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Recognizing the Signs of Schizophrenia

Schizophrenia is one of the many mental health illnesses that are often misunderstood. It affects about 1 in every 100 people, and it usually develops in early adulthood. The cause of schizophrenia is a combination of genetics, the environment, and a myriad of other factors. The issue is that recognizing the signs of schizophrenia can be an uphill battle, particularly in individuals also struggling with substance use disorders.  

What is Schizophrenia?

Schizophrenia is a mental health condition that impacts the way people think. Classifies as a psychotic disorder, people often experience symptoms of psychosis and an abnormal state of consciousness. These symptoms often come and go and appear to be disconnected from reality. 

The early stage of schizophrenia is known as the “prodromal phase.” Here, most people experience a change in emotions, communication, motivation, and ability to think clearly. These changes can be upsetting to someone and continue to buildup until they experience an acute episode of psychosis. At this stage, they’ll feel panic, depression, or anger out of a sudden, which can be shocking and scary for most people. 

Understanding the Types of Schizophrenia

There are different types of schizophrenia and variables of the illness. Some people might only experience schizophrenia, while others may exhibit signs of various ones in additional episodes. The International Classification of Diseases describes the types of schizophrenia as follow:

Paranoid schizophrenia:

  • The most common form of the disease
  • Hallucinations and delusions are common
  • Speech and emotions may be unaffected
  • Develops later in life than other types of schizophrenia

Hebephrenic schizophrenia:

  • Disorganized behavior and thoughts
  • Short-lasting delusions and hallucinations
  • Grimacing, giggling, and parks are common
  •  Develops between 15 and 25 years of age

Catatonic schizophrenia:

  • Very rare
  • People may not talk at all
  • Often switching between being very active to stay entirely still

Other types of schizophrenia include undifferentiated, residual, simple, and unspecified. These categories often include a blend of the previously discussed types. It also consists of a kind of diagnosis in which someone meets the general criteria for schizophrenia, but their symptoms don’t fit any of the main categories. 

Recognizing the Signs

There are many myths associated with schizophrenia. People think that schizophrenia equals having a split personality, a violent tendency, or that it means the sick have gone mad. None of these myths are real. Symptoms of schizophrenia can be positive or negative ones. This doesn’t mean they are good or bad. Positive symptoms occur in addition to reality, while negative symptoms affect someone’s ability to function. 

Positive Symptoms

These symptoms happen in someone with schizophrenia that someone with another mental health condition wouldn’t experience. Common positive signs include:

  • Delusions – fixed beliefs that don’t match up with what other people see. Usually, people believe they’re being chased or plotted against by someone they know or the government. They’re likely to think they’re famous or important in the world. Sometimes they may feel overwhelmed and act differently because of these false beliefs. 
  • Hallucinations – these are experiences that are simply not real, and other people don’t experience. Most hallucinations affect the senses, including sound, taste, sight, touch, and smell. Hearing voices is the most common hallucination and hearing voices in different languages or switches between females and males. Visual hallucinations are also common. 
  • Disorganized thinking – this means people start talking quickly or slowly out of a sudden. It’s common for people to switch topics without a prominent link or have a psychotically disorganized speech using language based on sounds, puns, rhyme, or free association. 

Negative Symptoms

These symptoms happen when the person with schizophrenia experiences an absence of traits often presents in healthier individuals. The negative symptoms of schizophrenia impact someone’s daily life and include things like: 

  • Flattened affect – people appear emotionless or have a minimal range of emotions. They’re unlikely to show any response to disturbing situations or images.  
  • Anhedonia – more than a change of interest, people with schizophrenia can demonstrate a complete lack of joy in this previously found enjoyable. 
  • Reduced speech – beyond speaking less fluently than before, some people might stop talking altogether. 
  • Lack of initiative – lack of motivation can be seen in every aspect of life. From dismissing hygiene altogether, stop making goals or plans, and losing interest in socializing, hobbies, or even waking up. 


The cause of schizophrenia remains unknown, and it’s likely to be the result of many factors. Some people might develop the illness due to a traumatic or stressful event, such as the death of a loved one. There are no tests or scans that can diagnose schizophrenia either. 

Only a psychiatrist can diagnose someone with schizophrenia. They use manuals like the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual (DSM-5) to assess their diagnosis. For someone to meet the diagnosis of schizophrenia, they must:

1) Experience at least two of the following symptoms types:

  • Delusions
  • Hallucinations
  • Disorganized speech and behavior
  • Negative symptoms

2) The symptoms must be experienced for at least six months, with psychotic features being present for at least one month.

3) The person must experience significant problems with work and social functioning because of their symptoms. 

4) The symptoms must not be caused by another medical condition, mood disorder, or substance use. 

Other diagnosis considerations include a family history of schizophrenia, increasing someone’s likelihood of struggling with the same condition. Age at onset, because most symptoms spur in the early to mid-20s, while symptoms later in life may indicate it’s about something else. 

Because of the many variables, schizophrenia is often challenging to diagnose, with many individuals are dismissed by their symptoms, resulting in untreated conditions. 

Schizophrenia and Substance Use Disorders

There is a strong link between the use of potent cannabis and the development of schizophrenia. Drug and alcohol use can also lead to an earlier presentation of psychotic symptoms, induce psychotic relapse, or increase symptom severity.

The link between substance abuse and schizophrenia is that studies vary widely, ranging from 10 to 70 percent of people with schizophrenia having a substance abuse problem. Even still, researchers found that over half of all people with schizophrenia abused at least one substance before the onset of the mental illness. On the other hand, people with schizophrenia also are 4.6 times more likely to have a substance use disorder than the general population. This is mostly because as they start to experience their symptoms, they’ll turn to different substances to manage their symptoms. 

Treatment Options

Unfortunately, there’s no cure for schizophrenia. Up to 3 in 10 people with schizophrenia have a lasting recovery, while 1 in 5 may significantly improve. Still, about half of people diagnosed with schizophrenia will continue to have it as a long-term illness. Treatment options will vary from person to person and may include addiction treatment if they have a substance use disorder as well. 

  • Medicationssome people may benefit from antipsychotic medication to reduce the symptoms of schizophrenia. 
  • Therapiesmost treatments include cognitive-behavioral therapy (CBT) to better manage their feelings and symptoms. Art therapies can help reduce some negative symptoms and show individuals creative ways to express themselves. 
  • Family therapyit’s recommended that family members participate in treatment. It is not only to help them understand the illness better but also to show them ways to proactively support their loved ones during psychotic episodes.
  • Addiction treatmentwhen addiction is present, a dual diagnosis program that helps treat both conditions simultaneously can be highly beneficial.

Many people with schizophrenia have recovery journeys that lead to meaningful lives. If you or someone you love is showing signs of schizophrenia, please know you’re not alone. It’s paramount that you speak with a mental health professional to learn more about your illness and find the best treatment for you. 

At Lighthouse Recovery Institute, our seasoned therapists can help those with a dual diagnosis get the help they need to get better. People can go on and live with schizophrenia while managing and healthily addressing their symptoms.

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