Signs and Symptoms of Schizophrenia

Schizophrenia is a chronic brain condition characterized by a “disconnection” from reality. These disconnections might appear as delusions, hallucinations, disorganized speech, and disorganized or odd movements. The term “schizophrenia” can apply to both a single condition and a group of conditions classified as psychotic conditions. Schizophrenia does not mean a split or multiple personalities. Multiple personalities are a symptom of dissociative identity disorder.

The primary symptoms of schizophrenia are most likely to occur during the active period. These symptoms can include any of the following:

Delusions

Delusions are persistent false beliefs that continue despite apparent or reasonable proof that they are untrue. The most common are persecutory delusions, in which a person feels they are being hurt or tormented by another person or group. These are thoughts that a person will not alter despite evidence to the contrary.

Hallucinations

Hallucinations are the illusion of hearing, seeing, smelling, tasting, or experiencing things that are not really there. They are clear and distinct, giving the appearance of normal experiences. The most prevalent type of hallucination in schizophrenia is an auditory hallucination, or “hearing voices.” These are things that don’t exist, yet you believe they do.

Disorganized thinking and speech

It refers to thoughts and speech that are disorganized, confused, and/or do not make sense. People may struggle to keep on topic, or it may be severe enough that you are unable to comprehend them because their words are jumbled or incomprehensible. People who have schizophrenia frequently struggle to organize their thoughts when speaking.

Disorganized motor behavior

These are motions that can range from childlike silliness to unpredictable agitation, disturbing, or repetitive movements. When the behavior is severe, it may interfere with daily activities. It comprises catatonia, a condition in which a person does not react to stimuli as expected. They may strike a certain pose, fail to reply to the person speaking to them, or begin moving around excessively for no apparent reason.

Negative symptoms

These are declines in specific behaviors. Impaired emotional expression, decreased voice output, fewer or no hand or other body movements, and reduced enjoyment are some examples. They also have a lack of motivation, especially when it comes to socializing or doing things they normally love.

Schizophrenia develops typically in stages, with various symptoms and behaviors associated with each stage.

• • Prodrome phase. This is a preliminary stage that occurs before a person gets more severe symptoms. It might appear as social withdrawal, anxiety, a lack of drive, and a disregard for personal cleanliness. This phase can last from weeks to years.
  • Active phase. This is when psychotic symptoms become fully apparent. Sometimes, this phase appears suddenly without a prodromal stage. Another word for this is “psychotic break,” which occurs when a person loses touch with reality. 
  • Residual phase. People in this stage still have some signs and symptoms of schizophrenia, although they are not as severe. The most visible symptoms include strange thoughts, lack of motivation, lower sensations of delight or pleasure, limited speech, and less emotional expressiveness. Many people typically heal to the point where they appear to be partly or completely recovered.

Although there is no cure for schizophrenia, many individuals can manage their symptoms effectively.

Two main types of medications are used to treat schizophrenia. Typical antipsychotics work by affecting how the brain uses dopamine, a neurotransmitter that helps nerve cells communicate. Atypical antipsychotics affect both dopamine and serotonin, two important neurotransmitters involved in brain communication. One specific atypical antipsychotic has a rare but serious side effect that requires regular blood monitoring, which is why other medications are usually prescribed first.

Cognitive Behavioral Therapy (CBT) can help individuals with schizophrenia understand, cope with, and manage their symptoms. It may reduce symptom severity, improve daily functioning, and support long-term stability. Therapy can also address related concerns such as anxiety, depression, or substance use.

Electroconvulsive therapy (ECT) involves delivering a controlled electrical current to the scalp, stimulating targeted areas of the brain. This creates a brief seizure that can improve symptoms related to severe depression, agitation, and other complications. Providers may consider ECT when medications fail to work, when the person is at risk of self-harm or harming others, or when rapid improvement is needed and medication alone may take too long to help.