High-Functioning Schizophrenia: Diagnosis, Symptoms & Treatment

What is High-Functioning Schizophrenia?

High-functioning schizophrenia describes when people are diagnosed with schizophrenia and experience symptoms of the mental health condition, but they’re largely able to maintain a high level of function in their daily lives, often with little intervention or support. Symptoms tend to be much more subtle, and while hallucinations, delusions, and disorganized thinking can still be present, they’re typically milder in form.

Recognizing the spectrum of symptoms in schizophrenia highlights the challenges faced by individuals with high-functioning schizophrenia. These individuals often manage jobs, relationships, and other responsibilities more effectively than those with severe symptoms. Understanding their daily routines and life allows for the development of personalized interventions aimed at enhancing their well-being.

Symptoms of High-Functioning Schizophrenia

Symptoms of high-functioning schizophrenia can include subtle manifestations, like very mild hallucinations or delusions that might not be obvious to others. There can also be cognitive and emotional symptoms as well. Negative symptoms like social withdrawal, disorganized speech, disorganized thinking, and a flat affect — feeling emotions but not showing any indication — can be less clear but still present.

It’s important to note that while symptoms of high-functioning schizophrenia might be less intense or obvious to others, they still have an impact on daily functioning, social functioning, and interpersonal relationships. 

Diagnosing High-Functioning Schizophrenia

Diagnosing high-functioning schizophrenia requires a comprehensive evaluation of symptoms that a qualified mental health professional completes. This kind of schizophrenia diagnosis requires careful attention to less apparent symptoms, like mild hallucinations or delusions. To rule out other psychiatric conditions and guide the best approach to treatment, it also necessitates a full examination of functional impairments, including work, relationships, and the ability to practice self-care.

Challenges in diagnosing high-functioning schizophrenia

Accurately diagnosing high-functioning schizophrenia might be difficult in some cases. This is primarily because even symptoms may not be overtly obvious. 

Common challenges to making a diagnosis include:

• Subtle symptoms: Hallucinations, delusions, and cognitive impairment may be much less pronounced.
• Symptom variability: Symptoms can widely fluctuate in intensity and frequency. Some people even have periods of relative stability.
• Patient insight: Because symptoms can be less pronounced, it’s common for some people with high-functioning schizophrenia to have limited awareness about their mental health condition. They might even rationalize or minimize their symptoms or believe they’re due to external factors, not a psychiatric cause.
• Denial: It’s not uncommon for people with high-functioning schizophrenia to deny they have symptoms for any number of reasons, including fear, an intense desire to maintain a sense of normalcy, or simply being resistant to seeking help.
• Stigma: While we’ve made great advances toward destigmatizing the topic of mental health, there’s still an obvious stigma surrounding mental healthcare that can cause feelings of shame or embarrassment. Fear of being labeled prevents some people from admitting they have symptoms or seeking support.

Diagnostic criteria & process

Diagnosing high-functioning schizophrenia involves symptom assessment. The process essentially follows the diagnosis criteria as outlined in the DSM-5. The manual emphasizes assessing specifics like:

• Duration
• Severity
• Impact on social occupation or other areas of functioning
• Comprehensive evaluation
• History
• Observation
• Results from psychological testing

How to Treat High-Functioning Schizophrenia

Treating high-functioning schizophrenia requires a multifaceted approach. The ultimate goal is to manage symptoms and improve functional outcomes while promoting overall well-being. A comprehensive treatment plan most often uses a combination of psychotherapy, medication, and psychosocial interventions that are individualized based on personal needs and preferences.

Schizophrenia treatment usually requires collaborative care involving a therapist, psychiatrist, and other support systems aimed at helping someone find a balance with their symptoms and condition.

Schizophrenia medications

Medication is often used to treat schizophrenia. Types of schizophrenia medication include:

• Atypical and typical antipsychotics — usually the first line of treatment.
• Antidepressants — often prescribed in cases where depression is comorbid with schizophrenia.
• Mood stabilizers — less common but might be prescribed in some cases.

Therapy

Several types of therapy are effective in treating high-functioning schizophrenia. Some of the more common types of therapy for schizophrenia include:

• Cognitive behavioral therapy (CBT) — focuses on identifying and changing unhealthy thought and behavior patterns. It can be effective in treating high-functioning schizophrenia.
• Cognitive enhancement therapy (CET) — can be helpful for people with stable symptoms who might need to improve social or vocational skills.
• Psychosocial therapy — combines various aspects of psychotherapy and vocational and social training.

Living with High-Functioning Schizophrenia

People often live independently and successfully with high-functioning schizophrenia. Doing so can involve learning to navigate daily challenges in a stable and healthy way and following a specialized coping strategy. 

Tips and coping tools for living with high-functioning schizophrenia include:

• Establishing routines and daily schedules
• Using your support networks
• Practicing self-care
• Monitoring your symptoms and communicate any changes with your healthcare team
• Being realistic with your goals
• Knowing which coping strategies work best for you
• Being vigilant with your medication adherence
• Engaging in meaningful activities you enjoy
• Educating yourself about treatment options
• Using complementary natural ways to treat schizophrenia
• Addressing stigma and stereotypes about high-functioning schizophrenia

Find Help with Online Schizophrenia Treatment

Schizophrenia can be challenging to deal with, even when it’s high functioning. That said, support and treatment can be game-changers in helping you deal with schizophrenia. Online schizophrenia treatment from platforms like Talkspace makes treatment hassle-free, accessible, and affordable. Talkspace offers convenient online scheduling so you can get help with high-functioning schizophrenia symptoms when, where, and how you need it.

Connect with an online therapist or psychiatrist from Talkspace today to learn how you can live with functional schizophrenia and have the most healthy, happy life possible.