If schizophrenia is left untreated, symptoms may intensify and last indefinitely. A multifaceted treatment plan can help.

Schizophrenia is a mental health disorder that features symptoms of psychosis such as hallucinations, delusions, and disorganized thoughts. Some of these symptoms may get worse if ongoing treatment isn’t received.

During its onset, known as the prodromal phase, schizophrenia symptoms may be missed or misdiagnosed. In some cases, they may be mild enough to be ignored. This doesn’t mean that treatment isn’t recommended in this phase.

Untreated schizophrenia may lead you to experience more intense and pervasive symptoms that could severely impact your relationships, self-image, and occupation. But treatment is often effective and can help you live a functional life.

Undiagnosed schizophrenia vs. untreated schizophrenia

Undiagnosed and untreated schizophrenia go hand-in-hand.

Receiving a diagnosis is the first step toward targeted treatment for your particular symptoms.

Schizophrenia is diagnosed when two or more of the following symptoms are persistent and impairing over the course of a month:

  • hallucinations
  • delusions
  • disorganized behavior
  • disorganized speech
  • negative symptoms

At least 1 of the 2 symptoms present must be hallucinations, delusions, or disorganized speech.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, revised text (DSM-5-TR), negative symptoms tend to be some of the earliest signs of the condition.

Negative symptoms include:

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Does schizophrenia always need to be treated?

Professional treatment for schizophrenia is highly advisable in all cases, even if you feel your symptoms aren’t impairing.

Schizophrenia is a progressive, lifelong condition that may cause changes in your brain’s structure over time.

Currently, there’s no way to predict if you’ll experience severe symptoms if schizophrenia goes untreated. Early interventions, however, have been linked to better long-term outcomes and fewer complications.

A 2019 article also notes that leaving schizophrenia untreated during the prodromal phase has been associated with an increased chance of experiencing more negative symptoms as well as more severe positive symptoms.

What are positive and negative symptoms of schizophrenia?

Positive schizophrenia symptoms include those that add a behavior or experience. For example, hallucinations and delusions are positive symptoms because they lead you to perceive or believe something that you wouldn’t otherwise.

Negative symptoms describe those that take away an aspect of functionality. For example, diminished emotional expression or the ability to speak in an organized way.

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Which symptoms tend to get worse in untreated schizophrenia?

Not everyone with schizophrenia experiences the same symptoms or with the same intensity. But, in general, untreated schizophrenia can lead to more severe positive and negative symptoms.

With untreated schizophrenia, some people may be more likely to experience:

Untreated schizophrenia may also increase the chance of engaging in self-harm.

Not getting treatment or interrupting the treatment may lead some people to experience more frequent active schizophrenia phases, which are periods of time when symptoms are dominant and recurrent.

Literature reviews also note that untreated schizophrenia may result in an increased chance of suicide attempts, particularly during the prodromal phase.

A 2019 study in the United States found that stigma, which increased the duration of untreated schizophrenia, also increases the likelihood of experiencing depression during that period of time.

What happens if someone with schizophrenia stops taking medication?

Stopping your medication without medical supervision isn’t recommended. It could lead your symptoms to intensify and you could also experience unpleasant withdrawal reactions.

The gold standard of schizophrenia treatment is antipsychotic use. How long you need to take these medications depends on many factors that your health team can discuss with you.

These antipsychotic medications can sometimes lead to side effects. In most cases, though, treatment with these drugs is highly effective. This may lead some people with schizophrenia to feel they don’t need to continue taking their medications.

However, you’re likely feeling better because of the medications, and stopping their use may lead you to experience again the symptoms you were treating.

Can you ever stop taking antipsychotics?

In some circumstances, when tapered under medical guidance, it may be possible for you to manage schizophrenia without medication.

A 20-year longitudinal study from 2012 found not all people with schizophrenia required lifelong medication to lead fulfilling lives.

Those who were able to manage without prescriptions, however, had innate protective features such as high resiliency, low anxiety, and effective coping mechanisms.

Only a health professional can help you determine when and how to taper your schizophrenia medication.

Main treatment options for schizophrenia

Schizophrenia treatment is more than medication and speaking with a therapist. It’s a dynamic, multimodal approach that aims to provide support in all areas of your life.

Schizophrenia treatment usually involves:

  • medication. The use of antipsychotics and other medications to manage symptom severity.
  • psychosocial therapy. Solution-oriented psychotherapy approaches like cognitive behavioral therapy (CBT) designed to meet everyday challenges at work, school, or home.
  • assertive community treatment (ACT). A network of community caregivers providing services for people living with schizophrenia.
  • coordinated specialty care (CSC). A recovery-oriented, collaborative effort between your healthcare teams to make joint treatment decisions.
  • family education. Programs that help family and friends learn coping strategies and ways to support a loved one living with schizophrenia.

Let’s recap

Schizophrenia is a lifelong disorder that traditionally requires ongoing, consistent treatment for the best outcomes.

In some cases, you may be able to experience remission of symptoms with treatment. Untreated schizophrenia, however, is associated with progressive symptom severity and frequency.