Apathy, eccentric behaviors and appearance, and social withdrawal are some of the most common symptoms of schizotypal personality disorder as per the DSM-5.

Living with schizotypal personality disorder is unique for each person. But, in general, you may have feelings, thoughts, and behaviors that others describe as unusual, eccentric, or atypical.

This personality disorder is also characterized by symptoms like:

  • odd beliefs and behaviors
  • distorted perceptions
  • relationship challenges

Schizotypal personality disorder exists in the same group as schizoid personality disorder and paranoid personality disorder, together known as the “cluster A” category.

Schizotypal personality is likely caused by a combination of factors, like:

  • genetics
  • childhood experiences and bonds
  • environmental factors
  • social influences

The treatment options include therapy, social skills training, and medication for overlapping symptoms like depression.

There are nine symptoms outlined in the reference guide that professionals use to make a diagnosis, called the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

To receive a formal diagnosis, five or more of these schizotypal symptoms must be evident across different situations and persistently over time:

1. Ideas of reference

If you’ve ever seen the movie “The Truman Show,” about a man who’s unknowingly the protagonist in a live broadcast, it may help explain what it feels like to have ideas of reference.

These are the belief that external situations are somehow tied to you in a meaningful way, when they may actually be random or unrelated. For example, you may read an Instagram caption from your favorite musician and believe it’s a message for you.

Ideas of reference are similar to delusions with schizophrenia, although they’re not fixed or unchangeable. When you have a schizotypal personality, you may be aware of these thoughts and entertain other logical explanations when offered.

2. Odd beliefs

In this case, “odd” refers to things that differ from cultural norms.

Odd beliefs can include superstitions and magical thinking, which is when you link two unrelated factors together and behave in a way that supports that view.

For example, you may feel that you must stay awake on a plane and concentrate on keeping it in the air, or it’ll crash. Or perhaps you believe you have extra senses, like the ability to read minds or influence the weather.

3. Perception distortions

You may have perceptions that alter the way you see the world, and that may make you see things in a way that others don’t share.

For example, you may see shadows or movements in your peripheral vision, or sounds that others don’t pick up on. These distortions can be similar to hallucinations, but may not be as intense or persistent.

You may also be able to understand these perceptions are distorted and not real, which helps distinguish the experience from an episode of psychosis.

4. Odd communication

In this case, “odd” refers to communicating in a way that’s distinct from others. You may find that you have a hard time relaying your ideas in a way that people can understand.

One older study of 28 people with schizotypal personality disorder noted a few speech patterns that differed from the control group. These included:

  • fewer expressed emotions
  • increased pauses
  • monotonal (less variability)
  • slower rate of speech

5. Paranoia

Feelings of paranoia can make it difficult to detect people’s motives or how they feel about you. For example, you may feel suspicious that your co-workers are trying to get you fired, or your therapist is recording sessions to post online.

6. Inappropriate affect and apathy

In this context, “inappropriate” refers to a reaction that’s atypical and unexpected for those around you.

For example, others around you may be laughing at a joke. Even if you find it funny, the reaction on your face may be “blunted” or non-expressive. This is known as a flat affect.

7. Odd behaviors

Everyone is unique. With that said, you may have noticed that your mannerisms, body language, and appearance are significantly distinct from most others. For example, you may dress in a way that your peers consider to be “eccentric.”

This may include:

  • unusual hairstyles
  • wearing bright colors that don’t match
  • using combinations of bold patterns

8. Social isolation

Research suggests that when you live with schizotypal personality disorder, you may feel less drawn to forming social relationships than others. For example, you may prefer solitude, while others around you are dating and going to events.

This could be explained, in part, by finding it difficult to communicate with other people and differences in the way you express yourself.

9. Social anxiety

In social situations, you may have a vague sense that you’re somehow different from those around you, like an outsider looking in. For example, you may have a hard time forming close relationships at work or with peers at school. Just the thought of it might cause signs of anxiety.

You may also experience social anxiety symptoms even around those you are familar with, like family members or people you’ve known your whole life.

What does schizotypy mean?

Reality is not quite as simple as “sane” or “psychosis” — this or that, black or white.

Instead, schizotypy is an umbrella term used to describe the continuum of behaviors that may help predict a schizophrenia diagnosis or schizophrenia‐related psychopathology, including:

In order to receive a diagnosis of schizotypal personality disorder, a professional will use the nine formal symptoms outlined in the DSM-5-TR as a starting point.

Through a series of evaluations, they’ll determine if at least five of the nine symptoms are present in your case, particularly in a range of different scenarios.

This is because a personality disorder is considered a persistent pattern of behavior that spans multiple (or all) areas of your life, including:

  • relationships
  • home
  • work
  • school
  • hobbies

If specific symptoms appear in some scenarios, but not others, a professional may say you have schizotypal traits instead of a personality disorder.

Unlike others in the cluster A camp, schizotypal personality disorder is categorized in the DSM-5 as both a personality disorder and a condition on the schizophrenia spectrum. Medical experts still have not reached a consensus about where, exactly, this diagnosis belongs.

While many symptoms do overlap, not all people diagnosed with schizotypal personality disorder meet the diagnostic criteria for schizophrenia, or go on to develop schizophrenia later in life.

Schizotypal personality disorder has nine formal symptoms including social withdrawal, eccentric appearance, odd communication patterns, and distorted perceptions of the environment.

Symptoms can range in severity. But, in general, they’re evident across multiple areas of your life.

Treatment is available and effective in helping you manage some of the symptoms. Finding a therapist may be the first step. They’ll work with you in creating a plan customized to your specific needs.