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Schizophrenia is an often-misunderstood mental health condition. Here's how to write about it in a sensitive, realistic way.

How to Write Schizophrenia

When we think of schizophrenia, we often imagine serial killers motivated by the voices in their heads.

But schizophrenia is so much more than that. Most of the people with it don’t hurt other people—they’re much more likely to hurt themselves.

Schizophrenia is a difficult condition to write about because it’s so misunderstood. Sadly, stories in the media don’t help. That’s why examples in literature are so important—they help to normalise mental health conditions.

This, in turn, makes those with the condition feel less alone. It also educates those around them so that they can be more supportive.

However, schizophrenia can and does ruin the lives of those with it, and those around them.

People with it can end up permanently institutionalised.

But this is only one side of it.

Much like with any other mental health condition, there are millions of different ways it can affect someone’s life.

Why not shake things up in your story? Why not have a schizophrenic character who has a high-powered job or leads a normal life?

Development of schizophrenia

Schizophrenia can appear suddenly and out of nowhere.

It can also develop gradually over months or even years.

The use of certain recreational drugs has been linked to the development of schizophrenia, but it’s not known whether users develop schizophrenia because of the drugs, or the other way around.

As with other mental health conditions such as anxiety or bipolar disorder, it’s also thought that stress could be a trigger.

Find out how to write about schizophrenia.

Symptoms of schizophrenia

Symptoms of schizophrenia are divided into two categories: positive and negative.

Don’t be fooled, though—this doesn’t mean that one set of symptoms are better or worse than the other.

Positive symptoms are when a person experiences things that aren’t real, such as hallucinations or delusions.

Negative symptoms are when a person withdraws and loses motivation.


Hallucinations—especially auditory hallucinations—are the most well-known symptom of schizophrenia.

Hallucinations involve seeing, hearing, feeling, or tasting something that isn’t actually there.

But the brain is convinced that it is.

It’s so convinced it’s there that when brain scans were conducted on people with the condition, their brains genuinely thought their hallucinations were happening.

For instance, if the person with schizophrenia hallucinates someone standing in front of them, they won’t know it’s a hallucination—they’ll actually believe there’s a person standing in front of them, even if the room they’re in is empty.

Some of the time, when someone hears voices, they’re friendly. A lot of the time, they’re not. They can be overly critical, or just downright annoying.


The NHS describes a delusion as:

A belief held with complete conviction, even though it’s based on a mistaken, strange or unrealistic view.

Delusions can be tied to hallucinations, or used as a way to explain them.

Sometimes they happen out of nowhere, other times they build up gradually.

Examples of delusions:

  • Believing they’re being followed or persecuted
  • Believing books, films, or TV shows are sending them subliminal messages
  • Believing they’re god

Difficulty concentrating

With so much going on in a person’s brain, it’s no wonder they can’t concentrate.

Disconnection from everything around you

When you have no idea what’s real and what isn’t, it can be very disorientating. This can lead to disconnecting from everything around you.

Auditory hallucinations may also tell the person to cut themselves off from the people around them because they’re harmful, or to avoid certain places.

Lack of self-care

This is a common symptom of many mental health problems. If you don’t feel great mentally, you feel less inclined to look after yourself.

Sufferers may also fail to realise they’re not conducting basic self-care tasks if they’re wrapped up in their own world and disconnected from everything around them.

Lack of interest in things

A lack of interest in things could be related to a change in thoughts or behaviours, or it could be related to hallucinations or delusions.

For instance, if someone believes they’re being followed, they’re less likely to want to leave the house.

Avoiding people

Avoiding people is a common sign of schizophrenia. If you can’t tell what’s real and what isn’t, it’s no wonder people want to cut off from the outside world.

Disorganised thinking and speech

People with schizophrenia can appear a little bit all over the place. They may jump from topic to topic when talking, and there may be no apparent pattern or thought process to what they say.

Treatment for schizophrenia

The most common treatments for schizophrenia are antipsychotic medications and talking therapy.

Talking therapy can include cognitive behavioural therapy, or family therapy, where a person’s family is included in the sessions. For sufferers whose schizophrenia was triggered or exacerbated by stress, this can help to alleviate symptoms.

Creative therapies may also be used if the person finds it hard to talk about how they feel.

Want to write about schizophrenia? Here's how.

Like this post? You may also want to check out the rest of the how to write about mental health series:

Thanks to Alexa Whitewolf for the blog post idea! If there’s another mental health guide you’d like me to write, get in touch!

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Kristina Adams

Kristina Adams is an author of fiction and nonfiction, writing and productivity blogger, and occasional poet. She has a BA in Creative Writing from the University of Derby and an MA in Creative Writing from Nottingham Trent University. When she's not writing she's reading, baking, or finding other ways to destroy the kitchen. She can be found under a pile of books with a vanilla latte.


  • 29th March, 2018 at 15:51

    Having had people with schizophrenia around me in my youth, I can fully attest to the reality of this post! Thanks so much for writing it 🙂

  • 8th July, 2019 at 07:11

    I’m taking on the challenge of writing for a character with schizophrenia. When I was designing the plot and characters I put into the storyline and character. That my protagonist Indigo has it. For a bit when I actually sat down to write I was thinking that maybe I should cut it out. I was and still am mostly afraid it won’t be accurate and I don’t want to get things wrong, and make it seem what it’s not. But it’s a main point in parts of the storyline and large parts of the climax wouldn’t work without it. As it’s needed so that some things can happen that I had planned. One of the main turning points has to do with the her medical records getting leaked to the school and the school finds out about it. Something she had been actively avoiding. So I’m keeping it in for storyline and plot sake. This helped a bit but I’m going to continue to research before delving into the story. I’m safe for the first chapter or so because it doesn’t have much impact on those but once I get 2 or 3 chapters in I have to take some more research to make sure I get this right.



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