Symptoms & Signs of Schizophrenia

The only way to manage this illness is to identify it, diagnose it, and undergo professional and ongoing treatment.

Schizophrenia affects millions of people in the U.S. About one percent of the population lives with this condition¹, which impacts friends and family as well. It can occur at any age, but the average age of onset of symptoms is in the teens for men and early 20s for women.

What is Schizophrenia?

Schizophrenia is a mental illness and brain disorder that impairs one’s ability to recognize reality. It causes hallucinations and delusions, as well as abnormal thinking and behavior. The symptoms of schizophrenia can be very disabling, making it impossible for a person to stay in school, hold down a job or manage relationships. It can be treated effectively, but only if the signs are recognized and a professional diagnosis is made. Genetics, environment and brain chemistry are thought to be contributing causes of schizophrenia.

Positive Symptoms of Schizophrenia

There are various symptoms that are attributed to schizophrenia. These symptoms are usually not seen in healthy people, so they are called positive symptoms, meaning they did not have them before the onset of the condition.

• Hallucinations, which may be visual or auditory, are visions, voices or images that a person with schizophrenia believes are real. A common type of hallucination is a voice speaking to a person but that no one else can hear.
• Delusions can also trouble people with schizophrenia. These are beliefs that are persistent in spite of evidence that they are false. Delusions commonly take the form of paranoia or conspiracies.
• A person with schizophrenia may also exhibit abnormal behaviors, like acting severely agitated or even aggressive. They may act like a child at times or may move in ways that are unusual. Catatonia is also possible, where a person barely moves for an extended period.
• Disorganized thinking involves jumping or racing, illogical thoughts. Other people may observe this in someone with schizophrenia as disordered speaking or confusing communication that doesn’t make sense.

Negative Symptoms of Schizophrenia

The negative symptoms of schizophrenia are categorized together, they are disruptions from normal behavior or mood.

• A person with schizophrenia may seem to lack emotion. The affect, expressions and the way a person speaks may seem flat and emotionless.
• Lethargy, a complete lack of energy or willingness or desire to do anything, may prevent someone with this condition from getting anything done or engaging in activities they used to enjoy.
• Signs seen in people with depression are also typical with schizophrenia. These include lethargy and flat affect, as well as a lack of interest in activities or socializing, lapses in personal hygiene, and an inability or unwillingness to manage relationships or work and other responsibilities.

Cognitive and Mood-Related Symptoms of Schizophrenia

Schizophrenia also affects mood and the way a person thinks and sees the world and even oneself. The mood and cognitive symptoms are not always as recognizable as the positive and negative symptoms.

• Mood changes are common in schizophrenia. A person may swing from depression and sadness to excited cheerfulness very quickly.
• Cognitive problems, or difficulty thinking, are also fairly common. A person may have memory issues, find it difficult to focus or concentrate, or may find it impossible to stay organized.
• A person with schizophrenia may also experience something called anosognosia. This means that the person lacks awareness of his or her own illness. In other words, people with schizophrenia often don’t realize that anything is wrong or abnormal.

Signs of Schizophrenia in Children and Teens

For men, the onset of schizophrenia most often occurs in the teens, but for women not until their 20s. However, it is possible for anyone to begin to experience signs of schizophrenia at any age, even in childhood. Some of the earliest signs of schizophrenia in young children² are delays in language, unusual crawling habits, delayed walking and any unusual physical behaviors, like rocking.

Teens may experience any of the typical symptoms of schizophrenia that adults do, but they are also likely to exhibit some specific early signs of the condition. These early indications may include social withdrawal, difficulty sleeping, irritability, depression, difficulties at school, poor motivation, substance abuse and any unusual behaviors or changes in behavior.  Compared to adults, teens are less likely to experience delusions but more likely to have visual hallucinations.

Early Signs of Schizophrenia

Because it is very common for someone with schizophrenia to be unaware they are behaving or thinking in an abnormal manner, it is important for family to be aware of the signs of schizophrenia, especially early signs. Recognizing the signs can lead to a quicker diagnosis and getting the help a person really needs to feel better, sooner. Early signs of schizophrenia include:

• Social withdrawal
• Depression
• A flat gaze or expressionless face
• Inappropriate emotional responses, such as laughing at something sad, or no emotional response
• A deterioration in personal hygiene
• Changes in sleep habits
• Saying things that are irrational or odd
• Forgetfulness or inability to concentrate

Diagnosing Schizophrenia

Diagnosis of schizophrenia should be done by a trained mental health professional. Early identification and treatment of a mental health disorder is key to getting schizophrenia symptoms under control. To be diagnosed with schizophrenia, a person must exhibit at least two of the characteristic symptoms and the symptoms must persist for at least six months and cause significant impairment in a person’s life. Medication, cognitive-behavioral therapy and social skills training are just a few of the methods used to treat schizophrenia.