• American Indians and Alaska Natives, like other persons, suffer and array of illness, including serious mental illness such as schizophrenia, manic-depressive illness, and severe depression. 

What Increases Your Risk
You are at higher risk for developing schizophrenia if you:

• Have a mother, father, or sibling with schizophrenia (genetic predisposition). However, having a relative with schizophrenia does not mean you will develop this disorder; many people have schizophrenia who do not have a relative with this condition, and many people who have relatives with schizophrenia will not develop this condition.
• Have another disorder that is like schizophrenia (such as schizotypal personality) or have family members with such a condition.
• Had a brain injury during fetal development, or complications at the time of birth (such as a lack of oxygen).
• Had a childhood head injury, especially if you have a family history of schizophrenia.
• Were exposed to a viral infection, malnutrition, or medications (diuretics) used to control a mother's high blood pressure prior to birth.
• Were born during winter. People born during winter have a slightly higher chance of developing schizophrenia than people born at other times of the year. One explanation for this is that people born during the winter months may have been exposed to a viral infection during the last part of their mother's pregnancy.
• Have a substance abuse problem. It is not yet clear whether the abuse triggers schizophrenia or whether a person with schizophrenia is more likely to have a substance abuse problem.
• Have a father who was over age 50 when you were conceived. It is not yet clear why the age of the father may put you at higher risk; research is ongoing to better understand and prove this risk factor.

Negative symptoms include:

• Inability to experience pleasure. This is a common symptom in schizophrenia and includes difficulty enjoying activities that once brought pleasure, such as playing golf or visiting with friends.
• Lack of emotion. This can lead to few friendships or social contacts. Showing little facial expression, having poor eye contact, and slowed speech are characteristic.
• Loss of motivation to succeed or accomplish goals. Job or school performance problems are common and usually due to an inability to complete tasks or goals.
• Problems focusing or paying attention, difficulty processing information, confusion, and fragmented thoughts.

There are three phases of disease progression: prodromal, active, and residual.

Prodromal phase

• Negative symptoms (such as lack of emotion or motivation), which may appear suddenly or slowly over time
• Social withdrawal
• Poor hygiene, such as wearing dirty clothes or not bathing
• Loss of interest in school or work
• Outbursts of anger
• Unusual or out-of-character behavior
• Anxiety
• Confusion or confused speech
• Terror or unreasonable fear of something or someone
• Depression

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