The Biology of Schizophrenia

Schizophrenia and bipolar disorder are brain disorders. They are fundamentally different from psychological disorders such as anxiety disorder, PTSD, or mild depression. They are physical illnesses. Schizophrenia is a wasting disease of the brain. On an MRI you can see decreased volume of the gray matter, with increased volume of the cerebral spinal fluid, enlarging the ventricles. Schizophrenia is like ALS (amyotrophic lateral sclerosis, aka Lou Gehrig’s disease), which is a wasting disease of the brain and spinal cord. 

The good news is that with schizophrenia if you start appropriate treatment early enough, you can arrest the disease process. But getting in early means starting the right treatment at the beginning of the illness, with the first psychotic episode if not before. The more months that pass with untreated psychosis the worse the prognosis is.