Schizophrenia is often misunderstood. However, learning about this serious mental disorder is important to encourage persons with schizophrenia to seek treatment. Learn about the signs, causes, treatment options and how families and caregivers can provide support.

 6 Common Misconceptions Abo​ut ​Schizophrenia

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Many people mistakenly believe that individuals with schizophrenia have a "split personality". In truth, it is a mental disorder that causes a breakdown in how a person thinks, feels and sees the world. Their thoughts, emotions and perceptions can become disconnected from reality.

For family, friends and caregivers, seeing a loved one go through this can be confusing and overwhelming. Their behaviour may seem odd or difficult to understand, and knowing how to respond or support them can be challenging.

A psychiatrist can diagnose schizophrenia and help patients manage it with the right medical support and consistent care.


Schizophrenia affects about one in 100 adults. It impacts both men and women equally. This mental health condition changes how a person thinks, feels and acts. Symptoms usually appear between the ages of 16 and 30, a stage in life that can be particularly disrupted as individuals often enter adulthood, tertiary education, the workforce, or start a family.

A person with schizophrenia may come across as odd, eccentric, suspicious, or emotionally inaccessible. Their thoughts may appear disorganised and their actions may seem irrational. Over time, these changes can take a toll on their social life, work, studies, or even their ability to care for themselves.

In younger individuals especially, early warning signs - known as prodromal signs - may appear before more obvious symptoms. These can include shifts in behaviour, mood and perception.


Symptoms of schizophrenia can be broadly categorised into two groups: positive or negative. In this case, "positive" symptoms refer to distortions or exaggerations of mental functions that are normally present, whereas "negative" symptoms refer to the abscence or deficiency of mental function that is normally present.


Positive symptoms:

  • Hallucinations: Hearing voices, seeing things, tasting, smelling or sensing things that are not there. As a caregiver, you might notice the person talking or smiling to themselves without any clear reason.
  • Delusions: Holding false unshakeable beliefs that are resistant to logic or evidence. For example, the person may believe they are being persecuted, controlled, that their food is poisoned or that someone is out to harm them.
  • Bizarre or disorganised behaviour: This may include acting out of their normal behaviour, such as responding to hallucinations or delusions.

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Negative symptoms:

  • Reduced speech: The person may speak very little or take a long time to respond.
  • Social withdrawal: Withdrawing from friends and family, or losing interest in previously enjoyed hobbies and activities.
  • Lack of emotional expression: Not displaying emotion, such as having a blank or flat facial expression.
  • Apathy: Disinterest in engaging with the world around them.
  • Impaired attention: Difficulty focusing, planning or following through with tasks.
  • Lack of motivation and drive: This can affect daily life and make work, studies and even basic self-care tasks harder.

Like many medical conditions, schizophrenia arises from a combination of factors, including environmental and genetic causes. For instance, having a family history of schizophrenia, such as a sibling or parent, increases one's risk of developing the disorder by tenfold, said Dr Charmaine Tang, Senior Consultant and Chief of Department of Psychosis at the Institute of Mental Health.

Research also suggests that biochemical imbalances in the brain may play a significant role in the development of schizophrenia. Other research has also linked environmental triggers to the disorder. These include extremely stressful living conditions or substance abuse, such as cannabis and other illicit drugs.

Schizophrenia is not caused by bad parenting or encountering someone with the disorder.​


​While there is currently no cure for schizophrenia, it is treatable. Effective treatment and support are available to help affected individuals manage their symptoms and reduce the risk of relapse.

Treatments for schizophrenia include:

  • Medication: The mainstay of treatment is the use of medication known as antipsychotics or neuroleptics. These help regulate brain chemicals and reduce symptoms such as hallucinations, delusions and thought disorders. Medication, when taken as prescribed, also lowers the risk of relapse.
  • Psychotherapy and rehabilitation: After a person is stable, therapy is important for long-term care. Rehabilitation and social skills training also play a key role to help the person cope with the demands of daily life.

​A person with schizophrenia may need care when they are sick. However, those who take their medication, have support and feel well can keep up their normal routines. They can also pursue their interests and join social activities. Receiving early treatment can make a big difference. Most people with the disorder learn to cope and go on to lead fulfilling lives.


One of the biggest challenges caregivers face is convincing the person with schizophrenia to accept that they need help. This is especially true if the person does not believe they are unwell. They may resist seeing the doctor due to the fear of stigma, or perceive their delusions and hallucinations to be real.

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What caregivers can do:

  • Start with empathy and not confrontation. Approach the person when they're calm and speak from a place of concern.
  • Offer choices, such as which hospital to visit, or doctor that they prefer to see, giving them a sense of control.
  • Offer to go with them and normalise the idea that seeking help is not a leap but a process.
  • Frame the visit differently. Suggest a doctor's visit for other specific symptoms such as insomnia, headaches or tiredness, rather than mental illness.
  • Once treatment begins, help monitor their adherence to medication, watch for side effects, symptoms and signs of progress.
  • Stay connected with your loved one's care team and consult medical professionals to adjust treatment when needed.

Schizophrenia is a long term condition, but the love and support of family and friends can make a real difference in managing the condition. Here are some tips for caregivers:

  • Educate yourself. Try to understand what your loved one is going through by learning about the symptoms, signs of relapse and available treatment. Knowing what to expect helps.
  • Good communication. Communicate with empathy and patience rather than criticism or confrontation.
  • Be prepared for emergencies. Relapses may happen. Have a plan ready in the event of acute episodes. This includes having emergency contacts for the hospital or ambulatory services. It also helps to have a list of trusted family and friends who can support you. In the event of a relapse, stay calm, seek professional help quickly and do not challenge the person.
  • Find support. Reach out to mental health professionals and explore community resources available. Work with community service providers. You are not alone in this caregiving journey.
  • Remember to take care of yourself too. Find healthy ways to relieve stress. Keep up your physical health, social life and support network.