There’s No ‘Cure’ for Schizophrenia, but Treatment Can Help

Thanks to medical and technological advancements, our understanding of schizophrenia has grown over the past few decades.

Schizophrenia is still a complex condition, and more research is needed to uncover how it develops. Symptoms, triggers, and medication responses differ greatly among people with schizophrenia.

So, what do we know so far?

Many studies point to irregular levels of neurotransmitters — brain chemicals that influence how we think, feel, and behave. People with schizophrenia have shown differences in levels of:

• dopamine
• glutamate
• GABA (gamma aminobutyric acid)
• acetylcholine
• serotonin

In addition to an imbalance of neurotransmitters, differences in brain signaling could also contribute to schizophrenia. When brain circuitry is out of balance, it can cause the mental, emotional, and behavioral effects we associate with schizophrenia.

Current antipsychotic drugs — called atypical antipsychotics — act on the brain’s dopamine system to reduce psychosis. And while these medications do help a majority of people with schizophrenia, about one-third still have persistent symptoms despite treatment.

These drugs may also be less effective at treating the negative symptoms of schizophrenia, such as lack of motivation and social withdrawal.

Some research suggests the immune system may also play a role in schizophrenia. For instance, one study shows that a leaky blood-brain barrier may cause the immune system to interfere with the central nervous system. This can cause inflammation, which may contribute to schizophrenia symptoms.

Other research suggests schizophrenia may not even be one condition, but rather a group of eight separate conditions, each with its own set of symptoms.

Researchers conducted a large genome-wide study of more than 4,000 people with schizophrenia. They discovered distinct gene clusters that contribute to eight different “types” of schizophrenia.

And another theory proposes that psychosis exists on a spectrum, much like autism spectrum disorder. In this theory, schizophrenia is on the severe end of that spectrum.

Overall, the complexity of schizophrenia suggests that a single “cure” isn’t likely to exist. Instead, it could be several treatment approaches.

There are several ways to manage schizophrenia symptoms. Medication, therapy, and possibly diet are just a few.

Atypical antipsychotics

Atypical, or second-generation, antipsychotics are the first-line treatment for schizophrenia. These drugs reduce dopamine levels in the brain, which helps treat symptoms of psychosis.

They may also block a serotonin receptor (5HT2a), which helps create a better balance of dopamine overall.

Atypical antipsychotics emerged in the 1980s as an alternative to first-generation antipsychotics, which have been around since the 1950s.

Due to their much lower chances for certain severe side effects, atypical antipsychotics have mostly replaced the first-generation drugs. Still, the first-generation medications are still in use for people with severe psychosis.

Atypical antipsychotics are usually available in tablets, solutions, and longer-term injections.

Psychosocial skills training

Schizophrenia often causes difficulties with social functioning. It can greatly affect how you understand yourself and your surroundings.

Several psychosocial therapies are available for people with schizophrenia.

Social skills training

A growing body of evidence supports the effectiveness of social skills training for schizophrenia. These approaches help you learn social and independent living skills.

Classes can cover a wide variety of topics, including:

• medication management
• interpersonal skills like eye contact, facial expressions, and voice volume
• finding hobbies
• how to handle anger or frustration
• how to deal with criticism
• money management

Cognitive behavioral therapy (CBT)

CBT is a short-term (about 12 to 16 weeks) form of therapy that can help you identify and change inaccurate thought processes and behaviors.

With CBT, you can learn a variety of coping skills to help manage difficult situations. Your therapist might teach you how to test the reality of your beliefs and manage any voices or hallucinations.

Cognitive remediation

Cognitive deficits are a core feature of schizophrenia. These include difficulties in learning, memory, attention, reasoning, and problem solving.

Cognitive rehabilitation helps you improve, restore, and train your cognition so you can better function in everyday life. The intervention targets skills like attention, memory, and flexible thinking.

Studies confirm the success of these programs, especially for people in the very early stages of the condition.

Social cognition training

Social cognition refers to the mental processes involved in understanding social situations and other people — and schizophrenia can cause deficits in social cognition.

Social cognition training could help you sharpen skills such as:

• emotion perception (recognizing and identifying other people’s emotions)
• social perception (understanding social cues or body language to read social situations)
• theory of mind (the ability to identify and understand other people’s mental state)

Diet

Some evidence suggests a particular type of high-fat, low-carb diet — known as the ketogenic (keto) diet — may help reduce symptoms in some people with schizophrenia.

Why would this work?

Schizophrenia may be linked to reduced energy production in the brain. For example, people with schizophrenia are about 3 times more likely to develop diabetes.

One study found that people with first-episode schizophrenia had higher levels of insulin and increased insulin resistance, meaning their brains may not be getting enough energy from glucose.

A keto diet is a high-fat, low-carb, moderate protein diet commonly used to help people with epilepsy. The diet produces “ketones,” which replace glucose as the primary fuel in the brain. This may provide energy to insulin-resistant brain cells.

Several studies show promise in the use of a keto diet to help manage symptoms of schizophrenia. The diet has also been shown to improve metabolism, decrease inflammation, and impact neurotransmitters.

You can learn more about managing schizophrenia here.

If you or someone you love has schizophrenia, it can be important to engage in self-care. Here are some easy-to-apply strategies for making life a little easier:

• Seek social support. If possible, get involved in a schizophrenia support group, whether in-person or online. Giving and receiving support from those who are living with similar experiences can benefit your emotional well-being.
• Lean in to a hobby. Take time to engage in activities that help you relax. This can be baking, playing your favorite sport or video game, or just lying in bed and coloring.
• Engage in therapy. A therapist can help you challenge false beliefs, manage any delusions or hallucinations, and encourage you to continue with treatment and self-help strategies.
• Take care of your health. You can eat a nutritious diet, engage in daily exercise, and try to get enough sleep.

Although there’s no one-size-fits-all treatment when it comes to schizophrenia, the right care and support can help.

As researchers continue to discover what causes schizophrenia and how it works, new and effective treatments will continue to come out.

With the help of medication, therapy, and a lifestyle that supports your health, it’s possible to manage symptoms that impact your daily life.