Recognizing the Signs and Symptoms of Schizophrenia

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Are you worried that you or a loved one might have schizophrenia? If so, you can help yourself or your loved one by staying calm and learning more about the signs and symptoms of the disease. Even if only one person in the family is diagnosed with the condition, the entire family is impacted. With early diagnosis and treatment, it's possible to manage the condition and greatly reduce its symptoms and abnormal behaviors.  

Don’t be misled by myths about schizophrenia. It does not mean you have a split personality. It does not mean you are dangerous or violent or will become homeless. Also, realize that schizophrenia affects only about 1% of the population. But, if a close family member has the condition, your chance of having it goes up. 

Schizophrenia is a chronic brain disorder that is hard to diagnose in its early stages. Symptoms usually begin between ages 16 and 30. Rarely do they start after age 45. Early symptoms may involve changes in behavior. These could include dropping friendships, losing interest in activities, or doing poorly in school. 

There is no single test for schizophrenia. Instead, a diagnosis comes from observing symptoms as they develop over time. That makes symptoms the key to diagnosis.

Doctors who treat schizophrenia divide symptoms of the disorder into three types: positive, negative and cognitive.  

Positive Symptoms

Positive symptoms are ones that involve “losing touch” with reality. These symptoms may come and go. Examples include: 

  • Hallucinations. This can include seeing, hearing, feeling or smelling things that are not real. The most common schizophrenia hallucination is hearing voices.
  • Delusions. These are false beliefs. For instance, paranoia is a delusion that people are trying to harm you.
  • Thought disorders. These are disorganized trains of thought. People with schizophrenia might lose their train of thought in the middle of a sentence. Or, they might forget words while speaking or make up meaningless words.
  • Movement disorders. These are abnormal body movements, like repeating motions over and over. They also include a complete lack of motion, called catatonia. It involves long periods of being still and not responding.

It is important to know that people with schizophrenia often experience their positive symptoms as real. They may not realize they have a problem. Friends and family members may be the ones who first recognize these symptoms. 
Other signs of schizophrenia are harder to recognize. Negative symptoms may seem like depression or confusion

Negative Symptoms

Negative symptoms involve a decreased ability to have normal behavior and emotions. They include: 

  • Not being able to carry out plans or finish activities
  • Loss of pleasurable feelings and emotions
  • Becoming withdrawn, silent and unemotional
  • Neglecting self-care such as not bathing

Cognitive Symptoms

Cognitive symptoms of schizophrenia are ones that show a decline in mental capacity. They include: 

  • Trouble understanding information and making decisions
  • Trouble paying attention
  • Poor memory

People with schizophrenia are more likely to smoke heavily and abuse drugs and alcohol. These behaviors are not symptoms or causes of schizophrenia, but they may make symptoms worse.  Also, it's important to know that drug use, other mental illnesses, and some medical conditions, such as metabolic and endocrine conditions, can cause symptoms that resemble schizophrenia. 

Get Help

It is important to get help if you or someone you know shows signs of schizophrenia. Earlier treatment means better results. Schizophrenia can be treated. Many people will get better with treatment and enjoy productive lives with only minor symptoms.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 2

  1. Schizophrenia. National Institutes of Health. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

  2. Help With Schizophrenia. American Psychiatric Association. https://www.psychiatry.org/patients-families/schizophrenia

  3. Schizophrenia. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia

  4. Schizophrenia Treatment. American Psychological Association. http://www.apa.org/topics/schiz/treatment.aspx

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