Do I have schizophrenia?

Originally Published: August 21, 2009 - Last Updated / Reviewed On: March 18, 2014
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Dear Alice,

I'm worried I have schizophrenia.

My main reason for this worry is that I have a number of voices in my head. They are present most every day, most of the day. We are able to hold conversations. (Usually screaming fights where one of us ends up crying.) Sarah is a distinct person in my mind. The rest are a large crowd. All are almost always hostile towards me. Any confidence I build for myself they knock down.

I am always agitated and anxious, and sometimes have panic attacks. Among my medical symptoms are dizziness and being tired all the time, and moderate headaches over half the week. I also have hypoglycemia. When my blood sugar is low, everything gets even worse. (Just last week I pushed all the furniture in front of the door and locked myself in my room for hours.)

I have been able to keep from injuring myself for the last 8 months, but only after major intervention and hospitalization. I want to be able to stay strong so I don't end up getting hospitalized again, because I would get behind in my college classes.

I try to talk to my parents about this, but the therapist they used to take me to believed that I was possessed or at least haunted by demons, and they agree with her.

—A frustrated, determined soul

Dear A frustrated, determined soul,

It is easy to understand why you're frustrated — while there is some debate about what factors are responsible for schizophrenia, demon possession definitely isn't one of the contenders. Schizophrenia is a well-documented mental disorder characterized by hallucinations, delusions, and disordered thinking and behavior, often resulting in a withdrawal from the outside world. Passing it off as a spiritual ailment is dangerous, since schizophrenia usually worsens without treatment. It may also cause you to miss a healing opportunity as therapy, medication, education, and proper support from family and friends can be extremely effective in helping people with schizophrenia manage their symptoms and lead productive, fulfilling, and enjoyable lives.

While the word "schizophrenia" means "split-mind," the disorder is distinct from split personality or multiple personality disorder. Schizophrenia is likely caused by a combination of genetics, neurochemistry, and environment. Studies show that the brain structure and central nervous system of people who have schizophrenia are markedly different from those who don't. Signs of schizophrenia vary, but according to The Mayo Foundation for Medical Education and Research symptoms generally include:

  • Beliefs not based on reality (delusions), such as the belief that there's a conspiracy against you
  • Seeing or hearing things that don't exist (hallucinations), especially voices
  • Incoherent speech
  • Neglect of personal hygiene
  • Emotions inappropriate to the situation
  • Angry outbursts
  • Catatonic behavior
  • A persistent feeling of being watched
  • Trouble functioning at school and work
  • Social isolation
  • Loss of interest in everyday activities
  • Clumsy, uncoordinated movements

Because of these symptoms some people find it hard to continue with their daily lives, responsibilities, and relationships, while others are able to function rather well. Either way, it's important that you find out what is causing you to feel agitated, anxious, dizzy, and to hear voices in your mind that are hurting your self-confidence. To determine if what you are suffering from is indeed schizophrenia, it's a good idea to visit a health care provider who will run medical and psychological tests for evaluation. Columbia students can make an appointment to see a health care provider at Medical Services (Morningside) or the Student Health Service (CUMC). Outside of Columbia, you can check out Mental Health America's factsheet on how to find a therapist or mental health care.

Schizophrenia can be a chronic condition that requires lifelong treatment. Treatments that combine medication and therapy are often the most effective. Common medicines for schizophrenia are antipsychotics that affect the brain neurotransmitters dopamine and serotonin. There is also a newer generation of drugs called atypical antipsychotics that can help control symptoms in similar ways. Myriad forms of "talk" therapy are also available that might help ease symptoms of the disorder. These include individual psychotherapy to learn how to cope with daily life challenges brought on by schizophrenia, family therapy to help family and friends understand what is really going on and how to be a support, art therapy for a more creatively expressive approach, behavioral-cognitive therapy for a more practical approach, and general education about the condition to empower a person to take an active role in the treatment plan. Some people also find it useful to join a support group in order to meet others in a similar situation and learn how they have handled their challenges. Counseling and Psychological Services (Morningside) and the Mental Health Service (CUMC) offers psychological counseling and support groups to Columbia students.

It's a sign of bravery and health that you've reached out for help and greater understanding. Here's hoping that your commendable determination eases some of the frustration of being formerly misunderstood, misdiagnosed, and untreated.

Alice