Schizophrenia and Addiction

Schizophrenia symptoms tend to revolve around ‘impairments in the way reality is perceived.’ People living with schizophrenia are often described as experiencing periods of ‘losing touch with reality.’  This is because schizophrenia often includes symptoms of psychosis. Psychosis has two key components:

1. Hallucinations
2. Delusions

Hallucinations

Hallucinations are when we perceive things that others do not. The most common types of hallucinations are auditory (‘hearing voices’) and visual hallucinations (‘seeing things’) that other people cannot. However, it is possible to experience hallucinations of touch, taste and smell too – these are just slightly less common.

Delusions

Delusions are less about what we perceive and more about what we think and believe. Delusions are persistent thoughts or beliefs that do not have a basis in reality. There are different kinds of delusions, such as:

• Persecutory delusions
• Referential delusions
• Grandiose delusions
• Erotomanic delusions
• Nihilistic delusions
• Somatic delusions
• ‘Bizarre’ delusions

Persecutory delusions are usually linked to paranoia and are often related to the fear that someone is trying to harm you in some way.

Referential delusions happen when someone thinks that everyday events, places and objects are sending them signs or signals about something in their life.

Grandiose delusions often showcase extreme confidence or belief that you are exceptional. For example, claiming to be a celebrity, politician or religious leader.

Erotomanic delusions manifest as a belief that someone is in love with you. This often happens with specific celebrities or people that you have yet to meet.

Nihilistic delusions are thoughts usually pertaining to the end of the world or, for example, a belief that the self, another person or the whole of humanity is already ‘dead, decomposed or annihilated.’

Somatic delusions link to our relationship with our body. This type of delusion is usually associated with believing that we are ill with specific illnesses or that an outside force is harming our bodies.

‘Bizarre’ delusions are beliefs that do not appear to be situated in reality. Common bizarre delusions include believing thoughts have been placed in your mind (or removed) by an outside force or that an alien being is controlling you.

There are other symptoms of schizophrenia outside of hallucinations and delusions. These can include:

• Flattened affect
• Disorganised thinking
• Disorganised speech
• Reduced personal care
• Dissociation
• Anhedonia (lack of interest)

Schizophrenia and Suicide

People with schizophrenia are ‘2 to 3 times more likely to die early than the general population.’ Around 40% of these early deaths are linked to suicide.This increase is thought to be linked to the presence of hallucinations that may be deemed dangerous, as well as agitation and difficulty adhering to mental health treatment.

There are many different types of schizophrenia. Each type can be linked to a specific subset of symptoms. These types include:

• Catatonic schizophrenia
• Cenesthopathic schizophrenia
• Hebephrenic schizophrenia
• Paranoid schizophrenia
• Residual schizophrenia
• Simple schizophrenia
• Undifferentiated schizophrenia
• Unspecified schizophrenia

Currently, there is no cure for schizophrenia. However, with appropriate treatment, some individuals may find that specific symptoms are alleviated completely or ‘go into remission’ for some time. It is possible, though, for these symptoms to recur.

Whilst researchers have been working on schizophrenia for decades, a clear causation of the disorder is yet to be found. Rather, there is a list of factors that can potentially contribute to the development of schizophrenia, such as:

• Experiencing chronic stress
• Experiencing abuse or neglect
• Chronic drug or alcohol use
• Genetic inheritance (a family history of psychosis)
• An imbalance of neurochemicals (dopamine and serotonin specifically)

Addiction can contribute to the development of schizophrenia. 50% of people with schizophrenia have some history of substance abuse. This makes the schizophrenia and addiction comorbidity particularly high. This use of drugs and alcohol can happen before the onset of psychosis or may happen after schizophrenia symptoms have begun to show.

There is a particular link between schizophrenia and weed (cannabis). Some people argue that cannabis use disorder may predict schizophrenia, whilst others suggest that specific uses of cannabis could decrease some of the difficult symptoms people experience.

Other common addictions among people with schizophrenia are nicotine, caffeine and cocaine.

Given the psychologically stimulating nature of many substances, heavy drug or alcohol use is not recommended for individuals dealing with any form of psychosis. However, it is particularly important to access appropriate support if you are dealing with both conditions.

If you are struggling with schizophrenia symptoms, there are several places you can seek help. These include:

• a primary care clinician or psychiatrist
• a social worker
• a support group
• a mental health charity (such as Mind)
• a crisis line (such as Samaritans)
• a mental health treatment facility 
• an specialist rehab service 

Schizophrenia Medication and Treatment

Schizophrenia is usually treated with medication. Common prescription medications include:

• antipsychotics
• antidepressants
• other forms of sedatives

Schizophrenia can also be managed through appropriate therapies, such as:

• cognitive behavioural therapy
• art therapy
• group therapy
• family intervention

Dealing with Addiction

Given the increased mortality rate among people living with schizophrenia, managing symptoms appropriately is a huge part of maintaining health and limiting the risk of premature death. This is especially the case when dealing with a co-occurring substance addiction, which can contribute to both the physical and psychological symptoms that can threaten life. Specialist rehab options designed to treat schizophrenia and substance use disorders in tandem can be a powerful way of breaking harmful cycles.

Addiction is a tough journey, but you don’t have to face it by yourself. If you have a dual diagnosis, we are here to help you overcome your addiction. Reach out to us today to begin your recovery journey. At UKAT, we believe everyone deserves stable mental health and a life free from substance use. Our expert team is here to guide you on your first step toward that goal.