Imagine walking alone down a long, dark corridor of an old building, late at night. Every creak of a floorboard sets your nerves on edge and every shadow looks threatening. Now imagine experiencing that anxiety and paranoia all day, every day.

That is precisely how many people with schizophrenia experience everyday life.

Contrary to popular belief, people with schizophrenia do not have multiple personalities, but rather experience an array of symptoms that can either make them appear agitated, anxious, or depressed.

"Schizophrenia can cause so-called 'positive' or 'negative' symptoms," explains Bonga Chiliza, an associate professor in psychiatry at the Faculty of Medicine and Health Sciences at Stellenbosch University. "Positive symptoms are when they hear voices (hallucinations) or believe things (delusions) that are not real or true – for instance that elite crime-fighting agents are after them. Negative symptoms are when the person does less than what is expected of them, for example, they smile or gesture less, are untidy, or don't reach out to friends or family.

"People with schizophrenia also have difficulty with their thinking processes (cognition), and may struggle to concentrate during long conversations. They also struggle to fit in in social situations, and often have serious anxiety and depression," says Chiliza.

Schizophrenia is a disorder of the dopamine system of the brain. Dopamine is a chemical that occurs naturally in the brain that filters out stimuli that a person is exposed to everyday. This filter doesn't work well in people with schizophrenia, causing them to experience everything they see and hear as significant.

Antipsychotic medication can help correct dopamine filters, and is commonly used to treat the positive symptoms of schizophrenia.

"Stares from neighbours or a police car driving past will matter less and less as people continue to take their antipsychotics. But unfortunately it doesn't help for the negative systems, like depression or anxiety," says Chiliza.

He and his team are doing research in the area of psychosocial rehabilitation (PSR), amongst other areas of intervention, which has been shown to help alleviate the negative symptoms of schizophrenia.

One of the key components of PSR is family psychoeducation, which entails working with a patient's family over a number of sessions to discuss different aspects of schizophrenia and its treatment.

"Our schizophrenia research team found that PSR is a feasible intervention in the public health sector if multiple families can be educated simultaneously in one group," Chiliza explains.

According to him, the group sessions have uncovered some of the challenges that the families of people with schizophrenia face.

"These groups remind us that for many people, having a son or daughter with schizophrenia is just one of the many burdens they carry and that issues like poverty, drug abuse and gangsterism should also be considered when dealing with the families of people with schizophrenia," says Chiliza.

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