive to external stimuli. They may be prone to bouts of explosive anger, strange speech patterns, or imitation of others around them.  
  • Disorganized Schizophrenia: Most often individuals with this type of schizophrenia display difficulty with cognitive function, attention span, intelligence, memory, and motor skills. 
  • Residual Schizophrenia: With this type, positive symptoms of schizophrenia are not displayed, but negative symptoms are. 

The Fluctuation of Schizophrenia 

Symptoms may appear, disappear, or fluctuate at any time with any of these types of schizophrenia. A person may go years without experiencing any symptoms and then may relapse suddenly. Doctors are not entirely sure what causes schizophrenia or why the symptoms are more severe in some patients as opposed to others.  

It can be difficult for people with schizophrenia to realize that they are experiencing or displaying symptoms, so they must have someone that they can trust and rely on. These helpful figures can spot relapses early so that they can seek medical attention before the symptoms become severe.   

Stopping a full relapse can be as simple as changing the medication that a person is on, so regularly visit your doctor or therapist and keep track of moods and symptoms.     

Is Schizophrenia Linked to Substance Abuse?

It is estimated that up to 50% of people with schizophrenia have a history of substance abuse. This abuse causes an increased risk of potential injury, relapse, or even death. Most people with schizophrenia may not understand what is causing their symptoms or may not even recognize that the things that they are experiencing, such as hallucinations or delusions, are caused by a mental disorder. 

Instead, they often try to silence or numb the symptoms through nicotine, cannabis, cocaine, or opioids most commonly. In some situations, a person may also turn to alcohol abuse or self-medicating themselves with prescription drugs to help alleviate their symptoms.  

However, none of these attempts to silence the symptoms help their condition. In fact, in most cases, substance abuse will only make their symptoms worse. It can be difficult and nearly impossible to stop using these illicit substances once someone has become addicted without help or medical intervention.  

Risk Factors for Schizophrenia and Addiction 

Due to the nature of schizophrenia symptoms, there is an unfortunate correlation between schizophrenia and drug use. Many people with schizophrenia use a combination of self-medicating, substance abuse, or alcohol and nicotine to try to suppress their schizophrenia symptoms.  

Genetic Vulnerability 

There is believed to be a genetic contribution to schizophrenia as it commonly runs in families, although there has yet to be a single gene that is considered responsible for the condition. There may be other genetic factors such as low prenatal Vitamin D, poor nutrition, and childhood trauma.  

In addition, there may be certain structural brain abnormalities such as a lack of neurotransmitters or an absence of dopamine and glutamate, that may contribute to the development of schizophrenia.   

Environmental Vulnerability 

Drug, alcohol, and substance abuse cannot cause schizophrenia, but they can worsen the condition or cause a person to experience a relapse of their symptoms. This factor is particularly true if a person has an unstable home, family, or work environment.   

Treating Schizophrenia and Addiction

Schizophrenia symptoms manifest differently for each person. When a person with schizophrenia has attempted to self-medicate or treat their symptoms with illicit substances, it can be difficult to get them back on the right path without treating both conditions. 

In these cases, a dual diagnosis program is often the most effective form of treatment as it treats both substance abuse and schizophrenia simultaneously. The first step of this program is almost always detox.    

Detox 

Detox works by helping a person get rid of all the substances that are in their body. It helps to ensure that the medical team is treating the correct symptoms of a person’s schizophrenia and not inadvertently treating the symptoms caused by the illicit substance or the subsequent withdrawal. 

Medication and Therapy 

From here, an antipsychotic medication will typically be prescribed, although it may take a few tries to find the correct one for each patient. Then, family therapy, talk therapy, or cognitive behavioral therapy will begin to help the patient find their support structure and to help repair any relationship damage that has occurred as a result of a patient’s actions during their episode.  

Family therapy can also help a therapist and patient recognize if there are environmental stressors that are taking place in the family environment that can be contributing to a patient’s relapses.  

Recovery from schizophrenia is possible and completely achievable. The symptoms almost always improve with age and with the support of a therapist and medication.   

Resources

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181760/
  2. https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599914/
  4. https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443
  5. https://www.nimh.nih.gov/health/topics/schizophrenia
  6. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizophrenia

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