Hello, My great Uncle suffers from schizophrenia, although I’m not sure what type (whether it’s paranoid, catatonic, etc.) It was brought to my attention that I [apparently] display some early symptoms of schizophrenia, though personally I believe it’s not so.

Some of these symptoms included anxiety, lack of motivation, social isolation, “stone faced” or expressionless, inability to differentiate dreams from reality (for things that happened up to 5 years ago), and so on.

Could they be right? Or is it nothing to worry about, just something that comes with age?

A. No one has determined conclusively that schizophrenia is genetic. There are still many theories about what causes schizophrenia but no one theory has been proven to be the cause. The prevailing theory is that schizophrenia is a brain disease. It is also believed, by many scientists and researchers, that stress and environment can play a major role in the development of schizophrenia.

Research shows that individuals who have relatives with schizophrenia are at an increased risk for developing the disorder. It is important to note that the increased risk is slight. Having a relative with the disease in no way guarantees that other family members will develop it. Again, the risk is slight and its development depends on many factors.

Some of the symptoms you have described are associated with both schizophrenia and schizotypal personality disorder. Anxiety is one such example as is social isolation. Lack of motivation, in the context of schizophrenia, would be considered a negative symptom of the disorder. Negative symptoms are characteristics of an individual’s behavior that should exist but do not.

Schizotypal personality disorder is characterized by a lack of social interaction and extreme anxiety in social situations. Individuals with this disorder tend to keep to themselves. They don’t have many or any close friends. They are very shy and have difficulty interacting with other people. They sometimes believe that they have special or magical powers.

Schizophrenia is similar to schizotypal personality disorder. In fact, it is most closely linked to schizophrenia, when compared to all the other personality disorders. The main difference between schizotypal and schizophrenia is that the individual with the personality disorder, for instance, may believe that other people are talking about them (ideas) versus the individual with schizophrenia who knows it’s true because they remember it happening (delusion).

The inability to express emotions, “stone faced or expressionless” might be considered a symptom called flat affect. Flat affect refers to an individual’s inability to show or to feel appropriate emotions.

You also mentioned having trouble with differentiating dreams from reality. You asked whether that is something that “comes with age?” I am not certain that I fully understand this question, however, it is abnormal to lack the ability to distinguish between dreams and reality. That symptom might be a reference to psychosis. Psychosis is a break with reality. Essentially, it is the belief in thoughts or ideas that are not real.

I cannot determine whether you have either disorder or any disorder. That determination would need to be made by a mental health professional who could evaluate you in person. I would highly recommend having a psychological evaluation. The “find help” tab could assist you in locating a mental health professional in your community. I wish you the best of luck.

Dr. Kristina Randle