Schizophrenia and psychosis
Schizophrenia and Psychosis in Kathmandu: Signs, Treatment and Family Support
Hearing voices that others cannot hear, holding strong beliefs that are not true, or withdrawing from the world can be frightening for the person and the family. These experiences are called psychosis, and schizophrenia is one of the conditions that can cause them. They are medical illnesses, they respond to treatment, and starting early makes a big difference.
Key takeaways
- Psychosis means losing touch with reality: hallucinations (such as hearing voices) and delusions (fixed false beliefs).
- Schizophrenia is not a split personality, not caused by black magic or a lack of will, and most people with it are not dangerous.
- Antipsychotic medicine plus family support and rehabilitation helps most people, and early treatment leads to better recovery.
- Someone who is unsafe or cannot look after themselves needs urgent medical care.
What psychosis and schizophrenia are
Psychosis is a set of symptoms, and it can occur in schizophrenia, in severe mania or depression, after drug use or with some physical illnesses. Schizophrenia is a long-term condition, usually beginning in the late teens to the thirties, in which psychosis and other changes occur. It is not "split personality".
Signs and symptoms
- Hallucinations: hearing voices or seeing things that are not there (आवाज सुन्ने समस्या).
- Delusions: fixed beliefs that are not true, such as being watched, poisoned or controlled (शंका गर्ने बानी, मानसिक भ्रम).
- Disorganised speech or behaviour: hard-to-follow talk, unusual actions.
- Reduced expression and motivation: flat emotion, withdrawal, neglecting hygiene and daily tasks.
- Sleep changes and falling function at study, work or in relationships.
Causes and myths
Genes, brain development, stress, substance use (especially cannabis and stimulants) and other factors contribute. Many families first seek religious or traditional healers, and comfort from them can be valuable, but psychosis also needs medical treatment, and delay can lead to a longer and more severe illness. It is nobody's fault.
Assessment
A psychiatrist takes a full history from the person and, with permission, from family, checks for physical causes and substance use, and may arrange blood tests or scans. Because people with psychosis may not recognise they are unwell, family accounts are important.
Treatment
- Antipsychotic medicine reduces hallucinations and delusions and prevents relapse. Side effects are discussed and monitored, and the plan is adjusted.
- Psychological support: education about the illness, CBT for psychosis, and help with stress and routine.
- Family involvement: teaching families how to respond and how to spot relapse lowers the chance of readmission.
- Rehabilitation: support to return to study, work and social life.
Stopping medicine without medical advice is the most common reason for relapse. If side effects trouble the person, speak to the psychiatrist rather than stopping.
How families can help
Stay calm and kind, avoid arguing about the person's beliefs, and instead acknowledge their feelings. Keep routines regular, reduce stress and alcohol or drug use, support medicine and appointments, and get help early if symptoms return. Do not lock the person away or use force. Look after your own health too.
When hospital care is needed
Seek urgent care when the person is a risk to themselves or others, refuses food or drink, is extremely frightened or agitated, or cannot be looked after at home. Call Nepal Police 100 or an ambulance 102 and go to an emergency department. See mental hospital or clinic? for how to choose the right level of care.
How we help
Our psychiatrists provide ongoing, steady care for schizophrenia and other serious illness, with family involvement. Where someone cannot travel, ask about a home visit. See severe mental illness care or call us.
Frequently asked questions
Is schizophrenia curable?
Schizophrenia is usually a long-term condition, but treatment controls symptoms well for many people, and some recover fully. Early and continuous treatment gives the best outcome.
Can a person with schizophrenia live independently?
Many can, especially with regular treatment, family support and rehabilitation. The level of support needed varies from person to person and over time.
Are people with schizophrenia dangerous?
Most are not. People with schizophrenia are far more likely to be harmed than to harm others. Risk rises mainly with untreated illness and substance use, which is why treatment matters.
What if my relative refuses treatment because they feel fine?
Lack of awareness of illness is common in psychosis. Stay calm, keep the relationship, and speak to a psychiatrist about how to encourage help. If they are unsafe, seek urgent care.
Further reading
Independent sources on this topic. They did not write this page and do not endorse this clinic.
- SchizophreniaWorld Health Organization
- SchizophreniaNational Institute of Mental Health (US)
- SchizophreniaNHS (UK)
This guide is general information and does not replace advice from a doctor. If you are worried about your health or someone's safety, seek medical help.
In an emergency: Nepal Police 100 · Ambulance 102 · Suicide prevention helpline 1166. Outside Nepal, call your local emergency number.