Fact file: Schizophrenia

Changes in thoughts and perceptions 

• Hearing or seeing things that aren’t there (hallucinations) 

• Strong beliefs that aren’t based on reality (delusions) 

• Confused or muddled thinking 

Changes in behaviour and motivation 

• Losing interest in everyday activities 

• Avoiding people, including friends and family 

• Struggling to manage day‑to‑day tasks 

• Not caring for personal hygiene 

It’s important to know that schizophrenia does not make someone violent, and it does not mean someone has a “split personality”. 

Positive and negative symptoms 

Schizophrenia symptoms are often described as either positive or negative. 

• Positive symptoms add something to a person’s experience, such as hallucinations or delusions. 

• Negative symptoms take something away, such as motivation, interest or emotional expression. 

Many people find positive symptoms the most distressing, but negative symptoms can be harder to manage long‑term because they often last longer. 

Learn to spot warning signs 

Around 1 in 4 people recover fully from their first episode of schizophrenia, but others may experience relapses. Learning to recognise early warning signs can help reduce the impact of future episodes. 

Warning signs differ from person to person but can include: 

• Changes in sleep 

• Loss of appetite 

• Feeling more anxious or stressed 

• Early symptoms returning, such as mild suspiciousness or hearing quiet voices 

Recognising these signs early gives you more time to prepare and seek support. 

Plan for difficult times 

Planning ahead can feel uncomfortable, but it’s one of the most helpful things you can do while you’re feeling well. During a crisis, it may be hard to explain what you need or make decisions. 

A crisis plan might include: 

• Early warning signs and coping strategies 

• Support that could help prevent hospital admission 

• Preferences for hospital care, if needed 

• Practical arrangements (for children, pets or dependants) 

• Who should be contacted in a crisis 

• 24‑hour services you can access 

You may also want to include an advance statement, which explains your treatment preferences if you become too unwell to make decisions. A healthcare professional can help you write one. Advance statements aren’t legally binding, but professionals will try to follow them wherever possible. 

More information about advance decisions and capacity is available on the Mind website. 

Avoid smoking, alcohol and drugs 

Some people use substances to cope with symptoms, but smoking, alcohol and drugs can make schizophrenia worse. 

• Smoking can affect how antipsychotic medication works 

• Alcohol can increase depression and psychosis 

• Drugs can interact badly with medication 

People with schizophrenia are advised to avoid all three. If stopping feels difficult, your GP can refer you to local support services. 

Reduce stress where possible 

Stress is one of the main triggers for schizophrenia episodes and can make symptoms worse. Reducing stress can help lower the risk of relapse. 

You might find it helpful to try: 

• Yoga or Pilates 

• Mindfulness exercises (available on the Mind website) 

• Talking to a trusted friend 

• Listening to music 

• Taking a warm bath 

In some cases, reducing responsibilities, including work‑related stress, may be necessary. Under the Equality Act 2010, employers must make reasonable adjustments for people with mental health conditions. 

Talk about how they’re feeling 

If someone you care about has schizophrenia, their experiences can be hard to understand, especially if they’re hearing voices or having unusual beliefs. 

What they experience feels very real to them. Avoid saying things like “it’s all in your head”. Instead, focus on how they’re feeling and how you can help: 

• “That sounds frightening — who do you feel able to talk to about it?” 

Focus on the positives 

Schizophrenia can affect motivation, confidence and self‑care. These are symptoms of the illness, not choices your loved one is making. 

Try to focus on small, realistic goals, such as: 

• Getting washed and dressed 

• Taking medication regularly 

• Attending an appointment 

Small steps can make a big difference. 

Help create a crisis plan 

When someone is very unwell, it can be distressing for everyone involved. Encouraging your loved one to create a crisis plan while they’re well can help you both feel more prepared. 

This might include: 

• Early warning signs 

• Triggers 

• Preferred treatments 

• Who they want contacted 

• How you can help 

Make sure you’re also realistic about what support you’re able to give. 

Be there in an emergency 

If your loved one is relapsing and may be at risk of harming themselves or others, their nearest relative can request a mental health assessment. This is carried out by an approved mental health professional and may lead to hospital admission under the Mental Health Act. 

The Mental Health Act defines the nearest relative in a specific order, including: 

• Spouse or civil partner 

• Child 

• Parent 

• Sibling 

• Grandparent 

• Other close relatives 

Understanding this process can help you act quickly in an emergency.