Schizophrenia is one of the medical sciences most misunderstood diseases, especially for laypersons, or people who have never had to confront the disease head on.

Schizophrenia is a chronic, psychiatric disorder that affects a person’s:

• Behaviors
• Thoughts
• Feelings
• Perceptions of reality

A person living with this disorder may experience periods in which they seem to have lost touch with reality. They may experience the world very differently than the people around them.

Researchers still do not know exactly what causes schizophrenia, but a combination of issues seem to play a role. Understanding the possible causes of schizophrenia can help clarify who might be at risk. It can also help you to understand what — if anything — can be done to prevent this lifelong, often baffling disorder.

Here are five of the known causes of schizophrenia.

1. Genetics

One of the most significant risk factors for schizophrenia may be genes. Schizophrenia does tend to run in families. If you have a parent, sibling, or other close relative with the condition, you may have a higher likelihood of developing it, too. However, researchers don’t believe that there is a single gene that is responsible for this disorder. Instead, they suspect a combination of genes can make someone more susceptible. Other factors, such as stressors, may be needed to “trigger” the disorder in people who are genetically predisposed to be are at a higher risk.

2. Structural changes in the brain

People who are diagnosed with schizophrenia, often may have subtle physical differences in the structure of their brains. But these changes aren’t seen in everyone with this disorder. They may also occur in people who don’t have a diagnosed mental health disorder. Still, the findings suggest that even minor differences in brain structure may play a role in this psychiatric disorder.

3. Chemical changes in the brain

A series of complex interrelated chemicals in the brain, called neurotransmitters, are responsible for sending signals between brain cells. Low levels or imbalances of these chemicals are believed to play a role in the development of schizophrenia and other mental health conditions. Dopamine, in particular, seems to play a role in the development of schizophrenia. Researchers have found evidence that dopamine causes an overstimulation of the brain in people with schizophrenia. It may account for some of the symptoms of the condition.

4. Difficult pregnancies or birth complications

Complications before and during birth may increase the likelihood a person will develop mental health disorders, including schizophrenia. These complications include:

• Low birth weight
• Infection during pregnancy
• Lack of oxygen during delivery (asphyxia)
• Premature labor
• Maternal obesity in pregnancy

Because of the ethics involved in studying pregnant women, many of the studies that have looked at the connection between prenatal complications and schizophrenia have been on animals. Women with schizophrenia are at an increased risk for complications during pregnancy. It’s unclear if their children are at an increased likelihood for developing the condition because of genetics, pregnancy complications, or a combination of the two.

5. Drug use

Using recreational drugs, including cannabis, cocaine, LSD, and amphetamines, doesn’t cause schizophrenia. However, research shows that the use of these drugs may trigger symptoms of schizophrenia in people who are more at risk.

Because researchers don’t completely understand what causes schizophrenia, there’s no sure way to prevent it. But if you’ve been diagnosed with this disorder, following your treatment plan can reduce the likelihood of relapse or worsening symptoms.