Understanding Schizophrenia and Addiction

Schizophrenia is not a disorder of multiple personalities, as it is often depicted in popular media (that disorder is dissociative identity disorder). Instead, the term means “split mind,” and it was coined by the psychiatrist Eugen Bleuler. This was depicted by Bleuler as a splitting of cognition from personality.

What Is Schizophrenia?

Schizophrenia is a heterogeneous mental health disorder that can be characterized by a range of dysfunctions, including:¹

• Intellectual deterioration.
• Emotional blunting.
• Disorganized speech.
• Disorganized behavior.
• Social isolation.
• Delusions, and/or hallucinations.

The American Psychiatric Association revamped its conceptualization of schizophrenia in 2013 to discontinue the long-standing use of the five major subtypes of schizophrenia. The current conceptualization of schizophrenia regards it as a singular disorder that presents with different symptoms as opposed to five different but related types of the same disorder.

Symptoms of Schizophrenia

The various symptoms of schizophrenia include:¹

• Hallucinations: These are distortions of the senses that include seeing or hearing things that are not actually present. The most common hallucinations occurring in people diagnosed with schizophrenia are auditory hallucinations.  Most often, the individual hears voices that are not really there. However, the individual can experience other types of hallucinations, such as visual or tactile hallucinations.
• Delusions: Delusions are very fixed beliefs that are simply not true. The most common delusion in people with schizophrenia is the delusional of persecution, formally most often identified with what was called paranoid schizophrenia.  However, delusions can be fixed beliefs that cover any domain, including religious-based delusions (e.g., the person believes himself/herself to be Jesus or some other religious figure), grandiose delusions, the illusions of reference (e.g., that most of the events that occur in the world are directly targeted at or directly relevant to the person), etc.
• Disorganized speech: This category consists of a number of speech-related issues, such as being incoherent, tangential (going off in all directions), frequent derailments, etc.
• Disorganized behavior or catatonic behavior: Disorganized behavior occurs when an individual’s actions have no goal or end function. Catatonic behavior consists of spending long periods of time either in a frozen position or repetitively performing a particular movement.
• Negative symptoms: These symptoms are considered to be extremely serious symptoms that reflect serious brain damage. These often are deficiencies of behavior, such as a lack of thoughts, a lack of emotional expression, a lack of motivation, a lack of speech, etc.

In order for a person to be a diagnosed with schizophrenia, the person must exhibit at least two of the above five symptoms for at least a six-month period.

At least one of those symptoms must be hallucinations, delusions, or disorganized speech. The individual must also have a significant period of time since the onset of the symptoms where serious functional issues are present as a result.  These can include problems or issues at work, school, issues with interpersonal relationships, etc. There must also be no evidence that the symptoms and issues with functioning are not better explained by some other mental health disorder, the use of drugs or medications, or some other medical condition.

As mentioned above, the disorder is a heterogeneous disorder, indicating that individuals with the disorder may display markedly different presentations. This heterogeneity is even further complicated by the American Psychiatric Association’s dropping the long-standing approach to schizophrenia that identified five specific subtypes of schizophrenia (e.g., paranoid schizophrenia, disorganized schizophrenia, etc.).

A good deal of the confusion stems from the fact that most individuals with schizophrenia will display some aspect of both the positive symptoms in schizophrenia (excesses of behavior, such as hallucinations and delusions) and the negative symptoms of behavior (deficiencies of behavior, such as a lack of motivation, difficulty expressing emotions, difficulty expressing thoughts, etc.). As such, there has always been some controversy surrounding the psychiatric conceptualization of schizophrenia.

What Causes Schizophrenia?

There is no formally defined cause for any form of schizophrenia, although many have been proposed. According to the modern psychiatry hypothesis, an imbalance of neurotransmitters in the brain is the primary cause of schizophrenia.²

The “dopamine hypothesis” regarding schizophrenia has long implicated the neurotransmitter dopamine as being a causal factor in at least the expression of the positive symptoms of schizophrenia.³ The dopamine hypothesis theorizes that it is an overabundance of the neurotransmitter dopamine that results in the expression of schizophrenia.

Even though the dopamine hypothesis has been shown to be quite limited and does not offer a complete explanation of the disorder, the notion that schizophrenia represents either an excess or depletion of neurotransmitters that include dopamine, serotonin, glutamate, and perhaps others is still a basic assumption of the psychiatric treatment approach to individuals with schizophrenia.  The medications used in the treatment of schizophrenia target dopamine and/or other neurotransmitters.

The bottom line is that schizophrenia is a disorder that does appear to have significant biologically based associations; however, a complete view of the research indicates that there are environmental factors that contribute to the development of the disorder in addition to biological influences.

Schizophrenia and Addiction: What Is a Dual Diagnosis?

A dual diagnosis, also called co-occurring disorders, is a diagnosis of one or more mental health disorders as well as one or more substance use disorders (SUDs).⁴ It is more likely for a person with a substance use disorder to have co-occurring mental disorders than someone without an SUD. In one study, 55% of people with schizophrenia had an SUD.

The co-occurrence of these disorders can negatively impact a person’s wellbeing in a multitude of ways, including by:^4,5

• Shortening mortality.
• Increasing risk of violent and self-destructive behaviors.
• Worsening the course of schizophrenia.

When a person is diagnosed with schizophrenia and a substance use disorder, both disorders need to be addressed together. An integrated treatment approach achieves better results than treating each diagnosis separately.⁶

Finding the Right Treatment for Your Schizophrenia and Substance Use Disorder

It is possible for people with schizophrenia to manage the disease with consistent treatment.⁷ When choosing a treatment center, there are some things to keep in mind:

• Types of programs offered: What levels of addiction treatment are available? Does the treatment center offer treatment specifically for co-occurring disorders? Are effective, evidence-based therapies used?
• Accreditations: What accreditations does the treatment center hold?
• Location of facility: Where the facility is located may affect both the cost as well as the convenience of treatment.
• Insurance accepted: Your level of insurance coverage may vary depending on the treatment center.

How Can I Pay for Treatment?

You can pay for schizophrenia and addiction treatment several ways. Many people find paying for rehab with health insurance covers all or part of their treatment for co-occurring disorders. For those without insurance, there are other rehab payment options, including financing.

To find out what your insurance covers, simply complete our secure or call a helpful admissions navigator at . We’ll quickly verify your insurance coverage and can answer any questions you may have.

How Will My Schizophrenia and Substance Use Disorder Be Treated?

Schizophrenia and addiction may be treated with both medication and behavioral therapies.⁴ The standard of care to reduce symptoms of schizophrenia such as hallucinations and delusions is antipsychotic medication. To treat the addiction component of the dual diagnosis, psychosocial interventions are employed to help support recovery.⁵

What Kinds of Therapies Will I Receive for My Schizophrenia and Addiction?

Various types of addiction therapies are used at Desert Hope to treat schizophrenia and addiction. These interventions include:

• Cognitive-behavioral therapy (CBT): Helps you identify and change behaviors that contribute to substance misuse.
• Dialectic behavioral therapy (DBT): Focuses on developing coping skills and working on acceptance.
• Motivational interviewing: Helps you resolve ambivalence about recovery.
• Psychoeducation: Teaches you about substance use disorders and mental health disorders to help you feel more empowered.
• Family therapy: Includes your loved ones in treatment to help resolve issues and repair relationships.
• 12-Step facilitation: Provides support and motivation from peers in a therapeutic setting.

What Kind of Medications Will I Receive for Schizophrenia and Addiction Treatment?

At our inpatient drug rehab facility in Las Vegas, Nevada, the clinical team evaluates each patient and prescribes medication based on their individual needs. We approach co-occurring disorders with a customized plan to ensure each person gets the appropriate treatment for them.

When you’re ready to begin your recovery journey, our compassionate team is here for you. We believe in treating the whole person with integrated, high-quality care. There is no better time than now to start the rehab admissions process at Desert Hope.