Schizophrenia and Addiction

Research has found that a high number of people with schizophrenia also struggle with addiction. Treatment for these co-occurring disorders typically involves psychotherapy, substance abuse counseling, medication and support groups.

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What is Schizophrenia?

Schizophrenia is a brain disorder that affects about one percent of all Americans—an estimated two million adults.

Individuals suffering from schizophrenia are often unable to distinguish the imaginary from reality.

People with schizophrenia may have difficulty responding to various social situations in an emotionally appropriate manner. This often results in issues with interpersonal relationships or in other major areas of their life, such as at work or school.

Schizophrenia is sometimes confused with multiple personality disorder (MPD). However, the overwhelming majority of people suffering from schizophrenia do not have multiple personalities and are not violent, which is more common among those with MPD.

While the direct cause of the disorder is still unknown, researchers believe it is linked to the following factors:

  • Genetics

    Schizophrenia tends to run in families. In fact, it occurs in 10 percent of people with a first-degree family member, such as a sibling or parent, who have the disorder. Researchers believe certain genes inherited from one’s parents may increase the risk of developing schizophrenia. Scientists have also found that people with schizophrenia often have rare genetic mutations that may disrupt brain development.

  • Brain structure and chemistry

    Imbalances of certain chemicals in the brain, such as glutamate, serotonin and dopamine, are linked to schizophrenia. These imbalances affect the way the brain reacts to stimuli and can lead to hypersensitivity and hallucinations—common symptoms of schizophrenia. Scientists have found small differences in the brain structure of those with schizophrenia, as well. These differences include decreased gray matter, enlarged ventricles (cavities in the center of the brain filled with fluid), and increased or decreased activity in some areas of the brain.

  • Environmental factors

    Some scientists believe a person’s environment combined with genetics may also play a role in the development of schizophrenia. Environmental factors may include health related problems occurring during birth such as exposure to infections, viruses or malnutrition. Other unknown psychosocial factors may contribute, as well.

Schizophrenia and Addiction

Schizophrenia and addiction, or substance use disorder, often co-occur. In fact, an estimated 50 percent of individuals suffering from schizophrenia have a history of substance abuse.

People with schizophrenia often engage in substance abuse as a way to self-medicate or alleviate feelings of anxiety and depression.

Although substance abuse cannot cause schizophrenia, it can act as an environmental trigger. Someone with existing genetic risk factors for the disorder may develop an active case of schizophrenia after extended substance abuse. Using drugs, such as marijuana, cocaine and amphetamines, can also exacerbate schizophrenic symptoms and worsen their severity.

Schizophrenia is often mistaken for substance abuse because the disorders have similar symptoms. This can sometimes make it difficult to diagnose schizophrenia or co-occurring disorders. However, researchers continue to study the disorders independently and concurrently to improve the accuracy of dual diagnosis.

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Schizophrenia Symptoms and Effects

Schizophrenia is characterized by a broad range of symptoms that make it hard for the affected person to function normally. Symptoms vary and may be cognitive, behavioral or emotional in nature. Common schizophrenia symptoms include:

Delusional thinking

An individual suffering from schizophrenia may have beliefs that are not based in reality. These delusions can be about anything and are usually based on misinterpreted sensory experiences (e.g. seeing a light flicker and thinking it’s a signal of some sort). Delusions may include:

  • Feeling harassed or threatened by someone, real or imaginary
  • Believing one has an incredible fortune or a mystic power
  • Feeling that a disaster is about to happen
  • Thinking they are someone else, like a historical figure or celebrity

It can be very difficult to convince someone with schizophrenia that these delusions are false.

Hallucinations

Hallucinations are when an individual hears, sees, smells or feels something that does not exist. Someone suffering from schizophrenia might be immersed in an experience that has no actual basis in reality. Hearing voices is one of the most common hallucinations among those with schizophrenia.

Disorganized speech

Disorganized speech is the result of disorganized thinking. Those with schizophrenia often have difficulty organizing and maintaining their thoughts. This can lead to sudden, mid-sentence changes in topic or saying meaningless words or gibberish that is difficult to understand. The person may also repeat words and phrases, use rhyming words, or make random, illogical statements.

Disorganized motor or catatonic behavior

Individuals suffering from schizophrenia might exhibit disorganized, almost childlike motor behavior. This behavior can include excessive movements, strange postures and a lack of impulse control. The person may also go in and out of a catatonic state, in which they will not speak, move or respond to communication.

Negative symptoms

Negative symptoms of schizophrenia are the absence of normal behaviors or function. These symptoms often present years before a person has their first schizophrenic episode—when psychotic symptoms, like hallucinations and delusions, set in. Negative symptoms are often mistaken for other mental health issues, such as depression or anxiety disorders. Common negative symptoms of schizophrenia include:

  • Lack of interest or motivation
  • Diminished emotional expression
  • Changes in sleep patterns
  • Becoming socially withdrawn
  • Not caring about their appearance or hygiene
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Addiction and Schizophrenia Treatment

When treated independently, treatment for schizophrenia and addiction both typically involve a combination of medications, psychotherapy, rehabilitation education and self-help groups.

Dual diagnosis programs work by treating both schizophrenia and drug addiction simultaneously, instead of as two separate conditions.

Generally, detox—the process of removing drugs from the user’s system—is the first step in dual diagnosis treatment. Once the user’s body is free of the substance, a clinical team can better assess the patient’s schizophrenia symptoms and determine the best course of treatment.

Antipsychotic medications are usually prescribed to help alleviate symptoms of schizophrenia caused by chemical imbalances in the brain. Sometimes, several drugs may be tested before finding the right medication to treat a patient’s specific chemical imbalance.

While taking medication to manage their symptoms, dual diagnosis patients also attend various therapies to address the underlying causes of their disorders. One of the most common forms of therapy used in dual diagnosis is family therapy. Many individuals suffering from schizophrenia are part of high-stress families. Family therapy can help to reduce the amount and severity of stressors that can act as a trigger for both schizophrenia and substance abuse.

Cognitive behavioral therapy (CBT) is another common type of therapy used to treat co-occurring schizophrenia and addiction. CBT helps the patient identify specific behaviors or ways of thinking that contribute to their addiction, as well as their schizophrenia. It can also help patients learn to manage symptoms of schizophrenia, such as auditory hallucinations, that may persist even when taking antipsychotic medications.

Recovery from schizophrenia and addiction is 100 percent achievable. If you or a loved one is suffering from co-occurring disorders, please contact a treatment provider for help finding a dual diagnosis treatment program.

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