Schizophrenia - Faking it or Real?

My understanding is generally no. It’s more likely they would experience more typical side-effects of AP medication like Parkinsonism rigidity, sedation, dizziness, weight gain and metabolic syndrome. People will try to get ‘high’ on anything, however.

As a practical matter SZ is one of the least likely diseases anyone would fake. The drugs for it aren’t particularly ‘desirable’, the disease is difficult to fake convincingly and it carries profound stigma. Patients with SZ and SZA often get injectable antipsychotic medication anyway, so there’s nothing to use trade or sell. The only reason I could think anyone might attempt faking SZ would be for an extremely dubious attempt at an insanity defense. There’s a very high bar for proving legal insanity, and contrary to popular belief, you don’t go free in the unlikely event you succeed in being convincing. Generally people who make these pleas often get more time, not less. It could be a gambit to escape a death sentence, but these are rarely carried out and it’s unclear such a risk would be worth it.

I have a friend who works in a state mental hospital, and she says it’s far more common for people to fake depressive and anxiety disorders. The reason is they are easier to fake and treatment is better and more marketable drugs. The bulk of people who fake illness are prisoners who have learned to say the right things about being depressed and suicidal to get transferred to mental facilities they perceive as more pleasant than prison. Once they get there, they malinger and most of the staff see right through it, but it’s difficult to get rid of them once they are transferred.

Disclaimer: While I am a part-time caregiver of my brother and father with SMI, I was diagnosed with SZA over thirty years ago. I’m an advocate of appropriate drug treatments for SMI, but I feel they are incomplete treatments and additional CBT, supportive talk and psychosocial therapies are helpful where feasible. Any drug advice is from personal experience or research and not a substitute for qualified Psychiatric care.

REAL for them and hard to understand for the caregiver. ITS REAL!

The proof is by looking at their face and eyes and behaviors. You can’t fake – at least most people, I think – the sincerity with which they react to their voices and act on their delusions.