Written by:Bisma Anwar, MA, MSc, LMHC

Published On: June 27, 2022

Medically reviewed by: Minkyung Chung, MS, LMHC

Reviewed On: June 27, 2022

Updated On: June 7, 2024

Overview

If you’re wondering how to diagnose schizophrenia, the truth is that it can be a long and difficult process. However, it’s not impossible. Schizophrenia causes people to feel disconnected from reality. It’s a chronic brain disorder that alters how someone thinks and behaves. It can cause psychotic symptoms like paranoia, delusional thoughts, and auditory hallucinations like hearing voices. Overall, there’s a lot to this mental health condition.

Dealing with the symptoms of schizophrenia can be very challenging. This is, in part, because regardless of whatever delusions and/or hallucinations someone may be experiencing, they’ll generally have a very insistent belief that the things they think, see, hear, and feel are truly happening, even if they’re irrational. As a result, getting an accurate diagnosis, finding the best treatment option for schizophrenia, and gaining access to ongoing care are all essential to schizophrenia management.

It’s very important you do not attempt to self-diagnose schizophrenia. Instead, if you’re concerned you or a loved one may be dealing with this mental health condition, make a list of your symptoms and reach out to a doctor or mental health professional who knows how to diagnose schizophrenia for appropriate testing as soon as possible. If you are dating someone with schizophrenia, you can read our guide on how to best navigate the relationship and create a safe environment for both you and your partner to seek help for a diagnosis.

Since testing and getting schizophrenia diagnosed can take time, understanding the process can be helpful as you go through the steps. We’re discussing everything you should know if you think you might have schizophrenia. Read on to learn more about the diagnosis process and to see what you should do if you find out you or a loved one does, in fact, have schizophrenia.

Who Can Diagnose Schizophrenia?

Typically, psychiatrists who specialize in mental health and are trained to assess the mental and physical aspects of psychological conditions, are qualified to diagnose schizophrenia. In some cases, clinical psychologists, equipped with specific training in psychiatric disorders, can also conduct assessments. These professionals use a combination of clinical interviews, psychological evaluations, and medical examinations to ensure an accurate diagnosis, adhering to the criteria set forth in the DSM-5-TR. It’s crucial to consult these specialists for a reliable diagnosis, as they possess the expertise to differentiate schizophrenia from other mental health disorders.

Our psychiatric providers at Talkspace can make the process of getting a diagnosis and treatment for schizophrenia as accessible as possible. From the comfort of your own, you can connect with a mental health professional for evaluation. You can also receive continued assessment and guidance through online therapy, complementing the traditional diagnostic process. This approach not only aligns with the standards of psychiatric care but also provides a flexible, confidential space for you to understand and manage your condition from the comfort of your home.

How Is Schizophrenia Diagnosed?

Diagnosing schizophrenia is a comprehensive process that involves interviews, reviewing negative and positive symptoms, and observing behaviors. There’s a concrete diagnostic process for schizophrenia that’s detailed through criteria outlined in the American Psychiatric Association’sDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5-TR) — the standard diagnosis manual used by mental health professionals.

Diagnosis process

In the initial stages, schizophrenia typically involves declining functioning and mild psychosis. During this period, someone may begin having strange beliefs or bizarre perceptions. A diagnosis generally isn’t made at this point, until more distinct and obvious symptoms of psychosis emerge. Even then, a diagnosis would only come after dismissing all other possible causes for the psychotic symptoms being exhibited.

Doctors diagnose schizophrenia by performing a thorough physical exam and carefully reviewing family, psychiatric, and medical history. They’ll ask about any unusual experiences or distressing perceptions.

Other possible topics of conversation during diagnosis will likely include discussions about cognition, motivation, and life goals. A doctor will also look for any indications of self-harm.

DSM-5-TR criteria for schizophrenia

According to the DSM-5-TR, the diagnostic criterion for schizophrenia requires that someone demonstrates at least 2 of the 5 primary common symptoms, which include:

  • Delusions — false beliefs that aren’t based in reality
  • Hallucinations— seeing and/or hearing things that aren’t there
  • Disorganized or incoherent speech — disorganized speech often suggests disorganized thinking
  • Disjointed or other unusual movements — abnormal motor behavior or catatonic behavior
  • Negative symptoms — avolition (a near-total lack of motivation), diminished emotional expression, social withdrawal, lack of interest in the world and people around, and little or no sense of purpose are the most common negative symptoms

According to the DSM-5-TR, the strongest symptom that presents itself must be present for at least 1 month for a diagnosis to be made. Lesser symptoms will have been present for at least 6 months.

Further, the DSM-5-TR also states that an accurate schizophrenia diagnosis can’t be made unless significant disruptions to either professional, family, and/or social life are seen.

Tests that diagnose schizophrenia

There are no specific diagnostic tests for schizophrenia. A diagnosis must be made on a case-by-case basis. There are, however, several tests doctors might run to get a better picture of what’s going on with someone from both a physical as well as a mental health perspective. They can use test results to rule out other potential conditions with similar symptoms before determining if any specific symptoms are related to schizophrenia.

Some of these tests can include:

  • Magnetic resonance imaging (MRI)
  • Bloodwork
  • Urine analysis
  • Spinal tap (lumbar puncture)
  • Brain scans

“Usually, healthcare providers run tests such as magnetic resonance imaging (MRI), spinal tap, and blood and urine, to rule out other conditions before diagnosing schizophrenia. There are no specific diagnostic tests for schizophrenia.”

Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

MRI

MRI scans create 2- and 3-dimensional images of inner-brain structures. Doctors can use these images to rule out any brain anomalies that could cause symptoms that falsely present like schizophrenia.

Blood test

Analyzing blood can help a doctor rule out other reasons for symptoms. Things they might screen for through a blood test can include excessive alcohol and/or substance abuse, other physical health conditions, or any potential adverse side effects from prescription medication.

Essentially, they’re looking for anything that might be causing similar symptoms to what is common with schizophrenia. Bloodwork also allows your doctor to get a good picture of your nutrient and enzyme levels, which could also cause or exacerbate certain symptoms.

Electroencephalogram (EEG)

An EEG records electrical activities inside the brain. This test can help rule out other conditions that might mimic some of the schizophrenia symptoms, like epilepsy, for instance. EEGs are also one of the most common tests used in schizophrenia research.

How to Receive a Schizophrenia Diagnosis through Talkspace

If you have symptoms that resemble those of schizophrenia you should get answers without delay. With Talkspace it’s fast and convenient to connect with a mental health provider for an evaluation of your symptoms and, if appropriate, a diagnosis. 

Talkspace makes it affordable to receive schizophrenia diagnosis and treatment, with  online therapy and psychiatry plans that take insurance. Coverage for schizophrenia treatment will depend on your insurance company and health plan, but a typical copay is $25, often less. If your insurance doesn’t cover Talkspace, check with your employer to see if they cover Talkspace mental health services directly (many do), use an FSA/HSA card, or pay out-of-pocket at a cost that’s less than most in-person providers.

Here’s how it works:

  1. Get started any time by answering a few questions on the Talkspace website or app. You don’t need a referral for either therapy or psychiatric care.
  2. You’ll be connected with a therapist within about two days or a psychiatric provider within about a week. 
  3. If you choose to start with therapy you can message with your therapist as much as you like and also schedule live sessions. If you choose psychiatry you’ll schedule a live video session with your psychiatric provider.

Usually schizophrenia is most effectively treated with a combination of medication and talk therapy. Online therapy helps you manage symptoms and develop coping skills, while online psychiatry addresses the physiological basis or your symptoms, usually with a prescription for medication and ongoing medication management.

What to Do if You Get Diagnosed with Schizophrenia

To get an accurate diagnosis, schizophrenia symptoms must be assessed by a trained doctor or psychiatrist. Psychiatrists are specialized in and qualified to assess mental health conditions. Diagnosing schizophrenia is complicated and takes time. It’s important to remain committed to the process and to cooperate with your doctor’s requests.

If youdoreceive a schizophrenia diagnosis, there are several important things you can do when it comes to how to deal with schizophrenia, including:

  • Make notes for your doctor about any new or worsening symptoms
  • Comply with taking your antipsychotic medication or other schizophrenia medications as prescribed
  • See your doctor as recommended
  • Avoid alcohol and drugs
  • Seek support
  • Begin therapy for schizophrenia

“Treatment of schizophrenia is usually a combination of therapy and medication management. There are chances of better outcomes when there is early diagnosis and treatment.”

Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

Successful schizophrenia treatment plans that are most effective in managing the symptoms of schizophrenia involve a combination of antipsychotic medication and either in-person or online therapy.

Early diagnosis and treatment can result in significantly better outcomes for this challenging mental health condition, especially with schizophrenia in children. Don’t hesitate to contact your doctor if you think that you or a loved one is showing signs or symptoms of schizophrenia. Your doctor can refer you to the right psychiatric services for a full, comprehensive assessment.

It’s crucial that you take care of your physical and mental health, whether you have schizophrenia or not. Consider routinely practicing mindfulness meditation, getting daily doses of physical activity, journaling for mental health, eating healthy foods, staying hydrated, and maintaining a positive, motivated attitude.

Life with schizophrenia can be difficult. With the right schizophrenia treatment plan and support, though, it’s something you can gain control over, so you can have a rewarding and enjoyable life.

See References

Bisma Anwar, MA, MSc, LMHC

Bisma Anwar is the Team Lead for the Talkspace Council of Mental Health Experts. A major focus in her work has been anxiety management and helping her clients develop healthy coping skills, reduce stress and prevent burnout. She serves on the board of a non-profit organization based in NYC called The Heal Collective which promotes advocacy and awareness of mental health issues in BIPOC communities.

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