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Schizophrenia - What Happens

Symptoms of schizophrenia usually start in the late teens to mid-20s for men and the late 20s to 30s for women. The symptoms may start suddenly or happen gradually.

Childhood schizophrenia is rare.

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There are four stages of schizophrenia: prodromal phase, active or acute phase, remission, and relapse.

Prodromal phase

Schizophrenia usually starts with this phase, when symptoms are vague and easy to miss. They are often the same as symptoms of other mental health problems, such as depression or other anxiety disorders. They may not seem unusual for teens or young adults. In fact, schizophrenia is rarely diagnosed at this time.

Symptoms are sometimes triggered by stress or changes, such as going away to school, starting to use drugs or alcohol, or going through a severe illness or a death in the family.

These first symptoms often include being withdrawn, outbursts of anger, or odd behavior. For more information, see Symptoms.

This phase can last for days, months, or years.

Active, or acute, phase

At some point you start to have symptoms such as hallucinations, delusions, or confusing thoughts and speech.

These symptoms may appear suddenly or slowly over time. They can be severe and can cause a psychotic episode, which means you can't tell the difference between what is real and what isn't real.

You may need to go to the hospital. You probably won't be able to make many decisions about your care.

This phase usually lasts 4 to 8 weeks. This is when schizophrenia usually is diagnosed.

Remission and relapse

After an active phase, symptoms get better, especially with treatment, and life may be more "normal." This is called remission. But symptoms may get worse again, which is called a relapse. You may have this cycle of symptoms that get severe and then improve.

In each cycle, symptoms such as hallucinations and delusions may become less intense, but other symptoms, such as feeling less interested in caring for yourself, may get worse. You may have few or many cycles before you are able to stay in remission.

Within 5 to 10 years, you may develop a unique pattern of illness that often stays the same throughout your life. It also is possible that you will have fewer relapses as you get older and may even not have symptoms.

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