Schizophrenia has three types of symptoms: negative, positive, and cognitive. Positive symptoms indicate novel or exaggerated experiences like hallucinations, delusions, or paranoia.
Positive symptoms involve exaggerated responses that make it difficult to function. Negative symptoms are those that demonstrate a lack of functioning, while cognitive symptoms are those that affect your thought processes.
Positive symptoms are usually the addition of something outside what a person without schizophrenia would experience. For example, if you live with schizophrenia, you may see or hear things that aren’t there.
Due to the nature of the positive symptoms of schizophrenia, many people are unaware of their diagnosis or have difficulty understanding it. However, treatment options are available, and you can manage symptoms effectively with a medical care team and the right tools.
The positive symptoms of schizophrenia can include:
- Hallucinations. These are perceptions based on sensory information that isn’t real.
- Delusions. These are beliefs that aren’t true and can’t be overcome by logic.
- Paranoia. This is a deep mistrust or suspicion of others.
We’ll look at these symptoms in more detail below.
Hallucinations are a positive symptom of schizophrenia in which you may have difficulty knowing the difference between what is real and what isn’t. Hallucinations often occur as a result of an imagined sensory perception.
Many types of hallucinations can occur:
- Visual hallucinations. These involve seeing things that aren’t really there, such as shadows or figures.
- Auditory hallucinations. These involve hearing things that aren’t really there, such as voices talking to you.
- Tactile hallucinations. These involve sensations of touch that aren’t really there, such as feeling bugs crawling on your skin.
- Olfactory hallucinations. These involve smelling things that aren’t really there, which are usually unpleasant, such as rotten food, gasoline, or smoke.
Hallucinations can feel frightening, as you may not know that you’re hallucinating.
Some people with schizophrenia also experience command hallucinations, which is when their hallucination — such as a voice — commands them to do something. Sometimes, when people experience command hallucinations, they’re told to harm themselves or other people. If this happens to you or someone you know, it’s important to seek help for your safety.
If you are facing mental health or substance use disorders, you can call SAMHSA’s National Helpline at 800-662-4357. If you or someone you know is considering suicide or self-harm, you can call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
Delusions are simply false beliefs that demonstrate inaccurate thought processes in people diagnosed with schizophrenia. If you experience delusions, you often won’t understand what you’re experiencing isn’t accurate. In addition, you might not respond to logic that goes against your delusion.
There are several categories of delusions:
- Persecutory delusions. These delusions involve the belief that someone is out to get you or that you’re being attacked or victimized in some way.
- Grandiose delusions. Also known as delusions of grandeur, these occur when you believe that you have special or unusual powers.
- Religious delusions. These involve a belief that’s religious in nature and doesn’t occur within a broader cultural context.
- Somatic delusions. These involve a belief that you have a physical ailment or something wrong with your body when there’s no evidence to support this.
- Referential delusions. These indicate a belief that ordinary events are impacting you in some way that has a hidden meaning.
- Erotomanic delusions. These indicate a belief that someone is in love with you when there’s no evidence to support this.
Paranoia is a cognitive phenomenon in which an individual feels a deep mistrust or suspicion of others. People who experience paranoia may believe that others are out to get them or hurt them somehow. Paranoia and delusions can be similar, as paranoia can develop into delusional thoughts.
Many treatments can help alleviate the positive symptoms of schizophrenia.
According to the National Institute of Mental Health, a large body of research suggests that a mixture of treatments called coordinated specialty care can be effective for people who experience psychosis.
Antipsychotic medication is one option for alleviating symptoms of schizophrenia, according to Mental Health America. These medications can be typical or atypical, and both can help treat positive symptoms of schizophrenia.
Typical antipsychotics can treat positive symptoms. Some standard typical antipsychotics include:
Atypical antipsychotics can treat both positive and negative symptoms. Some standard antipsychotic medications include:
It may take a little while to figure out the right medication regimen for you, as not every person reacts to medication in the same way. Therefore, it’s essential to talk with your psychiatrist or physician to determine which medications may be the most helpful in reducing positive symptoms associated with schizophrenia.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) focuses on identifying patterns in thoughts, feelings, and behaviors and how to manage unhelpful thinking. Then, you and your therapist can come up with solutions that involve reframing and coping methods.
Cognitive enhancement therapy
Research suggests that cognitive enhancement therapy (CET) improves emotion regulation in individuals with schizophrenia by improving prefrontal cortex function. This therapy uses group sessions and computer-based brain training.
Family support and education
Family support and education focuses on developing family support for the individual with schizophrenia. In addition, the program involves teaching the signs, symptoms, and strategies for managing schizophrenia effectively.
People with schizophrenia can access these services on an individual or group basis.
Assertive community treatment
An assertive community treatment (ACT) team provides specialized individual services to the person diagnosed with schizophrenia. ACT teams are a multidisciplinary ones that involves psychiatrists, therapists, and case managers.
Members of this team may be involved in helping with:
- medication management
- helping an individual through crisis
- helping an individual with daily functioning tasks
Case management services
Case management services for individuals with schizophrenia help with social services needs and provide additional ongoing support. For example, case managers may teach the individual life skills or help them get to necessary medical appointments.
Supported employment programs help people with mental health conditions achieve their work or career goals. Supportive employment programs often involve rapid placement in work or educational programs. The individual then has ongoing coaching and support while employed.
There are a variety of ways to access help if you have been diagnosed with schizophrenia.
If you or a loved one has been diagnosed with schizophrenia, support is available. Just knowing you aren’t alone can make a world of difference.
Consider reaching out to one of the resources listed below:
- SAMSHA’s National Helpline. This helpline provides 24-hour support for individuals diagnosed with mental health disorders or who have difficulty with substance use issues they can be reached at 1-800-662-HELP (4357).
- Early Serious Mental Illness Treatment Locator. This free resource is for patients and families of those with mental health disorders who are seeking treatment facilities.
- SAMSHA Behavioral Health Treatment Services Locator. This is a resource for finding mental health treatment near you.
- The Schizophrenia and Psychosis Action Alliance. This resource is for finding support groups near you and education on schizophrenia.
- The National Suicide Prevention Lifeline. This hotline is available 24/7, all 365 days of the year to offer support to individuals who have suicidal thoughts. You can reach them at 1-800-273-8255.
- Crisis Text Line. Text “HOME” to 741741 to start a conversation with a crisis counselor.