One of the most important factors in a novel, especially fiction, is that facts are correct. If they aren’t, there must be logical reasoning for why the author chose to deviate from realistic expectations. Take Superman as an example. There’s an explanation available for why he’s able to bounce bullets off his chest and laser criminals with his eyes: he’s an alien who gains power from the sun.
That’s why when I started with the new idea for a book where the main character has schizophrenia, I wanted to make sure I got it right. It wouldn’t make sense to portray a medical illness in a different light than what it is. Schizophrenia is a medical affliction I wouldn’t understand, and if I want to write about a character who suffers from it, then I need to do research!
5 facts of Schizophrenia – AJ Research for a WIP (Work in Progress)
1. There’s a lot more to schizophrenia than hallucinations

(In reference to the chart, a positive symptom is a trait which you don’t want but you have, and a negative symptom is a trait which you want but don’t have.)
When I first thought of schizophrenia, the image that came to mind was from the movie A Beautiful Mind. In the movie, the main character played by Russell Crowe (John Nash) has hallucinations of imaginary friends. But what I didn’t catch is what the movie was accurately trying to display: schizophrenia more often than not comes with paranoia and emotional suppression. I believe if I had read the book I would have gotten what the story was trying to express better, but in the movie it was difficult for me to catch the other side of schizophrenia, the things that are more than just visual and auditory hallucinations. A schizophrenic might believe himself at the center of conspiracy or a prophet. It may be difficult to express emotion since the afflicted is overwhelmed with anxiety, fear, and worry.
Michael Hendrick, an advocate for helping people to understand an illness for which he’s diagnosed, describes his symptoms here as extreme paranoia where “if you’re sitting in a coffee shop … and you hear someone laugh, there’s a part of you that thinks they’re laughing about you or that they’re making fun of you.” Before medication, that creeping thought would devour him, but with treatment it can be a momentary flash and something he’s able to let go.
2. Symptoms of schizophrenia don’t typically manifest until later in life. If schizophrenia does have early-onset, the experience can be largely different than schizophrenia experienced by adults.

Here’s an interesting article on what schizophrenia can be like for a teenager.
Adolescent manifestation of schizophrenia is actually rare. Schizophrenia tends to develop in the early to mid-20s for males, and late 20s for females. (Source) This is important for a writer to know because the age of the main character plays an important role in the book.
It’s a simple understanding like this that would have made my book a poor representation of someone experiencing schizophrenia if I have my main character as a 16-year-old experiencing the type of schizophrenia only prevalent in adults. I would be prone to choose a 16-year-old character in order to tick the “YA” box for literary agents, which is popular right now, but without knowing what that would mean for someone who actually has schizophrenia, I would have sacrificed the more important element of realism. Not to mention aggravated readers who have real-life experience with schizophrenia and would know that I was getting it wrong.
3. Someone with schizophrenia will likely experience psychosis rather than having consistent symptoms, depending on the individual
When I would think of schizophrenia before my research, I imagined it was a constant affliction with voices in your head and imaginary people telling you to do things. While true, it’s not that simple. There are degrees of how bad things get. Elyn Sak’s husband describes it as a dimmer. (Source) Sometimes an irrational thought will sweep in and it can be pushed aside, other times things can spiral out of control to the point where one can lose their grip on reality.
Losing one’s grip on reality would be called psychosis, or a psychotic break. What I find most interesting about this aspect of schizophrenia is that the onset of psychosis should be, or could be, triggered. Usually some form of stress, even minute, can trigger the domino effect that leads to psychosis. This is an element I can add to terrorize my main character to give a realistic psychotic break and responses to how she will have to deal with it, just like anyone else with schizophrenia. This could mean she will seek out a source of strength to bring her back to reality, or emergency medication. If I hadn’t done my research, there would be a whole scene left out of something like this happening that makes the character real and fleshes out the story.
4. Schizophrenia is not as rare as one might think.

This chart really blew me away. I didn’t realize how much more prevalent schizophrenia was than MS, Alzheimer’s, or Diabetes, all of which I’ve personally dealt with through people I knew. If I’ve experienced these disorders, how many more have experienced the struggles of schizophrenia? Knowing this, I need to tread all the more carefully to represent an individual suffering from schizophrenia in a correct light (not that I didn’t wish to do that anyway), but also proceed with the knowledge that the illness is actually more common than I’d realized.
5. Schizophrenics are people who can overcome their illness and accomplish amazing things.
After this research, I’m most interested in Elyn Saks, a fascinating woman with what should be a debilitating level of schizophrenia who has written a New York Bestseller Memoir and is an esteemed professor, lawyer, and psychiatrist. She has learned to overcome the illness and thrive. I want my main character to be a woman like Elyn, not only a functioning schizophrenic, but one who excels at life.
Thanks for joining me on this journey to make a well-written and well-researched novel. If you’d like to read books that have characters with schizophrenia, I invite you to join me in reading from the following list:
Genre: Mystery/Thriller (Published by one of the Big 5 – Macmillan)
First published in 1964, I Never Promised You a Rose Garden is considered a Classic Bestseller and while you could watch the movie, I’d suggest the book to get the most out of the experience.
Genre: Memoir (Published by one of the Big 5 – Hachette)
Elyn Saks experienced her first episode at age 16 and went through years of struggle with schizophrenia. She’s come out on top as an esteemed professor, lawyer, and psychiatrist. I’m looking forward to reading this one, even though memoirs are not usually my thing.
Genre: Biography (Published by one of the Big 5 – S&S)
A Beautiful Mind is the story of a brilliant mathematician who made fundamental contributions to game theory, differential geometry, and the study of partial differential equations. While you can watch the movie, you’ll miss the important details that can be found in the book.
Borderline (The Arcadia Project)
Genre: Fantasy Thriller (Published by one of the Big 5 – S&S)
While Borderline doesn’t have schizophrenia, the main character suffers from a mental illness called borderline personality disorder and must police traffic to and from a parallel world with creatures out of myth and fairytales. I’ve purchased the audiobook version and am excited to “read” it! I think this will be a valuable resource for the kind of book I wish to write.
Through my research, I’ve found a handful of fantasy and sci-fi books that have schizophrenic characters, but they weren’t published by the Big 5, which is a target for the novel I’m working on. So if you know any good examples, please leave them in the comments. Thank you!