Developmental disorders show up in childhood. Other mental health conditions typically start around puberty. Why does schizophrenia develop later than most?

A 20s-something young woman who has schizophrenia is making notes on two notepads, contemplatingShare on Pinterest
Kemal Yildirim / Getty Images

Schizophrenia is a chronic mental health condition that’s typically diagnosed in young adults — people in their 20s and early 30s. Diagnosis usually occurs after an episode of psychosis.

In males, onset usually begins during their late teens or early 20s, while it’s more commonly diagnosed between the early 20s to 30s in females.

While there’s no exact answer to this question, scientists believe that schizophrenia develops slowly over time, as the brain changes and matures during the teen years.

Signs often start to show up in the early teen years.

There are several theories about the exact changes that cause schizophrenia.

Development of the working memory

Your prefrontal cortex — the part of your brain responsible for storing memories and decision-making — finishes developing by 25 years old. When this happens, your brain has completed the process of determining how you should respond to what happens around you.

Some researchers believe that a variety of outside (aka environmental) factors can cause the prefrontal cortex to finish developing differently than it would have, causing a person to develop schizophrenia.

Accessing the right memories

Other experts believe it’s not outside factors that are the cause. Instead, a connectivity problem in the brain begins to break down.

This, researchers observe, causes people to reference the wrong experience related to what’s currently happening. When folks can’t make the right connection between what’s happening now and how they’ve felt about a similar situation in the past, they start to lose touch with reality.

Brain and skull size

Some research has also found that people who have a high risk for schizophrenia have a smaller skull and brain size than peers, either before or during their first episode of psychosis.

Although we don’t know exactly when the brain stops growing, it’s believed to be at the start of puberty.

Schizophrenia is a mental health condition that can affect how a person thinks, feels, and behaves. When having an episode of psychosis, someone can seem to lose touch with reality.

Over time, someone with schizophrenia may think differently than they did before, withdraw socially, find it hard to show emotions, and have altered perceptions of the world around them.

Friendships, relationships, and self-care can all be affected.

People with schizophrenia also commonly experience depression. If left untreated, symptoms may increase risk of suicide or other shizophrenia-related deaths, but seeking help early can increase the chances of managing and living well with the condition.

Schizophrenia is hard to diagnosis since people can have a variety of symptoms that range in severity.

Signs and symptoms of schizophrenia fall into one of three categories:

  • cognitive
  • positive
  • negative

Cognitive symptoms

Schizophrenia affects how people think, but these symptoms can be harder to notice than others.

Typically, when a doctor diagnoses schizophrenia, they’ll try to figure out if someone:

  • struggles to process information or make decisions
  • has problems using information after learning it
  • has trouble focusing or paying attention

Positive and negative symptoms

Positive and negative symptoms don’t mean good and bad. Positive symptoms are signs we observe as “standing out” — additional behaviors not seen in people without the condition.

Negative symptoms involve the absence of something, like emotional expression or speech.

Positive symptoms

  • Delusions (distorted thoughts, false beliefs)
  • Hallucinations (altered perceptions) may involve any of the five primary senses, including sight, hearing, touch, smell, and taste
  • Disorganized speech
  • Unusual motor activity or disorganized behavior

Negative symptoms

  • Limited emotional range (“flat affect”)
  • Scarce, unresponsive speech with little expression or inflection
  • Trouble starting or completing activities
Was this helpful?

While the majority of cases are diagnosed between a person’s late teens to early 30s, schizophrenia can still occur later. This is called late-onset schizophrenia.

While research is still limited, more and more people are being diagnosed with schizophrenia later in life. In fact, it’s believed that a quarter of people with schizophrenia develop it after age 40.

Many researchers currently believe these later diagnoses happen because the person had untreated cognitive obstacles and a small or poor network of support and camaraderie.

If you think you might have symptoms of schizophrenia (or a higher chance of developing the condition), there are many things that can improve your symptoms and reduce their frequency and severity.

There are a lot of options to choose from, so working with a mental health professional is key to finding the best treatment combo for you.

If you’re currently in college or university, you can visit your campus health clinic or counseling office. After all, the demographic they typically serve is the prime age of schizophrenia onset, so you can rest assured you’re not the first person to seek help.

While this is a safe place to start, you will need to establish long-term care.

If you do receive a schizophrenia diagnosis in college, you can still continue with your studies. But you may want to consider registering with the disability office so you can receive proper accommodations, especially while working out a treatment plan.

Typically, treatments will include a combo of:

  • Medications. There are a variety of antipsychotic meds that can reduce your current symptoms and help prevent them from returning.
  • Psychotherapy. CBT, CET, individual therapy, group therapy, family therapy, and many other types can help you manage your symptoms, relieve stress, and teach you self-care tools. And, if needed, you can get help with social and work skills.

There are also online and in-person support groups like NAMI On Campus.

Whether you’re in college now, taking a gap year, or working full-time to support yourself in your 20s and beyond, life with schizophrenia can be managed.

You can still live a full and productive life once you’re found the ideal treatment combo to manage your condition.