The Internal Experience of Schizophrenia

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Schizophrenia is a condition that affects how the brain functions and results in problems with thoughts, feelings, and behaviors. The condition affects less than 1% of adults in the U.S. and tends to be a highly misunderstood condition. While the condition is serious and can be very damaging if left untreated, there are effective medications and treatments that can help.

If you don't have schizophrenia, it is probably difficult to understand the internal experience of schizophrenia. People who have the condition often experience thoughts that do not align with reality or exhibit symptoms such as disorganized behavior and speech. Understanding what it is like to have schizophrenia can provide some insight into how these symptoms may feel and how they might affect a person's daily life.

This article discusses what it feels like to have schizophrenia including some of the symptoms that might affect a person with the condition. It also covers treatments and coping strategies that can help.

Overview of Schizophrenia

Normally, when we describe our experiences to one another, we assume there's a shared understanding of what it feels like to think and to perceive the world with our senses. We expect that we can talk about what we're thinking—without having to describe the ways in which our brains connect different pieces of sensory information and memory to make a thought.

In someone with schizophrenia, the most basic processes of perceiving and thinking are affected by the illness. Every person with schizophrenia will have a unique experience of the world, but there are common themes.

Some schizophrenia symptoms that a person might experience include illogical thoughts, hallucinations, delusions, and unusual movements.

Symptoms

One way to try to understand what it's like to have schizophrenia is to understand the experience of each of the basic symptoms of schizophrenia. An individual’s personal and unique experience, of course, won’t be broken into these neat categories.

Symptoms of schizophrenia usually first appear sometime between the late teens and mid-30s. The symptoms typically appear gradually and increase in severity over a period of time.

Because the onset of symptoms is gradual and progressive, it can make it harder to detect until more severe psychotic symptoms emerge.

Sadness and Loneliness

People who experience psychosis, which includes hallucinations and delusions, can also experience true sadness as well as isolation. Sadness is often a natural response to being trapped in a terrifying and isolating situation.

A stunning first-person account of schizophrenia, "Autobiography of a Schizophrenic Girl," describes very clearly the sadness and loneliness the young author felt when gripped by psychosis.

Delusions

To have a delusion is to be obsessed with an idea, and to have absolute certainty that the idea is correct. The person's thinking may be clear in other ways, with an otherwise logical ability to reason, starting with the absolute conviction of the incorrect premise.

Delusional ideas have a lot of power to preoccupy thoughts. Sometimes people with delusions can convince others that their delusions are true. This happens most often when the delusion is in the realm of common human experience, like an unfaithful spouse or a boss who’s "out to get them."

Some delusions are clearly recognized as abnormal, like when someone is convinced that they’re a famous person or that their thoughts are being controlled by aliens.

Even after responding well to antipsychotic medications, a person with schizophrenia may continue to believe their delusions are true. It's also possible that someone can develop an insight that other people think the ideas are probably delusions. Psychologists might call this a meta-awareness of the symptom or awareness that exists above the level of the symptom itself.

Hallucinations

Hallucinations are a symptom of psychosis that involves seeing or hearing things that are not there. Hallucinations and delusions can go hand-in-hand.

For example, hearing voices speaking to you from the radio is a hallucination. Being absolutely convinced that the voices are real and the things they tell you are true has a component of delusion.

It is possible to experience hallucinations while being aware that they aren’t real. As with delusions, this would require a meta-awareness of the unreality of what appears to be a real experience.

Human beings usually rely on their perceptions to tell what’s real. We’re often unaware that different people experience the same situation differently because those small differences don’t usually come up in conversation. For example, people can go their entire lives without knowing they’re colorblind because they don’t know what they’ve never experienced.

Likewise, at a party, an outgoing person may perceive friendly, receptive faces, while a shy person may perceive the same faces as being indifferent or even critical. Both of these perceptions are within the realm of normal human experience, and neither are pathological.

Hallucinations
  • Hearing (auditory hallucinations) or seeing (visual hallucinations) something that is not there

Delusions
  • Being absolutely convinced that a false belief is real

Perception Distortion

People with schizophrenia may also experience perceptual distortions that make it difficult to distinguish between hallucinations and reality. For example, a person with schizophrenia may actually hear people saying things that are critical or insulting when those conversations aren’t really taking place. That would be a type of auditory hallucination.

Visual hallucinations can take many forms as well. A person with schizophrenia may find their attention drawn to one particular person’s face, notice that the teeth are very white, and then perceive the mouth and teeth growing to fill the room.

This perceptual distortion would feel like a real visual perception, and the person may believe it's actually occurring. If they're frightened by the perception, they might try to hide their fear, cry out, or run away.

Some people have persistent visual hallucinations, such as small children or animals that frequently appear or follow them around. They may even hold open doors for these hallucinations to pass through when they leave a room.

Disorganized Speech

People with schizophrenia also experience thought disorder, which leads to problems with organizing speech. The process that disrupts the normal operations of the brain also disrupts the process by which the brain monitors its own operation.

People experiencing disorganized speech are often aware that their thoughts and words aren’t communicating the things they intend. However, they typically don’t understand why.

They may earnestly try to communicate their thoughts in nonsensical, stream-of-consciousness language, and become frustrated when the other person doesn’t understand or the words aren’t coming out right. On the other hand, they may seem to be unaware that the listener doesn’t understand them.

Disorganized Behavior

There are many kinds of disorganized behavior, and people are usually unaware of these motions and believe the behavior is entirely reasonable. For example:

  • Moving their empty hands as if they’re knitting
  • Making an apparently meaningless hand gesture or body posture
  • Remove clothing in an inappropriate place

Disorganized public behaviors often result in contact with the law. More and more legal jurisdictions are recognizing mental illness and referring people for psychiatric evaluation. However, there are still far too many mentally ill people in jails and even prisons for nothing more than disruptive, disorganized behavior.

People without schizophrenia also perform bizarre and socially unusual behaviors. Relatively healthy people engage in socially inappropriate or unusual behaviors. The difference is that these people are aware that the behavior is unusual and are looking for the attention it attracts.

Negative Symptoms

People with schizophrenia have a particularly difficult time recognizing negative symptoms as being symptoms of an illness or even abnormal. In this way, the experience can be like that of certain kinds of depression.

For example, the person doesn’t express emotions or expresses them only mildly, even when confronted angrily or in a dangerous situation. Or the person may also fail to find significant pleasure in things that were once delightful, called anhedonia.

If you're experiencing negative symptoms, you often have little energy or motivation, and your mental energy and acuity may also be depressed. Because the mind itself feels fuzzy or dull, there’s limited perception that it’s possible to feel differently and little memory of a time when you felt differently. Many people who have experienced depression will understand this feeling of being in a mental fog.

Recap

If you want to understand what it is like to have schizophrenia, it is important to know more about the symptoms of the condition. Loneliness, delusions, hallucinations, perceptual distortions, and disorganized speech and behaviors are common.

Real People, Real Emotions

Psychiatrist Samuel Keith, MD, a professor at the University of New Mexico School of Medicine and former head of the Schizophrenia Research Program at the National Institute of Mental Health (NIMH), expresses the plight of a person with schizophrenia very well.

Samuel Keith, MD

Real people with real feelings get schizophrenia. One should never underestimate the depth of their pain, even though the illness itself may diminish their ability to convey it…As one of my own patients told me, 'Whatever this is that I have, I feel like I’m a caterpillar in a cocoon, and I’m never going to get the chance to be a butterfly.'

— Samuel Keith, MD

People with this condition may experience feelings of fear about not having control over their own minds. Problems with thinking and sensory disruptions can also make it challenging at times for people to trust their own thoughts and sensory experiences. 

While it can be challenging, supportive care and an effective treatment plan can help people manage their symptoms and experiences. There is no cure for schizophrenia, but there are ways to cope and function effectively in daily life.

Treatment

Treatments that can help with schizophrenia symptoms include medication, psychotherapy, and skills training.

Medications

Diagnosis and treatment with antipsychotic medications early in the illness, optimally within the first six months of symptoms, have the greatest potential to reduce the severity of a person’s illness. As such, antipsychotic medications are the first-line treatment for schizophrenia.

They can help reduce the frequency and intensity of psychotic symptoms and are usually taken each day as either a pill or liquid. Some antipsychotic medications can be administered by injection once or twice each month.

Psychotherapy

Therapy can also be helpful for managing the symptoms of schizophrenia. Cognitive behavioral therapy (CBT) may be helpful for some of the negative symptoms or cognitive symptoms of the condition. Family therapy can also be beneficial for addressing issues with family dynamics and relationships. Some people may find that group therapy can be helpful for practicing skills and getting encouragement from other people who are facing the same problems.

Psychosocial Treatments and Skills Training

Supportive psychosocial treatments can help people learn coping skills that will help them live with some of the day-to-day challenges they may face while living with their condition.

Schizophrenia Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

Recap

Schizophrenia is a progressive illness and treatment with antipsychotic medications along with therapy can decrease symptoms and potentially stop or slow the progression of the disease. It is absolutely essential for people to get help, and insist on an evaluation by a psychiatrist when psychotic symptoms occur.

Ways to Cope With Schizophrenia

While having schizophrenia presents a number of obstacles, there are things that a person can do that can improve their ability to cope. Having an understanding of how their individual symptoms affect them and the areas where they seem to have the greatest difficulty provides a solid foundation. 

The next step is finding strategies that can help them function and live their best. If your loved one has schizophrenia, encourage them to:

  • Seek out social support: Encourage them to talk to you or their close friends or family members about their condition. Sharing their challenges can help their loved ones learn to notice when their symptoms might be worse and when they could use additional support. 
  • Join a support group: In addition to leaning on their loved ones, joining a support group can be a way to learn new skills and get encouragement from people who share their experiences.
  • Practice self-care: Caring for yourself is important. Encourage them to take steps to make sure that they are treating themselves with kindness and caring for their physical and mental health. 
  • Participate in skills training: Skills training can help them with both daily living skills as well and social skills. They can explore ways to manage some of the daily challenges they face and build coping skills that will help both now and in the future.

Recap

In addition to seeking treatment, it is also important for people with schizophrenia to care for themselves. If your loved one is living with schizophrenia, encourage them to look for strategies that can help them cope with their symptoms such as finding social support, joining a support group, and attending skills training.

A Word From Verywell

While it is not a treatment per se, family support is an important part of coping with schizophrenia. Supporting a loved one with schizophrenia means more than just learning about symptoms and treatment; it's about understanding what it's really like to live with these symptoms day in and day out. This way, you can give your loved one the empathy and support they need to better manage their condition.

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9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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