Schizophrenia is a chronic psychiatric disorder. People with this condition may experience periods of time when they feel disconnected from reality, usually experiencing a combination of hallucinations and delusions.
People with schizophrenia often face stigma and misconceptions due to sensationalist media stories that portray people with the condition as dangerous.
In reality, most people with schizophrenia aren’t violent and pose no threat to others. Most can lead highly productive and rewarding lives.
You may be diagnosed with schizophrenia if you experience at least two of the following symptoms for at least 1 month, and signs of the condition — possibly in milder form — persist for at least 6 months. Also, at least one symptom must be from among the first three on this list:
- disorganized speech, such as frequent derailment or incoherence
- grossly disorganized or catatonic behavior
- negative symptoms, such as reduced emotional expression or total lack of motivation
To be diagnosed with schizophrenia, your healthcare provider will also consider what degree symptoms negatively affect different aspects of your life, such as your work, academic performance, interpersonal relationships, or self-care.
Your medical professional will also rule out any other possible causes of your symptoms, such as schizoaffective disorder, mood disorder with psychotic features, autism spectrum disorder, a general medical condition, or substance use disorder.
Keep in mind that about half of people with schizophrenia have co-occurring mental or behavioral health conditions, such as
Common misconception: Schizophrenia causes a “split personality”
Some people incorrectly believe that schizophrenia causes a “split personality.” However, split personality — an outdated term for dissociative identity disorder — is a separate condition.
Schizophrenia may develop slowly, and symptoms often appear first between the late teen years and early 30s.
Women tend to develop symptoms in their early 20s to early 30s, compared with men in their late teens to early 20s.
Though it’s possible for younger people to develop schizophrenia, it’s rare.
Symptoms of schizophrenia are divided into three categories:
- positive symptoms
- negative symptoms
- cognitive symptoms
Positive symptoms of schizophrenia represent additional behaviors not generally seen in people without the condition. They include:
- disorganized thinking
- abnormal body movements
If you experience delusions, you believe an untruth.
For instance, you may think that you’re in danger and someone wants to hurt you when there’s no evidence to that effect.
If you see, hear, smell, taste, or feel something that isn’t real, you’re experiencing hallucinations.
For example, people with schizophrenia may hear voices.
If you have schizophrenia, you may find it difficult to organize your thoughts, stop talking in the middle of a thought, or make up words that have no meaning to others.
Your way of thinking may appear illogical to other people.
Abnormal body movements
If you have schizophrenia, you may experience unusual body movements, including:
- stereotyped movements: Repeating certain motions over and over.
- catatonia: No longer responsive to the environment. It can range from being completely “frozen” and not moving or talking to engaging in excessive activity without an obvious cause.
Unlike positive symptoms, which represent additional behavior, negative symptoms are behaviors that are missing or underdeveloped.
Negative symptoms of schizophrenia include:
- a lack of emotional expression
- social withdrawal, including talking very little with other people, even in situations when it may be important
- difficulties planning or sticking with an activity such as grocery shopping
A mental health professional may use the terms:
- affective flattening: lack of emotional expression
- alogia: poverty of speech
- avolition: difficulties planning or sticking with everyday activities
Common misconception: People with schizophrenia are dangerous
The vast majority of persons with schizophrenia are not aggressive and are more frequently the victims of violence than the perpetrators.
Though hostility and aggression can be associated with schizophrenia, spontaneous or random assault is uncommon.
There is no need to be fearful of a person with schizophrenia.
Schizophrenia can affect your memory and how you think. It’s not easy to detect these effects because they can be subtle. Tests can detect cognitive symptoms of schizophrenia.
Cognitive symptoms include:
- difficulty processing information and making decisions
- difficulties using information after learning it
- trouble focusing or paying attention
Symptoms of schizophrenia that lead to a diagnosis typically don’t emerge until an individual is in their 20s.
However, some symptoms — often milder forms of hallucinations or delusions — may occur before a person experiences episodes of psychosis. These are called prodromal symptoms.
For example, you may have unusual perceptual experiences, such as sensing the presence of an unseen person, or your speech may be generally understandable but vague.
Your behavior may also be perceived as unusual but not as grossly disorganized, such as if you mumble in public.
Symptoms in children and teens
Though it’s possible for children and younger teens to develop schizophrenia, it’s rare.
Medical researchers differentiate between two types of schizophrenia in younger people:
- early-onset schizophrenia: onset before the age of 18 years
- childhood-onset schizophrenia: onset before the age of 13 years
Schizophrenia in children and teens is difficult to diagnose because symptoms can be related to other conditions, substance use disorder, or even typical childhood behavior, such as having an imaginary friend.
Also, depending on the child’s age, it may be difficult for them to describe their experiences and symptoms.
Generally speaking, children and teens with schizophrenia have positive and negative symptoms like adults, but these symptoms may look slightly different.
According to the American Academy of Child and Adolescent Psychiatry (AACAP), symptoms of schizophrenia in children and teens may include:
- unusual or eccentric behavior, speech, or both
- odd thoughts and ideas
- inability to distinguish between television or dreams and reality
- confused thinking
- unexpected academic difficulties
- extreme moodiness
- changes in personality
- signs of paranoia, such as the idea that people are out to get them
- severe anxiety and fearfulness
- difficulty connecting with peers or keeping friends
- increasingly withdrawn or isolated
- neglecting personal grooming
Symptoms of schizophrenia, especially episodes of psychosis, may lead you to feel distressed.
If you believe that you have developed symptoms of schizophrenia, speak with a healthcare professional. The sooner you begin your personalized treatment plan, the better you may feel.
If you’re concerned because someone you care about shows signs of schizophrenia, encourage them to seek help. Support from family and friends can be vital for people with schizophrenia.
If you or someone close to your child, such as a teacher, notices early symptoms of schizophrenia, speak with your family physician. You can ask for a referral to a mental health professional who specializes in children with schizophrenia.
Keep in mind that with treatment and support, you’ll be able to control and reduce the severity of schizophrenia symptoms.
If suicidal thoughts are surfacing
About 5% of people with schizophrenia die by suicide. That’s more than the general population.
If you or someone you know is considering suicide, you’re not alone. Help is available right now: