Symptoms of Schizophrenia

Schizophrenia is a serious mental disorder that impacts an individual’s life in a debilitating manner. According to the World Health Organization, 24 million, or 1 in 300 people suffer from schizophrenia worldwide. The rate among adults is 1 in 222 people.

Individuals with schizophrenia suffer from episodes of psychosis that include hallucinations, delusions, paranoia, and distorted thinking. It disrupts a person’s thinking ability, causing them to make irrational decisions, which could lead to detrimental consequences.

What are the Symptoms of Schizophrenia?

While the symptoms of schizophrenia may vary from person to person, some symptoms are common among individuals suffering from the condition. Some of these symptoms are:

  • Hallucinations
  • Delusions
  • Social Withdrawal
  • Reduced movement
  • Abnormal physical behavior
  • Disorganized thinking
  • Limited emotional expressions
  • Little-to-no motivation

These symptoms could be categorized into three categories. These are:

  • Positive Symptoms
  • Negative Symptoms
  • Cognitive Symptoms

Positive Symptoms of Schizophrenia

Positive symptoms are symptoms of schizophrenia that are not seen in individuals who do not suffer from schizophrenia. The term ‘positive’ refers to the presence of additional abnormal behaviors/ symptoms in a person with schizophrenia. These symptoms hinder a person’s working ability and mental functioning. Following are some positive symptoms of the condition:

  • Hallucinations- Hallucinations are false perceptions of things, objects, and people that involve our five senses. These occur in the absence of external stimuli. Hallucinations are of five types and are a common symptom of schizophrenia.
  • Delusions- Delusions are false thoughts, ideas or conceptions that a person holds. Schizophrenia leads people to believe in these false ideas which more often than not, result in unwanted challenges or difficulties. These are of multiple kinds and are also a common symptom of schizophrenia.
  • Disorganized thinking- Disorganized thinking, also sometimes known as the formal thought disorder, is an additional symptom of schizophrenia that disrupts a person’s thinking ability, as a schizophrenic person cannot draw a connection between two or more thoughts, which results in incoherent speech and jumbled thoughts.
  • Abnormal physical behavior- Abnormal physical behavior refers to disturbances in the movement activities of an individual with schizophrenia. Schizophrenia could put individuals in a state of catatonia; a motionless state, agitation; a restless agitated state, and could result in hyperactivity; state of being overly active or hypoactivity; decreased levels of energy, resulting in low activity.
  • Paranoia- Paranoia refers to an irrational fear of being in danger at all times. For instance, a common paranoiac example is people thinking someone is ‘out to get them’ or that they are being ‘conspired against’. People suffering from schizophrenia may occasionally get paranoid about certain things.

Negative Symptoms of Schizophrenia

Negative symptoms of schizophrenia refer to the basic functionalities that are not present in individuals with schizophrenia. These symptoms hinder a person’s ability to function regular tasks and therefore, disrupt their overall progress. The term ‘negative’ refers to the ‘missing’ qualities/ functionalities in a schizophrenic individual. Following are some negative symptoms of the condition:

  • Flat affect- Flat affect, also known as ‘affective flattening’, refers to a reduction in emotional expressions. Individuals with a flat affect do not display any emotions or gestures, which is a symptom of schizophrenia.
  • Anhedonia- Anhedonia refers to the reduced ability to experience pleasure. Individuals with schizophrenia find it difficult to experience pleasure in activities they once enjoyed. There is a reduction in the ability to enjoy things/ activities that provide pleasure.
  • Avolition- Avolition refers to a decreased sense of motivation. Schizophrenia leads individuals to lose motivation to do regular tasks, or achieve their goals. For instance, people experiencing avolition may not feel motivated to prepare a schedule or go grocery shopping.
  • Alogia- Alogia refers to a disruption in speech. Schizophrenic individuals may find it difficult to form full sentences and engage in conversations. They may also give brief or short replies to questions that require proper or appropriate answers. It contributes to a reduction in speech output.
  • Social Withdrawal- Schizophrenia forces individuals to reduce interactions with their families and peers, resulting in social isolation, which could potentially lead to depression. Social withdrawal leads to a sense of loneliness and alienation. Schizophrenic individuals tend to avoid social situations, as these could exacerbate the symptoms of delusions and hallucinations.

Cognitive Symptoms of Schizophrenia

Cognitive symptoms are symptoms that affect a person’s thinking processes, which results in a decreased mental capacity and ability to perform regular or daily tasks. These are called cognitive symptoms as these concern the cognitive functions; these disrupt the mental processes of the individual, thereby hindering their psychological progress. Some of the cognitive symptoms are:

  • Attention deficit- Schizophrenia affects the attention span of individuals. Schizophrenic individuals find it difficult to stay focused on tasks, have difficulty in concentrating, and pay less attention to things due to reduced attention capacity.
  • Impaired verbal ability- Speech disruption is something many people with schizophrenia go through. Disorganized thinking may sometimes result in speech impairment. Schizophrenic individuals struggle to form sentences, answer questions properly, or understand the underlying message of any information.
  • Poor problem- solving skills- Since their brain activity is low, schizophrenic individuals have a hard time performing tasks related to problem- solving and reasoning. They find it difficult to tell the truth and lie apart, as hallucinations and delusions cloud their judgment.
  • Memory deficit- Schizophrenic individuals find it difficult to remember things, recall details, certain words or numbers. For instance, they sometimes struggle to memorize a phone number or a grocery list. It is hard for them to retain their memory. This is one of the most common symptoms of schizophrenia.
  • Difficulty in concentration- Similar to attention deficit, schizophrenic individuals have difficulty in concentrating. They may find it hard to concentrate in lectures, classes, or meetings. It is another common symptom of schizophrenia.

Are Delusions a Symptom of Schizophrenia?

Delusions are a prominent symptom of schizophrenia. These are false beliefs, ideas, or conceptions of things, objects or people that a schizophrenic individual perceives as the truth. Delusions are common in some other mental conditions like:

  • Delusional Disorder
  • Bipolar Disorder
  • Dementia
  • Schizoaffective Disorder
  • Major Depressive Disorder

Some of the most common delusions are as follows:

  • Grandiose- Grandiose delusion refers to the delusion of extreme wealth, fame or extraordinary abilities. People with grandiose delusions believe that they are rich, extremely famous, or have exceptional abilities that no one else possesses.
  • Persecutory- Persecutory delusions lead schizophrenic individuals to believe that they are being targeted, harassed, or conspired against. They believe that they are in imminent danger and everyone is out to ‘get them’.
  • Jealousy- The delusion of jealousy arises when a schizophrenic individual starts to believe that their partner is being unfaithful to them. The delusion of jealousy severely affects healthy relationships and causes people to drift apart.
  • Erotomania- Also known as the delusion of love, erotomania makes a person believe that a certain someone is in love with them. They become fixated on that person and therefore, show inappropriate gestures of jealousy and anger when that person is seen with their partner.
  • Bizarre- Bizarre delusions refer to the belief of an implausible or bizarre event happening. Schizophrenic individuals with bizarre delusions might believe that a catastrophe is about to happen when in reality, that might not be the case.
  • Folie a’ deux- Folie a’ deux translates to ‘madness of two’ in french. It is a shared delusional belief between two or more people. The primary individual is known as the ‘inducer’, who may have a psychotic disorder with delusions, and the secondary individual is known as the ‘recipient’ who accepts these delusions.

Are Hallucinations a Symptom of Schizophrenia?

Hallucinations are false perceptions of events or objects involving our five senses. However, people who have hallucinations might not necessarily suffer from schizophrenia. Some other mental illnesses that have hallucinations as a symptom are:

  • Dementia
  • Parkinson’s Disease
  • Borderline Personality Disorder (BPD)
  • Sleep Disorders
  • Delirium

Some of the most common hallucinations are:

  • Auditory- Auditory hallucinations refer to the noise, sounds or voices that a schizophrenic individual hears, that are not present. For instance, they might hear constant ringing, whispers or the sound of an alarm going off.
  • Visual- Visual hallucinations refer to the things that individuals with schizophrenia see that are not usually there. These could be objects, certain people, patterns or lights. For instance, seeing bright red lights, or recurring geometrical patterns might be a sign of hallucinations.
  • Olfactory- Olfactory hallucinations involve our sense of smell. People with schizophrenia smell odors that are not present or constantly think that their body odor is foul. For instance, they might smell smoke in the air, or a smell of something burning.
  • Somatic- Also known as ‘tactile hallucinations’, somatic hallucinations refer to the sensations that schizophrenic individuals feel on their skin that are not real. They might think that someone is pinching them, there are bugs crawling on their hands, or they might feel a burning sensation.
  • Gustatory- Gustatory hallucinations make schizophrenic individuals believe that their food or drink tastes weird, when in reality, there is nothing wrong with what they are consuming. They might experience distorted tastes, or tastes like metallic, rustic, salty, or bitterness.

Is Paranoia a Symptom of Schizophrenia?

Paranoia is the intense and irrational distrust of everyone. Schizophrenic individuals may experience episodes of paranoia as their delusions and hallucinations play a part in aggravating the condition. Some of the symptoms of paranoia are as follows:

  • Difficulty in relaxing
  • Not trusting anyone, even those close to you
  • Feeling like someone is conspiring against you
  • Not confiding in anyone
  • Defensive attitude
  • Hypervigilance

While paranoia is a symptom of schizophrenia, it is common in other mental conditions as well. Some of these are:

  • Bipolar Disorder
  • Paraphrenia
  • Borderline Personality Disorder (BPD)
  • Delusional Disorder
  • Obsessive Compulsive Disorder (OCD)

Paranoia has a detrimental effect on individuals with schizophrenia as it affects their relationships with those around them and influences them to isolate themselves. It could lead them to think about ending their lives over the delusions that paranoia causes.

Paranoia stems from the already existing delusions of schizophrenia and exacerbates them. One of the most common delusions of paranoia is the delusion of persecution. It is when individuals think that they are in imminent danger and not safe around people.

This gives rise to an irrational fear of people, which further pushes schizophrenic individuals away, resulting in them isolating themselves.

Is Depression a Symptom of Schizophrenia?

One of the most common symptoms of schizophrenia is depression. Depression is a serious mental condition that affects the way a person thinks, feels, and reacts to situations. It also has a debilitating effect on their lifestyle. Studies show that 17.3 million American adults, or 7.3% of the U.S. population suffers from Major Depressive Disorder.

Some of the conditions that share the symptoms of depression and schizophrenia are:

  • Schizoaffective Disorder
  • Substance- Induced Psychotic Disorder
  • Psychotic Depression
  • Bipolar Disorder with Psychotic Features
  • Atypical Depression

While depression is one of the symptoms of schizophrenia, it is crucial to distinguish between schizophrenia and depression (as a separate condition) to get an accurate diagnosis. Both conditions have different symptoms, and therefore, have different treatment procedures.

Depression, just like paranoia, isolates a person and makes them believe that no one will believe their experiences. A schizophrenic individual might also experience symptoms of anxiety along with depression since both the conditions have similar symptoms.

Social withdrawal, decline in cognitive abilities, and disorganized thinking are some of the contributing factors to the development of depressive symptoms in a schizophrenic individual. All of these conditions could lead to feelings of hopelessness and loneliness.

Behavioral Symptoms of Schizophrenia

Behavioral symptoms refer to the changes in an individual’s behavior suffering from schizophrenia. Since schizophrenia makes an individual wary of their surroundings, there are different behaviors that they display. Following are some behavioral symptoms of schizophrenia:

  • Social withdrawal- Schizophrenia causes a person to self- isolate, which could lead to the development of symptoms of other conditions like depression, anxiety, bipolar disorder, psychotic disorder, and many more. Further, it causes a strain in their relationships with others as they do not engage in conversations with anyone and try to avoid social situations.
  • Agitation- Schizophrenic individuals may display signs of extreme agitation during periods of heightened stress and anxiety. Due to their inability to express emotions, they release their anger or frustration in an inappropriate or improper manner, thus, aggravating the symptoms of the condition.
  • Catatonia- Catatonia refers to an unresponsive or motionless state. It could lead an individual to a state of ‘stupor’; remaining motionless or unresponsive for long periods, ‘hyperactivity’; high energy levels that could either lead to agitation or purposeless activities.
  • Substance- abuse- Substance abuse is common among individuals suffering from schizophrenia. However, it exacerbates the symptoms of the condition, which could result in detrimental outcomes. It results in social isolation, cognitive impairment, catatonia or agitation.
  • Self- neglect- Personal hygiene is crucial for every individual. However, people suffering from schizophrenia might not take care of their personal hygiene and themselves. They might also develop negative habits like substance abuse, excessive self- monitoring or engaging in risky activities or behaviors.

Physical Symptoms of Schizophrenia

Physical symptoms are some observable and obvious signs of schizophrenia that a person displays. These could contribute to the changes in bodily function or condition. Some of these physical symptoms are:

  • Abnormal physical behavior- Schizophrenic individuals display inappropriate or improper physical behaviors like constant agitation, sexual gestures, or random outbursts. Poor hygiene is a result of abnormal physical behavior as well.
  • Muscle rigidity- Muscle rigidity is one of the physical symptoms of schizophrenia. It makes movement difficult. This could also put a schizophrenic individual in a state of catatonia.
  • Lack of body coordination- Schizophrenic individuals may sometimes find it difficult to maintain balance and coordination. This could also be due to neurological impairments but mostly, symptoms of schizophrenia contribute to this problem.
  • Changes in facial expressions- It is hard for schizophrenic individuals to maintain their facial expressions. This could result in poor eye contact, less engagement in conversations, involuntary facial movements or delayed responses. It could also lead to a ‘flat affect’.
  • Tremors- Extreme stress levels or anxiety in a schizophrenic person could cause tremors and exacerbate the physical symptoms of the condition. These could also be caused as a result of the side effects of some antipsychotics. Some other factors could be excessive caffeine intake, substance abuse, or nutritional deficiencies.

Treatment for Symptoms of Schizophrenia

There are many treatment options available to those suffering from schizophrenia. While it is important to seek accurate diagnosis of the condition, it is equally crucial to seek appropriate treatment for it as well. Some of the treatment options for the condition are:

  • Medication- While healthcare professionals prescribe medications according to the severity of the condition, some of the most common medications are Aripiprazole, Cariprazine, Paliperidone, Fluphenazine, Chlorpromazine.
  • Individual Therapy- Individual therapy involves one- on- one sessions of a patient with their therapist. This therapy helps the patient address their deep- rooted, unresolved issues, intense emotions, and unfavorable behaviors.
  • Educational Support- Knowledge about schizophrenia is an important component of the educational support treatment plan. It involves educating individuals and their families about the condition, its symptoms, diagnosis, causes, risk factors, and much more. It helps individuals and their families to deal with the condition in an appropriate and relevant way.
  • Occupational Support- Occupational Support usually involves the enhancement of a schizophrenic individual’s skills to prepare them for job placements. Therapists usually work with their patients on developing skills that would help them enter the work field.
  • Group Therapy- Group Therapy, like support groups, allows individuals with the same condition to come together and share about their experiences. It provides emotional and mental support to the individual. It further helps every member of the group to develop their communication and interpersonal skills.
  • Cognitive Remediation- Cognitive Remediation (CR) focuses on the cognitive functioning of the individual. Using certain drills, techniques, or exercises, therapists help their patients improve their problem- solving and reasoning skills, which further helps them improve their daily- functioning skills.
  • Alternative treatments- Some of the alternative treatments suggested by certified and licensed therapists are Acupuncture, Mindfulness and Meditation, Exercise, Art Therapy, Supportive Therapies, and much more.
  • Socialization- Since social withdrawal is one of the symptoms of the condition, socialization is one of the options that could curb that symptom. Socialization leads to skill development, improvement in communication and interpersonal skills, and provides the individual a sense of normalcy.
  • Emotional Support Animal- An emotional support animal is helpful for individuals with schizophrenia as it reduces stress, provides companionship, distracts them from the seriousness of the problems, and keeps a check on their daily routine.

If you notice any signs of schizophrenia, or experience any of the above mentioned symptoms, do not hesitate to reach out and seek help.

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Virtual Psychiatrist
Fact Checked by
- Dr. Gundu Reddy
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