B. Precipitating Factors

The manifestation of symptoms begins at the most concrete level with alterations in neurotransmitters and/or changes in cerebral blood flow patterns. Specifically, dopamine and serotonin are implicated in schizophrenia. With no set formula, upsetting the balance of neurotransmitters can precipitate disease symptom onset. Stress and other environmental triggers are implicated in the increase or decrease of symptoms. Social isolation may be a major environmental trigger. Substance abuse is also implicated as a factor that may precipitate symptom onset. Birth defects and complications that surface during childhood development, exposure to pathogens, and head injury may also precipitate disease onset.

Symptoms vary and so do patterns of symptom onset. Mainly involving profound shifts in communication and personality patterns, the symptoms of schizophrenia include social withdrawal, inappropriate emotional responses, delusional thinking, paranoid thinking, perceptual distortions, and psychotic episodes that may or may not involve hallucinations. Nonsensical speech, often referred to as disorganized language, is another common sign that the illness has set in. Hearing voices in the head is a common manifestation of the illness. Someone suffering from the disorder often feels like they are being watched, monitored, or told what to do.

No one trigger is implicated in all cases, and symptoms may manifest gradually over time. Each person who suffers from schizophrenia will demonstrate different features of the illness, and different symptoms will manifest at different times. Although schizophrenia is a brain disorder, its symptoms are behavioral. The disorder is diagnosed primarily through observations of the person's behaviors and may later include brain scans, which usually reveal abnormalities. The patient's responsiveness to antipsychotic medications may also indicate presence of the disorder.

When friends or loved ones notice the onset of symptoms, the individual usually consults a psychologist or psychiatrist and tests are administered to help definitively diagnose the disorder. Dynamics responsible for the intensity, frequency, and duration of the disorder include the person's lifestyle habits such as any existing substance abuse problems; external stressors such as divorce, death in the family, or moving; genetic factors; head trauma; and several other variables may also be implicated in the surfacing and duration of symptoms. Usually symptoms evolve and vary in intensity over the course of a person's lifetime.
C. Perpetuating Factors

Because each person who develops schizophrenia has a different biochemical makeup and genetic history as well as a different set of psycho-social variables, perpetuating factors vary considerably. The behavioral symptoms will persist over time because schizophrenia is an disease for which no known cure exists. Symptoms may be managed through the use of medications but medications do not offer a definitive solution to the problem. Because schizophrenia is a brain disorder with concrete biological and possibly physiological signs, the disease is relatively unyielding to treatments. Interventions can reduce the tendency of the person to be a danger to themselves or to other people but in general will not eradicate the illness entirely.

The symptoms of the disorder may also vanish temporarily only to resurface at a later date. A resurfacing of symptoms may be due to environmental triggers such as