Schizophrenia – Maligned and Misunderstood

Posted by in Louise Behiel | 31 comments

How many times have you watched television and the villain has schizophrenia? Or worse (cue drum roll here) he has paranoid schizophrenia.

Sheesh, get a grip and find an illness that is somewhat probable. Schizophrenia occurs in less than 1% of the population worldwide. I’m not saying that people with this illness don’t get violent. Some do, the same as pastors, ministers, doctors and shrinks. But it’s not nearly as common as writers would have us believe.

The illness usually begins in the teens or early adulthood, although a later onset is not impossible. (My girlfriend’s daughter, a professional woman, was diagnosed in her 40’s.

I think because this illness is so grossly misunderstood, it is frightening. Hopefully I can shed a little light on the disease and its symptoms.

First of all, Schizophrenia does NOT mean split personality. There’s another illness to account for multiple personalities residing in the same body. Schizophrenia is a chronic illness that will affect an individual’s functioning in many areas of life. I say likely because this disease, like any other, occurs on a continuum from very mild to very serious. The severity of the illness is a major factor in determining if or what medications are given and what support is required.

Schizophrenia is characterized by serious disruption in thinking and feeling, affecting the basic elements of human experience: language, thought, perception, affect (expression of emotion), and our sense of self.

Diagnosing this illness requires a look at the symptoms it adds (for example hallucinations) and the symptoms that remove a slice of ‘normal’ behavior (this could be the facial and physical expression of emotion). In shrink language, these are called positive and negative symptoms.

Scizophrenia requires a multi-level diagnosis, but to ensure I don’t write a book, I’m going to talk about the first level today. Diagnosis requires that two or more of the following must be present for a significant part of a month. Additionally, at least one of the first three must be included.

What are the symptoms of this illness? Just reading them sounds scary, so bear with me:

  1.  Delusions

Delusions are, quite simply, false beliefs, or beliefs that appear false to the majority of the culture. This is where many people indulge in discussions of what is normal. Perhaps the person is ‘seeing’ the truth and the rest of us can’t see that because a part of our brain isn’t evolved enough or we’re not spiritual enough or whatever…take your pick of reasons. Those possibilities are true. But since many people share similar delusions this doesn’t seem likely. Although, I have to admit the delusion that the government is watching me and tracking my movements may have some validity in this post 9/11 world.

Are these spiritual experiences?  Could be but remember the diagnosis of Schizophrenia is multi-tiered and must be accompanied by more than the presence of delusions.

2.  Hallucinations

Hallucinations can occur for many reasons other than Schizophrenia. For example, fevers, stress, and medications can all contribute to them. What are they? They are the presence of visions, voices or sounds, touch, smells or tastes that are not present to anyone else. Did you notice the five senses? Give yourself a gold star. Hallucinations can occur as any or all of the senses.

I used to wonder why a person having an auditory  hallucination wouldn’t simply look around. I mean if you’re hearing voices and no one is there, isn’t that a clue that this is a mind problem? A client once explained it to me this way: hallucinations are processed through the same physiological mechanism that the real thing is processed through. So for someone having an incident, he ‘hears’ voices through his auditory nerves, and ‘sees’ angels through the optic nerve. He can’t tell the difference. Imagine a life where you really didn’t know if anything was real?  Absolutely terrifying, in my opinion.

3.  Disorganized Speech

Disorganized speech is often considered to be a reflection of the thoughts of the individual. It includes speech that is garbled, erratic jumping from topic to topic and using made up words. These make the individual hard to understand.

4.  Grossly abnormal psychomotor behavior, including catatonia

Abnormal psychomotor behavior manifests in a number of ways. For example, it might show up as inactivity as a result of being in a stupor. Or as mania. Or it might show in the body as extreme flexibility or rigidity of the limbs.

5.   Negative symptoms

Negative symptoms include a wide array of behaviors that psychiatrists look for to diagnose Schizophrenia.

These might include any of the following:

  •  lack of emotion – the inability to enjoy regular activities (visiting with friends, etc.) as much as before
  • Low energy – the person tends to sit around and sleep much more than normal
  • lack of interest in life, low motivation
  • Affective flattening – a blank, blunted facial expression or less lively facial movements, flat voice (lack of normal intonations and variance) or physical movements.
  • difficulty or inability to speak
  • Inappropriate social skills or lack of interest or ability to socialize with other people
  • Inability to make friends or keep friends, or not caring to have friends
  • Social isolation – person spends most of the day alone or only with close family

This is a complicated illness. Diagnosis is complicated (more on this in a subsequent post) and getting the right medication in the right dosage can be a nightmare. Additionally, people with Schizophrenia are highly vulnerable to stress, which can make a managed illness unmanageable, seemingly overnight.

Imagine this: you’ve been diagnosed with Schizophrenia and you’re coping. Your meds are working and all is well. But then something happens: a parent gets sick, you get evicted from your apartment, someone starts to bully you. That additional stress is enough to push hormones and chemicals into the brain at an astounding rate. When that happens, usually the medications stop being effective and you are back to square one, often hospitalized for treatment of an illness you no longer know you have.

This is an insidious disease. My friend’s daughter, who was diagnosed in her 40’s is very astute. And she has coped with Schizo-affective disorder (schizophrenia and bi-polar affective disorder together) extraordinarily well.  But she told me a story that happened to her late one night that I’d like to share:

She was sitting in the kitchen, drinking coffee and talking with her boyfriend. They put the cigarette butts in a ‘can’ and put water in it, to ensure there was no risk of fire. Then they dumped the can in the toilet and flushed it. Tidied u the kitchen and he went on his way.

An hour later, she was sound asleep when she dreamed she smelled smoke. She jumped out of bed and went running to the kitchen, the only room she smokes in. Searching frantically, she didn’t see a cigarette burning anywhere. The ‘smoke can’ was under the sink, empty and washed out as it should be and their coffee cups had been washed and put away. But the voices took over and told her that a butt was burning in her apartment and if she didn’t find it, the entire ten storey apartment building would burn down and everyone would die.

So she tore her apartment apart. Finally five hours later, with every drawer emptied, the frig and stove pulled out, she accepted that this was a hallucination and called 911. Clearly, for no reason she’s been able to discern, the illness had taken a turn and she needed her meds adjusted.

So let’s stop making people with Schizophrenia the likely suspect for everything imaginable. Violent tendencies in this group are no higher than in the rest of the population. I think they’ve been maligned enough.

For more information, please visit: which also provided the list of negative symptoms.

Do you know anyone with Schizophrenia? Have any experience with the illness?  What do you think?




  1. Iy, yi, yi, Louise. Yes, I do know about Schizophrenia. My husband’s cousin was diagnosed with it later on in years. He was a mess. Then he died. But my sister-in-law’s oldest son was diagnosed with Schizophrenia. (yes, it does run apparently in the family and no one said anything for years, which didn’t help) Anyway, he also died just last year at age 40. They think from the meds because he was on the same medication as the second cousin. I cannot imagine having Schizophrenia along with bi-polar. Poor girl. She must live in constant torment. Nope, I cannot imagine.

  2. It’s amazing to me how people can have mental disorders and KNOW they have mental disorders. Like your friend, who figured out she was hallucinating. Popular belief is that you end up in a nut house drooling on yourself and talking to people that aren’t really there 24/7, thinking them to be real.
    I think the people without mental disorders have some strange perceptions…lol

    • I totally agree. both Canada and the US closed mental hospitals many, many years ago, deciding to keep those with these illnesses in the community. Unfortunately a disproportionate number of them are not in jail across the two countries. so sad.

      I have had the pleasure of knowing a number of people who knew they had a mental illness and varying degrees of success at managing those illnesses.

  3. Louise thanks for your straight talk and explanations of this illness. With so much misinformation on the web, it’s nice to come here and get a dose of reality.

    • thx for stopping by Kourtney. This is a terrible illness but we needn’t make it sound so awful

  4. For a while, a schizophrenia clinic was operating in Ann Arbor, MI (maybe affiliated with the University of Michigan), and they advertised in the Chicago area. The commercials would give me nightmares, because they made it seem as though the disease was destructive and incurable. Maybe in the Sixties it was, because families didn’t talk about mental disorders and no one admitted that they or someone they loved had one. The more open and honest people have gotten about mental disorders, the less ominous they’ve become. Of course, writers associating mental disorders with their antagonists (particularly the violent psychotic ones) haven’t helped. I don’t think I’ve ever read a book whre the protagonist was schizophrenic; maybe there’s a market for that…?

    • I don’t know about a market for that, but I do know it’s time to shine the light on these illnesses and stop allowing the media to create havoc among a group of sick people. we didn’t understand much in the 60’s (we still don’t in my opinion) but it’s getting better and it’s good to shine a light on things.

  5. I’m glad people like you are around to clear up misconceptions about disorders like this. Writers, and Hollywood, make illnesses so much worse than they really are. I suppose it makes for a more interesting, if NOT factual, story though. Great information. I used to know someone who had this. He was a pretty cool person…until he stopped taking his meds. It was sad to see the way his life turned out before he died…way too young.

    • It is sad when people stop taking their meds. Pretty scary how badly our own brains can cause us so much trouble.

  6. Great explanation of a very complex disorder, Louise. Your poor friend. How terrifying that would have been – and exhausting! Specifics of how it is to live with this illness are fascinating, frightening, and enlightening all at the same time. Thanks for helping us all understand a little better.

    • how nice to ‘see’ you Lynette. I’m glad you found it helpful. as long as we remember these are real people with hopes and dreams like the rest of us with these terrible illnesses, we’ll be fine.

  7. These posts are so enlightening for authors. I had known the difference between this and split personality disorder, but had heard from someone that a doctor had warned her daughter about her boyfriend’s first psychotic breaks since they could be violent. I think it was because he was seeing monsters and would try to defend himself.

    • Susie this is very possibly a violent scenario. Good for the doctor for understanding.

  8. Your posts keep a lot of writers from perpetuating misconceptions about mental diseases–and offer information and comfort to those affected by them. Well done, Louise!

    • Thanks Pat. Hopefully we’ll all learn through this process and be accurate in our use of mentally ill villains and victims

  9. Louise, thanks for shedding some light on this very misunderstood disorder (see, I’m learning the correct terminology, too. :)) There is a woman who lives in my area that people call the “Crazy Bicycle Lady” because she rides around randomly screaming at people (usually with lots of profanity) for no reason, or sometimes screaming at inanimate objects or at nothing. The first time I saw her was in the bar when my husband owned it. She started out yelling and shaking her finger at her purse, but when she started going off on other patrons, he kicked her out, which made her yell all the more.

    She has gotten in trouble with the law for yelling profanities at kids in front of my daughter’s school years ago, and once threw a brick at a kid. Months will pass where no one sees her – she’s probably in jail or institutionalized, people guess. A friend and my sister-in-law who both work in the mental health field say her actions sound like things a schizophrenic might do.

    • Yes it does sound like schizophrenia. and she is likely in the hospital in those ‘away’ times. so sad

  10. I had a family member that suffered for decades with schizophrenia. I always remember having to explain to people it wasn’t a split personality thing. Her biggest issue was paranoia and worry. She suffered a lot with worry about things that a healthier person would not think twice about. Thanks for the information Louise!

    • It is beyond me why Paranoid schizophrenia is such a magnet for television villains. weird. they suffer so terribly with their fears.

  11. What an informative post! An organization that comes to mind is NAMI this organization was very helpful when a family member was diagnosed. Thank you.

    • You are absolutely right, Stacy. Nami does incredible work. I will have them in a future post.

  12. I love this. You’re so right. I read a very mainstream mystery novel a few years ago that just butchered schizophrenia and bipolar. Made me furious, as it purely bent the conditions to serve the plot.
    Cheers to you!

    • Amen, Kelley. It happens all the time. I think if you’re going to use mental illness in your story, the least you can do is be accurate. There are lots of ways for our minds to become ill without creating nonsense.

  13. I cannot begin to imagine what coping with this sort of illness would be like. My heart breaks for these people and their families. There is so much negative stigma associated with this disease and so many other mental illnesses Louise. I am thrilled to read your posts and know that you are out there helping people break down barriers and gain a new, true-to-life understand. Keep up the great work!

    • thanks Natalie. These illnesses will be cured, as medicine advances. but for right now we need to treat them and that doesn’t include stigma or shame.

  14. I think it would be very scary to have this before you’ve been diagnosed. I can’t begin to imagine the life of this person.

    • It is terrifying and mostly because they’re afraid they’ll be called ‘crazy’

  15. In TV when they say he’s schizophrenic it always bugs me, because more often then not, the character they describe is usually Dissociative Personality or something. Writers should start carrying a DSM if they want a character who’s ill.

    • amen. I totally agree.

  16. This is a well written, and timely, post. I have a young relative with this condition and it helps a lot to understand what he’s gone through. I also have a character in the novel I’m working on. This post showed me I’m on the right track with her (she is a victim not the antagonist) but you’ve also given me a lot of information that will help flesh her out as a believable, relateable character. Thank you!

    • Thanks so much. I’m glad it was helpful. Stay tuned. More to come.

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