Schizophrenia is a mental health challenge with symptoms that generally begin to show up in adolescence until early adulthood. However, some will develop symptoms earlier and others will develop them later. Symptoms are not identical for everyone and may vary over time. Some may only have one episode with symptoms that impact them over multiple months or years, while others may have multiple episodes or more severe symptoms. 

Schizophrenia is a chronic condition that may include periods of more active symptoms and periods of recovery. With effective treatment, many people can manage their symptoms and function well in relationships and at school, work, and other activities. Early intervention and treatment improve symptoms and functioning in the longer-term.

People with schizophrenia experience at least one episode of psychosis, which is a group of symptoms that can be different for everyone.   

Psychosis involves significant changes in how someone experiences their environment and involves changes in thinking and behaviour, including trouble distinguishing between what is real and not real. These symptoms can impact participation in school or work, as well as relationships. While not all symptoms are present for everyone, symptoms of psychosis can include the following:

• Hallucinations: When someone hears, sees, tastes, smells, or feels things that are not actually there.
• Delusions: New and firmly held beliefs that are different from usual for someone and are not based in reality (considering their usual belief systems, developmental level, and culture).
• Changes in thinking or speech compared to someone’s usual patterns, which can cause others to have difficulty understanding what they are saying or thinking.
• Changes in behaviour, which can become more disorganized compared to usual and does not fit the situation.
• Negative symptoms, which do not mean they are “bad” but that there is a loss of usual functions. These symptoms can be hard to notice and need careful checking. They might include showing fewer feelings, changes in how someone talks, trouble starting tasks, and less motivation to do things.

While psychosis can be a part of schizophrenia, psychosis can also happen in several other mental and physical challenges (such as bipolar disorder, depression or a brain injury). Schizophrenia is usually diagnosed when someone has had symptoms of psychosis over a period of at least 6 months, without other causes, and when it interferes with multiple areas of their life or development. Sometimes after a first episode of psychosis, the diagnosis is not clear, and schizophrenia is one of several possibilities. Learn more about psychosis here.

Schizophrenia is a sign that the brain is not functioning well. However, the direct cause of schizophrenia is not fully understood. Research has shown that schizophrenia runs in families. If your child has a parent or sibling with schizophrenia, the chance of your child developing schizophrenia will be higher. Other factors in the environment, like using cannabis, can make it more likely for someone with a genetic risk to develop it.

Schizophrenia is usually diagnosed by a doctor following a first episode or multiple episodes of psychosis. It tends to develop when youth are in their late teens to early 30’s. Some children have it at a younger age. Sometimes symptoms of schizophrenia can develop at a later age. Youth with schizophrenia may have developmental differences, appear socially withdrawn, or show unusual behaviour. Many of these early symptoms are similar to other problems or mental disorders, so it's best to ask for help from a health care provider to know what is going on.

Signs and Symptoms

Take your child to a doctor if you are concerned and they:  

• Are slower to grow or learn skills than other kids their age or stop doing things they used to do, like bathing or dressing.
• Spend more time alone or struggle to keep up at school or in activities.
• Act suspicious, have strange fears, or believe things that don’t make sense for their age.
• Behave very differently than before, like getting angry easily, feeling confused, or losing skills.
• Show little emotion, become very sensitive to sounds, smells, or tastes, or feel less physically.
• Have trouble focusing, remembering, solving problems, or jump from one topic to another.
• Struggle with simple tasks like eating, deciding, or reacting to what’s happening around them.
• Hear or see things that aren’t there or react in ways that don’t match what’s really happening.

These signs do not necessarily mean your child has schizophrenia, but it may mean that your child needs some assessment or support. 

Other symptoms that can occur along with psychosis can include depression, anxiety, suicidal thoughts or behaviour, substance use, and sleep disturbances. These can be signs that the brain is having problems but may not mean your child has schizophrenia.  

It’s also important to recognize the difference between beliefs that are normal in someone's culture (like spiritual beliefs) and delusions, which are false beliefs that happen during psychosis. Diagnosing someone involves understanding their unique ways of thinking and speaking. Treatment should also consider the history of medical and other trauma experienced by groups affected by racism and colonialism, including Indigenous peoples.

If you suspect that your child might have psychosis or schizophrenia, talk to a health care provider as soon as possible. You may be referred to another doctor or psychiatrist. Getting help as early as possible during a first episode of psychosis is important. Studies have shown that the earlier schizophrenia is diagnosed, and symptoms managed, the more likely someone will be able to manage their illness and the better their future outcomes. Most areas in BC have Early Psychosis Intervention (EPI) programs to help youth who have psychosis. EPI programs are a very good place to start if you think your child might have psychosis.

Treatment and Strategies

Medication: Medication is very important in treating schizophrenia and is the main treatment for psychosis. Everyone's brain is a bit different, and it may take time for doctors to find the right medication to help your child. They may need to stay in the hospital for a while to help with this. Getting a diagnosis early can help your child’s team find treatments that work faster, which can improve the chances of managing symptoms and developing skills for school, work, and life. Treatment usually needs to continue long-term to prevent symptoms from coming back (relapse). It’s best when everyone—including the patient, family, doctors, and support systems—works together with the child’s best interests in mind.

Therapy and Support: Education about psychosis, family support, and cognitive behavioural therapy (CBT) can help young people manage symptoms and deal with the illness.

Self–management strategies (including tips for parents)

• Providing and getting support. Having a serious illness can be hard and lonely. It helps to talk to caring people or others who have gone through the same thing.
• learning about schizophrenia
• trying to keep stress low
• keeping noise and confusion low at home
• speaking in short simple sentences
• being patient and positive with your child
• exploring additional treatment options that work in conjunction with medication to address other types of symptoms
• Helping your child to be active and eat well. While maintaining general health is important, there are no supplements that can replace the need for antipsychotic medication.

• If you are concerned that your child may be experiencing a first episode of psychosis or schizophrenia, make an appointment to see a primary care provider (e.g. family physician, nurse practitioner, walk-in clinic, Foundry BC).
• For imminent concerns about your own or others’ safety, call 911 or go to your nearest emergency department.
• You can also call the early psychosis intervention (EPI) program in your region directly to make a self-referral. There is a list of all the programs in BC at the BC Early Psychosis Intervention Program website. EPI programs are made for young people and help them get quick access to treatment services.
• If there is no early psychosis intervention program in your area and you do not have access to a primary care provider, then call 811 to ask for the number of your local mental health team or to find out how to connect to the intake process for local mental health and substance use services
• B.C. Schizophrenia Society offers support groups and resources for families affected by schizophrenia. Visit their website or call 1-888-888-0029 to speak to a Regional Educator near you.

Looking for more information on this topic? Connect with a family peer support worker at the Kelty Centre to discover additional resources, learn more about support and treatment options, or just to find a listening ear.