A schizophrenic child is unsettling for most people to think about, especially if all we know about the illness is what we see in Hollywood.

And while childhood-onset schizophrenia is rare, it exists. About one in 40,000 children is diagnosed with the illness. But before we can try to understand the illness in children, we need to begin to understand it in adults as well.

Like most things in Hollywood, the depiction of schizophrenia we see in movies and on television is very different from the reality of the illness.

Having multiple personalities—termed Dissociative Identity Disorder in the DSM—is not a by-product of schizophrenia. Schizophrenia is not synonymous with violence, either. And perhaps the one of the biggest misconceptions our society has about the illness is that it can’t get better; with treatment, it can usually be controlled.

About one percent of the population suffers from the illness. By itself, the illness can be very mild, but is easily exacerbated by trauma. It is not unusual for victims of physical or sexual abuse with a predisposition to the illness to begin displaying symptoms at some point in their lives.

But what are these symptoms? The biggest indicator of schizophrenia happens when a person begins to lose touch with reality. This can range from experiencing confusion and sometimes having trouble discerning dreams from reality, to the kind of extreme cases of schizophrenia often exploited in the entertainment industry. 

These extreme cases, which have usually gone untreated for long periods of time, involve the total warping of one’s perception of reality. A person with schizophrenia might confuse television or movies with everyday life, believe they are in constant danger, or see and hear voices and sounds that aren’t there.

In children, these symptoms manifest somewhat differently. Childhood-onset schizophrenia may begin with symptoms like not wanting to bathe, withdrawing and becoming more isolated, or having difficulty connecting with others. More noticeable and indicative symptoms are changes in speech and behavior patterns, hallucinations, and severe anxiety or fear about things that may seem odd.

We must keep in mind that the illness can take on many forms, and symptoms listed here can overlap with those of other mental illnesses.

Unfortunately, it is believed that the earlier the onset of schizophrenia, the worse it is likely to get. As with many mental illnesses, the best treatment is the combination of therapy and medication, and a supportive family life. Specialized programs (with school or community projects) can help moderate symptoms as well.

While there are many treatments for schizophrenia, the illness is chronic. In order to control the condition, which is usually accompanied by depression, people who suffer from the illness will require life-long treatment and support.

But research and treatments for schizophrenia in children and adults have made much progress in the past few decades, and the ability for people who suffer from the illness to lead a normal life has largely increased.

There are support groups for children with schizophrenia as well as parents with children who suffer from schizophrenia. They can be found both online and at many community health centers. More resources about schizophrenia in children can be found on the American Association of Child Psychiatry’s website, as well as Mental Health America’s resource page.