Schizophrenia is a serious, complex, and long-term neurological disorder. It disrupts a person’s ability to think clearly, manage emotions effectively, make rational decisions, interpret reality, and relate to others. For this reason, schizophrenia is often detrimental to a person’s well-being. For those suffering, it interferes with their ability to maintain relationships and take part in mainstream society.
As a result, many people with schizophrenia turn to drugs and alcohol to cope. In efforts to feel good, feel better, or escape negative thought patterns, they may turn to substance use. In fact, the rate of substance abuse is 50 percent higher among individuals with schizophrenia than the general population.
Recognizing Symptoms of Schizophrenia
The onset of schizophrenia is most prevalent during adolescence or young adulthood, when the brain is still developing. This is when the first symptoms usually occur, however, they are often overlooked. According to the National Institute on Mental Health (NIMH), subtle symptoms – such as cognitive or social changes – may precede an actual diagnosis by years.
Early symptoms of schizophrenia can look like typical teenage behavior, and drug and alcohol use can mask other recognizable signs. As a parent especially, it is important to be aware of the potential risk. Below are common, early symptoms of schizophrenia in teens and young adults:
- Inability to control impulses
- Neglect of grooming and hygiene
- Sudden lack of awareness and flat facial expression
- Failure to focus on one topic for long
- Isolation from family and friends
- Sudden loss of interest in favorite activities
- Failure to finish projects or meet commitments
- Intense attention to negative, destructive thoughts
- Unusual changes in speech or handwriting
Over time, schizophrenia shows symptoms such as delusional thinking, severe paranoia, hallucinations, disorganized speech, and disrupted motor or catatonic behaviors. These symptoms will vary depending on the type of schizophrenia that a person has – paranoid, disorganized, residual, or undifferentiated.
Schizophrenia is typically diagnosed in the late teens years to early thirties. For young males, symptoms tend to arise in late adolescence and their mid-twenties. For females, symptoms often arise later – between their early twenties and thirties. During this period of life, a critical stage of development, is typically when substance abuse is introduced.
Although schizophrenia can have a dramatic effect on an individual’s thought, speech, and behavioral patterns, symptoms are not always easy to identify when a substance abuse is brought into the mix. If you are a parent and have a teen who may be using drugs, or who may be at risk for schizophrenia, it is important to keep an eye out for the symptoms listed above. Remember that substance abuse can mask symptoms of schizophrenia, and vice versa. Shared symptoms of schizophrenia and addiction are:
- Erratic moods and (often high-risk) behaviors
- Social withdrawal and disinterest in friendships
- Delusional beliefs about oneself and others
- Strange or inappropriate emotional reactions
- Hallucinations and/or disorganized thoughts
- Poor judgement and concentration
Understanding Schizophrenia and Substance Abuse
Schizophrenia is one of the most debilitating brain disorders out there today. The difficult hallucinations, delusional beliefs, paranoia, and disorganized thoughts that stem from schizophrenia can be frightening for those suffering, not to mention their family members. And because the disorder interferes with a person’s ability to think, behave, and communicate properly, it also profoundly impacts their everyday lives. Untreated schizophrenia often leads to hospitalization, unemployment, homelessness, suicide, and substance addiction. Consider the following statistics.
According to national sources, almost 5 percent of people with schizophrenia die from suicide – a rate far greater than the general population.
According to Nora Volkow, director of the National Institute on Drug Abuse, “Nearly half of the people suffering from schizophrenia also present with a lifetime of substance use disorders. This rate is much higher than the one seen in the general US population.”
As noted above, the inclination towards substance abuse is seen as a way to cope – a form of self-medication. Drugs and alcohol affect the biochemical makeup of the brain. Initially, they cause a surge in dopamine, leading a user to feel pleasure. Over time, however, dopamine levels deplete and users must consume more and more of a substance to feel its effects. This is the start of the addiction cycle.
When a person with schizophrenia uses drugs, they are likely to repeat use. This is because after the high they experience, they will experience a comedown period, and will want to use more drugs to feel “okay” again. Repeated and long-term drug use can lead to a co-occurring substance use disorder, and can severely exacerbate the symptoms of schizophrenia over time.
Substance abuse can increase the severity of schizophrenia, as well as the number of psychotic episodes and their risk of hospitalization and suicide attempts. Even without schizophrenia, drug abuse and withdrawal from drugs can cause difficult psychological symptoms, such as:
- Increased anxiety
- Hallucinations and delusions
This leads us to our next point. In addition to the self-medication theory, some researchers believe that drug abuse and addiction can cause schizophrenia in individuals. Or, it may cause symptoms of schizophrenia to surface. While this is still up for debate, several studies have linked drug abuse (particularly marijuana abuse) to psychotic disorders.
Dr. Dost Öngür, chief of the Psychotic Disorders Division at Harvard-affiliated McLean Hospital, notes this is especially a risk for adolescents: “Teenagers who are smoking daily are at about threefold higher risk of developing schizophrenia down the road.”
According to Nora Volkow’s article linked above, the most commonly abused drugs among schizophrenic patients today are alcohol, cocaine, and marijuana.
Treating Substance Addiction and Schizophrenia
Just as schizophrenia is a complex brain disorder, treatment of schizophrenia is complex and multi-layered. This is especially true for those battling both schizophrenia and addiction – a condition known as dual diagnosis or co-occurring disorders. For these individuals, integrated, intensive dual diagnosis treatment is a must.
Integrated dual diagnosis means that both disorders – schizophrenia and substance use disorders – are treated at the same time, in the same place, by the same team. This level of treatment requires a highly specialized team and an intensive focus on:
- Addressing the symptoms of both disorders
- Diminishing negative thought patterns and behaviors
- Building healthy coping strategies to manage the symptoms
- Recognizing that full recovery is possible
The treatment team must also have a deep compassion and understanding for the disease of schizophrenia. Schizophrenia is a highly destructive, yet very treatable disease with the right steps taken. In all cases, however, professional intervention is needed.
If your loved one is struggling with substance addiction, schizophrenia, or any other co-occurring mental health disorders, it is important to seek help. Turnbridge is a residential, dual diagnosis treatment center helping adolescents and young adults overcome their co-occurring disorders. Call 877-581-1793 to learn about our highly-specialized programs for young men and women.