@mathanxiety
Severe paranoid schizophrenia is a condition that is profoundly disabling because the person suffering from it is incapable of engaging with reality a lot of the time.
It is a mental illness that affects every aspect of a person's life - interpretation of official communications, ability to engage with medical providers, ability to maintain family relationships, ability to engage with bureaucracy, and ability to hold down any sort of job.
Paranoid schizophrenics are notoriously non-compliant with medication use and their condition is usually very poorly controlled if at all. This is due to the nature of the illness. It's a vicious circle.
I have had experience of this condition with 2 people I knew personally. It can be controlled with medication, but not cured.
The problem is that the persons I knew would take their medication for so long then decide that, because they felt better, the didn't need it any more. So they stopped taking it. This lead to psychotic breakdowns requiring them to be hospitalised in secure units for their own protection.
So, this condition is notoriously difficult to treat. In persons with schizophrenia, antipsychotic medications often provide dramatic symptomatic relief for hallucinations and delusions, and improvement for disorganized thoughts and behaviour. However, because they are associated with a multitude of adverse effects, some of which are medically serious and many of which affect patient attitudes toward treatment, discussions about these medications are often dominated by their side effects rather than their benefits.