Schizophrenia Symptoms
Schizophrenia can cause hallucinations, delusions, and other unusual behaviors like confused thinking or speech.
Updated on September 20, 2024
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What Are the Symptoms of Schizophrenia?
Psychiatrist Allison Young, MD, describes some common and less-known symptoms of schizophrenia.
Schizophrenia is a serious brain disorder that can affect your thoughts, feelings, and actions. It can cause you to become disconnected from reality and can affect your ability to recognize that you’re experiencing symptoms of the condition.
Symptoms of schizophrenia may be severe or even disabling. And because many with schizophrenia may not recognize all of their symptoms, it can be tricky to diagnose, according to the National Alliance on Mental Illness (NAMI).
But many of the symptoms can be managed over time with proper treatment, and people can live well with schizophrenia.
Symptoms of Schizophrenia
There are five main symptoms of schizophrenia: delusions, hallucinations, disorganized speech, disorganized movements, and negative symptoms, which refers to a loss of ability you previously had, such as a new lack of emotional expression. These symptoms fall into one of several broader categories, per the American Psychiatric Association (APA): positive symptoms (those which are abnormally present), negative symptoms (those which are abnormally absent), and disorganized symptoms.
These symptoms may vary in type and severity and can change over time. They usually first appear in a person’s late teens through early thirties, according to the National Institute of Mental Health (NIMH).
To be diagnosed with schizophrenia, a person must have at least two of the five main symptoms, according to Cleveland Clinic.
Positive Symptoms of Schizophrenia
People with schizophrenia may display psychotic symptoms, meaning they become detached from reality or experience the world in distorted ways. These symptoms can be particularly troubling for friends and family.
These are what doctors call “positive” symptoms — characteristics or behaviors that are abnormally present. While schizophrenia is one potential cause of psychosis, there can be other causes, such as dementia, bipolar disorder, or substance use disorder, which is part of why diagnosing schizophrenia can be challenging.
Positive symptoms of schizophrenia include the following.
Hallucinations
This is when a person hears, sees, smells, or feels things that aren’t really there.
Auditory hallucinations — hearing sounds or “voices” that are not really there — are the most common type of hallucination in people with schizophrenia. This could come in the form of hearing a clear voice or hearing many less-clear voices, like the noise on a busy subway. Other types of auditory hallucinations include music, nature calls, or animal calls, per Cleveland Clinic.
Visual hallucinations are less common in schizophrenia and occur more in neurological illnesses, such as certain forms of dementia, but they tend to be vivid and colorful, and may include scenes with family members, religious figures, or animals, past research has noted.
Delusions
These are beliefs that a person with schizophrenia is completely convinced are true, but that are very clearly illogical or untrue to those around them. For example, a person with schizophrenia may believe they’re being watched by another person, followed by the government, or that people on television are sending messages directly to them and require a certain response.
Many people with schizophrenia may have paranoid delusions, believing that others are trying to harm or plot against them. Paranoid delusions can make it difficult for a person with schizophrenia to cooperate with treatment, research shows.
Negative Symptoms of Schizophrenia
Other schizophrenia symptoms are sometimes referred to as “negative” symptoms. This means that the usual and expected ways for someone to interact with their surroundings are abnormally absent. Negative symptoms of schizophrenia can include:
- Becoming withdrawn and disinterested in daily social interactions
- Speaking little, even when forced to interact
- Lack of emotional expression when talking (the face may not move, and the voice may be dull and monotonous)
- Lack of pleasure in activities
- Difficulty focusing or paying attention
- Difficulty using information to make decisions
- Neglecting physical appearance or hygiene
- Severe lack of energy
Disorganized Symptoms of Schizophrenia
These symptoms involve confused and disordered thinking and speech, difficulty with thinking logically, and abnormal movements.
Disorganized Thinking and Speaking
People with schizophrenia may have trouble organizing their thoughts in a logical pattern. Disorganized thinking manifests as disorganized speech. As a result, people with schizophrenia may talk in a jumbled way that’s difficult to understand.
In rare cases, someone with schizophrenia may put together sentences containing random words with no decipherable meaning to those around them — sometimes known as “word salad,” according to Mayo Clinic.
Unusual Body Movements
People with schizophrenia may make unusual movements ranging from agitation to purposeless repetitive movements, states the APA. When severe, these movements can interfere with the activities of daily living. Antipsychotic medications taken to treat schizophrenia can cause tardive dyskinesia, a neurological syndrome that causes involuntary movements.
Cognitive Symptoms of Schizophrenia
In addition to positive, negative, and disordered symptoms, cognitive symptoms of schizophrenia are very common. These symptoms include difficulties with memory, attention, concentration, and educational performance, per the APA.
Someone who’s experiencing cognitive symptoms of schizophrenia may struggle with:
- Working memory (short-term memory that allows someone to remember information while working on a task, such as instructions)
- Processing speed
- Planning
- Reasoning
- Problem-solving
Cognitive problems among people with schizophrenia are known to significantly affect their ability to stay employed, live independently, and function in social settings.
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Potential Complications of Schizophrenia
There’s no cure for schizophrenia but symptoms can be managed with a combination of medication, psychotherapy, and social support. If it’s not treated, or if treatment isn’t complied with or isn’t effective, serious complications can occur. These include:
- Suicidal thoughts and attempts
- Depression, anxiety disorders, and obsessive-compulsive disorder
- Substance use disorders
- Inability to work or attend school
- Financial problems and homelessness
- Social isolation
- Repeated hospitalizations
- Being victimized
While schizophrenia can lead to aggressive or violent behavior, people with schizophrenia are more likely to be assaulted rather than cause harm to others.
When to See a Doctor
As mentioned earlier, people with schizophrenia may not realize they have symptoms of the disorder and may not seek medical attention on their own — particularly if they’re experiencing paranoia. Family and friends will likely need to help their loved one get a diagnosis and treatment from a medical professional.
Early detection of schizophrenia, and treating the symptoms as soon as they appear, can reduce the severity of symptoms, notes NAMI.
If you’ve been diagnosed with schizophrenia, you should see your doctor if you notice any changes in your symptoms, or if the side effects of your medication are causing you difficulty.
If you think you’re in immediate danger of hurting yourself or someone else, call 911 or go to the nearest emergency room, advises Cleveland Clinic.
The Takeaway
Schizophrenia is a serious brain disorder affecting thoughts, emotions, and behaviors. Key symptoms include hallucinations, delusions, and disorganized speech. Schizophrenia is a complex, challenging condition, but symptoms can often be managed with proper treatment. If you notice any of these symptoms in yourself or a loved one, see a doctor, because early treatment can reduce their severity.
Additional reporting by Christina Vogt.
Resources We Trust
- Mayo Clinic: Schizophrenia Symptoms and Causes
- National Alliance on Mental Illness: My Schizophrenia Checklist
- National Institute of Mental Health: Schizophrenia
- Cleveland Clinic: Psychosis
- American Psychiatric Association: What Is Schizophrenia?
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Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adul...
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Resources
- Schizophrenia. Cleveland Clinic.
- Schizophrenia. National Alliance on Mental Illness.
- What Is Schizophrenia? American Psychiatric Association.
- Schizophrenia. National Institute of Mental Health.
- Auditory Hallucinations. Cleveland Clinic.
- Teeple RC et al. Visual Hallucinations: Differential Diagnosis and Treatment. Primary Care Companion to the Journal of Clinical Psychiatry. 2009.
- Acosta FJ et al. Medication Adherence in Schizophrenia. World Journal of Psychiatry. October 10, 2012.
- Mosolov SN et al. Primary and Secondary Negative Symptoms in Schizophrenia. Frontiers in Psychiatry. 2021.
- Symptoms - Schizophrenia. NHS. February 12, 2021.
- Schizophrenia - Symptoms and Causes. Mayo Clinic.
- Tardive Dyskinesia. Cleveland Clinic.
- Tripathi A et al. Cognitive Deficits in Schizophrenia: Understanding the Biological Correlates and Remediation Strategies. Clinical Psychopharmacology and Neuroscience. February 2018.