One common myth about schizophrenia, a mental health disorder, is that people with this diagnosis tend to be aggressive and even commit violent acts. That idea often comes from how schizophrenia is portrayed in the media. In movies and TV shows, people with schizophrenia are sometimes shown yelling at or hurting others. In addition, if a person with schizophrenia commits a violent crime, news stories often focus heavily on their diagnosis.

If you or someone you care about is living with schizophrenia, it’s important to understand how aggression and this condition are — and aren’t — connected. That way, you can make sure that you or your loved one gets the care they need to stay safe and well. In this article, you’ll learn more about when and why aggression might happen in people with schizophrenia.

How Common Is Aggression in Schizophrenia?

Research suggests that people living with schizophrenia may have a higher risk of becoming aggressive compared with the general population. In one study of almost 4,000 people diagnosed with schizophrenia, about 43 percent had been verbally aggressive. However, the study didn’t explain whether those individuals were on an effective treatment plan or if they were misusing drugs or alcohol — two factors that can make aggression more likely in people with schizophrenia.

People living with schizophrenia may have a higher risk of becoming aggressive compared to the general population.

It’s also hard to know just how common aggression is in people who aren’t diagnosed with schizophrenia. Many acts of verbal aggression — or even actions such as damaging property or cars — may go unreported to doctors, researchers, or the police.

It’s important to note that compared to those without the condition, people with schizophrenia are more likely to be harmed by others. They also tend to hurt themselves, rather than others around them.

Most people living with schizophrenia aren’t violent. Violence isn’t a core part of the condition. It’s wrong to assume someone will be dangerous or engage in aggressive behavior simply because they’ve been diagnosed with schizophrenia.

Possible Causes of Aggression in Schizophrenia

Aggression related to schizophrenia may be linked to a few different factors, including:

• Substance use or misuse — Using alcohol or drugs is the most common factor connected to aggression in schizophrenia.
• Lack of an effective treatment plan — This can include not taking medications for schizophrenia as prescribed.
• Genetic differences — Some people may have genetic traits that affect how their brain uses and processes certain neurotransmitters (brain chemicals) or handles stress.
• Brain function changes — Schizophrenia can affect how different parts of the brain work, which may influence emotions or behavior in some people.

People with schizophrenia are more likely to hurt themselves, rather than those around them.

As long as someone with schizophrenia is getting effective treatment and isn’t misusing drugs or alcohol, they’re no more likely to be violent than anyone else. If you’re concerned about aggression in yourself or a loved one living with schizophrenia, talk to a psychiatrist (a medical doctor who specializes in diagnosing, treating, and managing mental health conditions). They can help you understand how to monitor and manage these risk factors.

Warning Signs of Possible Aggression

There’s no sure way to know if someone will become aggressive or violent, whether or not they live with a mental health condition like schizophrenia. Still, certain signs may suggest an increased risk of aggressive behavior.

One risk factor is an early history of aggression. Some people who became aggressive later in life were diagnosed with conduct disorder — a condition linked to trouble following rules and to acting out or hurting others — as kids. This may mean that they didn’t learn how to manage emotions or recognize other people’s feelings by looking at their faces. Having conduct disorder also raises the risk of being mistreated, including later in life.

As long as someone with schizophrenia is getting effective treatment and isn’t misusing drugs or alcohol, they’re no more likely to be violent than anyone else.

Other signs to look out for include:

• Using or misusing alcohol or drugs
• Not taking responsibility for personal actions
• Having hallucinations (seeing visions or hearing voices that aren’t actually there) that encourage aggression
• Feeling paranoid or fearful without a valid reason
• Talking about hurting people (the more specific the details, the higher the chance of aggression)
• Focusing on aggression, death, or violent behavior
• Getting access to weapons or ways to hurt others
• Talking about feeling afraid or in danger
• Having a history of violence or aggression
• Experiencing new symptoms of schizophrenia (or the first episode of schizophrenia)
• Stopping or skipping treatment

If you notice any of these indicators in yourself or your loved one, reach out to a psychiatrist or mental health team right away. They can offer treatment and support to help reduce aggressive behavior and keep everyone safe.

Management of Aggression Related to Schizophrenia

There are several ways to help manage aggression in people diagnosed with schizophrenia. The most important step is to get effective treatment — and stick with it. If you or a family member is following a treatment plan but still experiencing aggression, it may be time to change medications. Clozapine (Clozaril) is an option that can help reduce aggressive episodes. Other antipsychotic medications and psychosocial options, such as therapy, may also help.

Avoiding alcohol and drugs is another key step. If an individual has a substance use disorder, treating that condition can help lower their risk of aggression.

If you’re living with someone who is acting aggressively, you can take action in the moment to help calm the situation. You may have to use these techniques before getting medical help or making treatment changes. You can try:

• Giving the person extra physical space — Step away or leave the room or home to avoid an unsafe confrontation.
• Staying calm and supportive — Speak in a steady, clear, and gentle voice, and don’t confirm or challenge what they say or believe to be real.
• Getting help — Call a local mental health crisis team or 911 if there’s a risk of violence.

If you’re concerned about safety, especially the risk of self-harm or violence, call the Suicide and Crisis Lifeline at 988 for immediate support.

Talk to a Doctor if You’re Concerned About Aggression

If you or a loved one is showing signs of aggression related to schizophrenia — or you’re worried it might happen — it’s important to talk to a mental health professional, such as a psychiatrist. They can do a risk assessment to help determine if someone with schizophrenia is in danger of being aggressive. A healthcare provider who is trained and skilled at understanding schizophrenia can help ease your worries and make sure that person with this condition gets the right treatment and support.

They can also help if you or your loved one has been a victim of aggression or violence. You don’t have to handle these situations alone. Your healthcare team can provide the support you need to heal and stay safe in the future.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and their loved ones. On MyDepressionTeam, more than 150,000 members come together to ask questions, give advice, and share their stories with others who understand life with depression and other mental health conditions.

Do you have any experience with aggression connected to schizophrenia? What steps did you take to address the situation or get help? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.