Signs & Symptoms of Schizophrenia

Conditions Under the Schizophrenia Spectrum

Alongside the different types of schizophrenia, there are conditions that fall under the schizophrenia spectrum. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, or the DSM-5 classifies these as disorders in the schizophrenia spectrum:

• Schizophrenia
• Schizotypal personality disorder
• Delusional disorder
• Brief psychotic disorder
• Schizophreniform disorder
• Schizoaffective disorder
• Catatonia
• Other schizophrenia spectrum disorders

Signs of Schizophrenia

People with schizophrenia usually first exhibit schizophrenic symptoms in their late teens to early 20s. It’s rare for very young children or people older than age 40 to be diagnosed with the disorder or first see their symptoms at those ages.

Signs of schizophrenia include:

• Hallucinations
• Delusions
• Grandiose ideas
• Becoming overly excited for no reason
• Memory problems
• Lack of emotional expression
• Confused thoughts and disorganized thinking
• Extreme changes in thoughts and behavior
• Negative symptoms like withdrawal and isolation — this includes withdrawing from friends, family, and activities that were once enjoyable

Symptoms of Schizophrenia

Mental health professionals categorize symptoms of schizophrenia into two arenas — positive and negative symptoms.

Positive symptoms

Positive schizophrenic symptoms are loosely defined as changes in thoughts or behaviors. These are new thoughts, like suddenly believing that people on television are listening to what you’re thinking, that the FBI is out to get you, or that someone is following you.

Hallucinations

Hallucinations can be either visual (seeing things that aren’t there), auditory (hearing voices that aren’t real), or both. For someone with psychosis from schizophrenia, hallucinations seem very real. They often have difficulty telling them apart from actual experiences. Understandably, hallucinations can be frightening and disorienting for the person experiencing them.

Delusions

Delusions (false beliefs that aren’t based in any sort of reality) are when someone with psychosis from schizophrenia believes things that aren’t real are actually happening. For example, some delusions include believing they’re an important political figure, that a movie star they haven’t met is in love with them, or that a major catastrophe is about to occur.

They can also include things like paranoid delusions, where someone believes their private thoughts are being broadcasted, someone is spying on them, someone is out to get them, or there are special messages specifically for them in ordinary items. Delusions can begin suddenly, or they can gradually develop over weeks or months.

Confused thoughts and disorganized thinking

A type of cognitive symptom, schizophrenia can cause what people describe as confused thoughts, like a haze being cast over their thinking. They might even believe that someone is stealing their thoughts. A sign of this positive symptom is being unable to follow the plot of a television show or the main point of a newspaper article.

Behavior and thought changes

People with schizophrenia often have confused, disorganized speech. This means that when they talk, they don’t make much or any sense. In addition, they may behave in bizarre or unusual ways, like making sudden faces, striking unnatural poses, or becoming very silly or extremely agitated for no reason.

Negative symptoms

Negative symptoms, unlike positive symptoms, are actions and thoughts that should be present but aren’t. For example, seeming withdrawn rather than engaged, having no interest in social surroundings, or looking “flat” or emotionless. If you’re wondering what are the symptoms of schizophrenia, these are a few of the negative things you want to be aware of.

Withdraw from the world

A common schizophrenia negative symptom is social withdrawal, where someone stops engaging with friends and family and seems to find little pleasure in activities they once enjoyed. They may begin spending the entire day in bed, start avoiding eye contact with others, or suddenly neglect personal hygiene.

Lose interest in everyday social interactions

People with negative schizophrenia symptoms might have little interest in social gatherings. Their attempt to avoid engaging in the world around them can go so far that they might even stop answering the telephone or the door.

Appear emotionless

A common negative symptom of schizophrenia is the absence of outward emotion. People with schizophrenia are often described as having a blank face with no expression. The term “flat” is used, as they might speak in a monotone voice and may not express much, if any, emotions (like laughing or crying). They also may not make any attempt to carry on a conversation.

Managing Symptoms of Schizophrenia

It’s important to note that schizophrenia isn’t “curable,” and exact schizophrenia causes are largely unknown. It is, however, very treatable, and most people can successfully manage their condition and go on to live very rewarding, fulfilling lives. That said, learning to cope with schizophrenia is a lifelong endeavor.

Several types of treatment are available to help people better manage the symptoms of schizophrenia. The most commonly used techniques are psychotherapy and medication. In addition to those, support and self-help tools can also be essential components of any successful treatment plan.

Psychotherapy, also called talk therapy, teaches people with schizophrenia ways to deal with their symptoms and better engage with the outside world. Therapy for schizophrenia can also be useful in helping manage stress, which is a common trigger for schizophrenia symptoms.

Talk therapy for schizophrenia is usually done in one-on-one sessions with a therapist, however, sometimes, regarding how to help someone with schizophrenia, family members or close friends will join to learn how they can better support a loved one. When it comes to treatment for schizophrenia without medication, either in-person or online therapy is the way to go.

Medication is often used in conjunction with psychotherapy. Common medications to treat schizophrenia include 2 classes of drugs — older generations of antipsychotics drugs (known as typical antipsychotics) and the newer versions, which are referred to as atypical antipsychotics. No one medication will be right for everyone, though, so patience will be key in finding the most effective treatment plan.

Atypical antipsychotic medication will generally be tried first, as these newer medications can have less severe side effects and often be more effective at treating psychotic symptoms. However, in cases when they’re not working, typical antipsychotics can also be tried.

• Typical antipsychotics:
  • Haldol (Haloperidol)
  • Loxitane (Loxapine)
  • Navane (Thiothixene)
  • Prolixin (Fluphenazine)
  • Thorazine (Chlorpromazine)
  • Trilafon (Perphenazine)
  • Stelazine (Trifluoperazine)
• Atypical antipsychotics:
  • Abilify (Aripiprazole)
  • Fanapt (Iloperidone)
  • Geodon (Ziprasidone)
  • Invega (Paliperidone)
  • Latuda (Lurasidone)
  • Risperdal (Risperidone)
  • Rexulti (Brexpiprazole)
  • Saphris (Asenapine)
  • Seroquel (Quetiapine)
  • Vraylar (Cariprazine)
  • Zyprexa (Olanzapine)

A common issue with treating schizophrenia is difficulty ensuring someone continues to take their medication consistently. Many times, when they start feeling better, people will discontinue their meds, believing they no longer need them. Most of the time, though, this results in the return of symptoms, sometimes with a vengeance.

Self-help techniques and self care is often recommended in schizophrenia treatment plans. Getting enough sleep, eating a healthy diet, working out, and doing things like meditating and journaling can all be beneficial, both mentally and physically.

When to Seek a Professional

It’s important to seek professional help when you first notice signs of schizophrenia, either in yourself or in someone you care about.

Early treatment vastly increases the chances for someone with schizophrenia to improve and have a better quality of life. Sometimes people with schizophrenia are unaware of their condition. In these cases, it can fall on a family member or close friend to help them find schizophrenia treatment.

A primary care physician can connect you with a psychiatrist, psychologist, or therapist who has experience in treating schizophrenia successfully. The most important thing to remember is that this is a treatable condition, and you deserve to get the help that’s out there. Don’t wait — reach out to find guidance and support in managing symptoms of schizophrenia.