Schizophrenia | Signs and Symptoms | MedStar Health

Schizophrenia is a serious, chronic illness that interferes with a person’s ability to think clearly, manage emotions, make decisions, and relate to others. The disorder is complex and long term. People with schizophrenia may seem to have lost touch with reality.

This disease can disrupt a person’s daily function and typically requires ongoing treatment. The symptoms can be debilitating and disabling; however, with treatment, it is possible to live well with schizophrenia.

What are the signs and symptoms?

This disease can be difficult to diagnose, especially in teens. In general, symptoms will begin between ages 15 and 25 for men, and between ages 25 and 35 for women. For many people, the early stages of schizophrenia are characterized by disruptions to normal emotions and behaviors, which can be referred to as negative symptoms.

The symptoms of schizophrenia can affect a person’s career, academic performance, interpersonal relationships, and social activities. One of the most common early indicators is social withdrawal and isolation. Other initial signs can include changes in friends, sleep problems, and irritability. Other symptoms include:

  • Hallucinations. These include hearing voices, seeing things, or smelling things others can’t perceive. Hallucinations are very real to the person experiencing them and it can be confusing for a loved one to witness. The voices in a hallucination can be critical or threatening.
  • Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions may also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
  • Negative symptoms. These symptoms may present as being emotionally flat or speaking in a dull, disconnected way. Individuals may be unable to start or follow through with activities, show little interest in life, or sustain relationships.
  • Cognitive issues and disorganized thinking. People with cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts, or complete tasks. Sometimes people with schizophrenia have anosognosia, or lack of insight, which means the person is unaware they have the illness, making treatment more challenging.

What are the risk factors?

Schizophrenia is a disease that is caused by a chemical imbalance in the brain. When levels of dopamine, a neurotransmitter, are increased in certain parts of the brain it can trigger psychosis. There are many possible causes, including family history and genetics.

  • Genetics. Schizophrenia isn’t caused by just one genetic variation, but a complex interplay of genetics and environmental influences. Having a family history of psychosis greatly increases a person’s risk of developing the disease.
  • Brain chemistry. Problems with certain brain chemicals, including the neurotransmitters dopamine and glutamate, may contribute to schizophrenia.
  • Substance use. Research has indicated that smoking marijuana increases the risk of psychotic incidents and ongoing psychotic experiences. The younger and more frequent the use, the greater the risk. Smoking marijuana can also lead to earlier onset schizophrenia. The use of mind-altering drugs during teen years and young adulthood can also increase the risk of schizophrenia.

What is the difference between schizophrenia and schizoaffective disorder?

Schizophrenia and schizoaffective disorder can be difficult to distinguish because many of the symptoms overlap. The important distinction is that individuals with schizoaffective disorder will typically also experience symptoms of a mood disorder, such as mania or depression, in addition to symptoms of schizophrenia. Because the symptoms of schizoaffective disorder are the same as those of other illnesses, it can be difficult to diagnose. Each person may experience different symptoms, but some of the common symptoms of schizoaffective disorder include:

  • Hallucinations: seeing or hearing things that aren’t there
  • Delusions: false, fixed beliefs that are held regardless of contradictory evidence
  • Disorganized thinking: a person may switch very quickly from one topic to another or provide answers that are completely unrelated
  • Depressed mood: feelings of sadness, emptiness, and worthlessness
  • Manic episode: feelings of euphoria, racing thoughts, increased risky behavior, and other symptoms of mania

What are the treatments?

People with schizophrenia can lead normal, prosperous lives with treatment. It’s important to seek treatment as quickly as possible, as the disease becomes more difficult to treat the longer it is left untreated. Schizophrenia treatment involves a multi-modal treatment approach, including biological, psychological, and social symptoms. Medications, such as anti-psychotics, are used to reduce or eliminate symptoms of psychosis, such as delusions and hallucinations.

Our providers

Psychiatrist performing therapy with young patient

Expert behavioral health care

Getting the care you need starts with seeing one of our psychiatrists.