What Are the Early Signs of Schizophrenia?

Reviewed on 4/8/2022
What Are the Early Signs of Schizophrenia?
Schizophrenia is a brain disorder that often causes a split with reality, resulting in patients seeing or hearing things that aren't there.

Schizophrenia is a brain disorder that affects how a person thinks, feels, and behaves. People who have schizophrenia may lose touch with reality and see or hear things that aren't there, believe things that aren't true, and/or not display emotions. 

It’s not always possible to tell if someone is schizophrenic, but some early signs may include: 

  • Depression
  • Social withdrawal
  • Hostility 
  • Suspicion
  • Extreme reactions to criticism
  • A decline in personal hygiene
  • Flat, expressionless gaze
  • Inability to cry or express joy 
  • Inappropriate laughter or crying
  • Oversleeping or insomnia
  • Forgetfulness
  • Inability to concentrate
  • Odd or irrational statements
  • Strange use of words or way of speaking

Other signs and symptoms that are often present in people who have schizophrenia may include:

  • Abnormal behaviors that occur because of schizophrenia (psychotic manifestations called “positive symptoms”)
    • Hallucinations: hearing, seeing, feeling, smelling, or tasting things that aren't there
    • Delusions: paranoia, believing untrue things, irrational fears
    • Disorganized thinking or speech 
  • Normal behaviors that stop because of schizophrenia, are called “negative symptoms”
    • Lack of emotional display or not showing facial expressions (“flat affect”)
    • Not moving or speaking much
    • Lack of basic hygiene
    • No interest in spending time with others or doing things that once were enjoyable
    • Reduced motivation 
    • Difficulty planning, starting and sustaining activities
  • Cognitive symptoms affecting thinking and memory 
    • This can cause problems with:
      • Learning and remembering
      • Making sense of new information
      • Solving problems
      • Focusing or paying attention
      • Decision making
      • Understanding speech or other types of communication
  • Emotional symptoms

What Is the Treatment for Schizophrenia?

Treatment for schizophrenia includes medications combined with counseling and support.

The main type of medication used to treat schizophrenia is antipsychotics. Patients typically must take these drugs for the rest of their lives. 

Antipsychotics can cause unpleasant side effects and many patients stop taking them as a result. Never stop taking a prescribed medication without first talking to your doctor. It may be possible to change the dosage or regimen or switch to a different medication to find one that works best for you and also minimize side effects. It usually takes several attempts with different medications to find the right one for each individual patient. 

Counseling and other support for schizophrenia include: 

  • Cognitive-behavioral therapy (CBT)
  • Cognitive remediation interventions to help address the negative and cognitive symptoms of schizophrenia
  • Behavioral skills training
  • Supported employment
  • Family education and support programs
  • Coordinated specialty care (CSC), which is a recovery-oriented treatment program for people with first-episode psychosis, an early stage of schizophrenia
  • Assertive Community Treatment (ACT) for individuals with schizophrenia who are at risk for repeated hospitalizations or homelessness
Reviewed on 4/8/2022
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