Understanding Schizophrenia: Treatment Options and Paths to Hope 

Schizophrenia is a neurodevelopmental disorder, meaning it begins to take shape long before symptoms appear. It’s often misunderstood as a sudden onset of psychosis in early adulthood, but we now know that subtle signs can show up earlier in life, such as cognitive difficulties and social challenges.

The exact cause? We don’t fully know. There’s a strong genetic component—if schizophrenia runs in your family, your risk is higher. But environmental factors also play a role. Things like growing up in an urban environment or even prenatal exposures, like certain infections during pregnancy, can increase risk. It’s likely not just one disorder but a group of conditions with similar symptoms.

Most people think of schizophrenia as hearing voices or seeing things that aren’t there. And yes, hallucinations and delusions—fixed, false beliefs—are part of it. But schizophrenia symptoms fall into two main categories:

• Positive Symptoms: These are symptoms that add something that isn’t normally there, like hallucinations, delusions, or disorganized thinking.
• Negative Symptoms: These are symptoms that take away from normal function, like a lack of facial expression, social withdrawal, or difficulty feeling motivated.

In many ways, negative symptoms can be even more disabling because they affect daily life so profoundly. And unfortunately, while we have medications that often help with positive symptoms, negative symptoms remain much harder to treat.

A schizophrenia diagnosis often follows what we call a psychotic break—the first severe episode that lands someone in the hospital. This usually happens between ages 18 and 30, but symptoms can emerge earlier or later. Diagnosis isn’t based on one test. Instead, it requires a comprehensive psychiatric evaluation to assess a person’s symptoms over time, looking for a pattern of psychotic and cognitive symptoms. Family history, medical history, and response to treatment also play a role in confirming the diagnosis.

The gold standard for treating schizophrenia is antipsychotic medication. These meds target neurotransmitters—primarily dopamine, but also glutamate and serotonin—to help reduce symptoms. That said, they can come with side effects that may include weight gain, high blood pressure, and even diabetes. It’s frustrating when a medication works well for symptoms like hallucinations but then causes other health issues. Helping to manage side effects is an important part of treatment and is something that I take very seriously as a clinician.

For some individuals, long-acting injectable antipsychotics (LAIs) are a game-changer. Instead of taking daily pills, they get an injection that may last weeks or even months. But I know many individuals hesitate to try these, especially if they’ve had traumatic experiences with forced injections in the past. My job is to work with each individual to find a solution that fits their comfort level.

In addition to medication, we sometimes use electroconvulsive therapy (ECT)—yes, the same thing you’ve seen in movies, but in a supportive and controlled environment. It’s often especially helpful for older patients or those with treatment-resistant symptoms.

Medication is just one piece of the puzzle. Managing schizophrenia is about more than just taking a pill—it’s about building a strong support system. Family involvement is crucial, but I also see many families struggle with frustration and exhaustion. It’s hard. That’s why professional support, therapy, and peer advocacy groups are so important.

Managing schizophrenia is about more than just taking a pill—it’s about building a strong support system.

One thing I encourage my patients to do is get involved—whether it’s attending a support group, volunteering, or advocating for mental health awareness. Having a sense of purpose and connection can be life changing.

Schizophrenia still carries a heavy stigma. Too often, people picture someone talking to themselves on the street, completely disconnected from reality. But the truth is, many people with schizophrenia are able to live full, meaningful lives with the right support and treatment.

Our understanding of schizophrenia is evolving, and that means progress. New treatments are being developed. More clinicians are trained to take a compassionate, collaborative approach. Families and patients are becoming better educated about the illness. There’s hope.

If you or someone you love has been diagnosed with schizophrenia, know that you’re not alone. We’re here to help, and with the right treatment and support, many people with schizophrenia can thrive. Let’s keep the conversation going and continue breaking the stigma—because no one should have to face this journey in fear or shame.