How Does Schizophrenia Change With Age?

Medically Reviewed by Melinda Ratini, MS, DO on May 10, 2022
4 min read

If you or someone you love has a diagnosis of schizophrenia, the aging process can affect how well you manage the disease. Most people with schizophrenia are diagnosed before the age of 40. Men are generally diagnosed in their early 20s and women in their late 20s or early 30s. So there is plenty of time to develop a long-term strategy that can help through all decades of your life. For many people, schizophrenia is manageable, no matter what your age.

Like any complex medical condition, a diagnosis of schizophrenia needs a comprehensive evaluation. Your doctor will make it if common symptoms of the disorder last for at least a month. Effects of schizophrenia, such as depression and paranoia, must be present for at least 6 months. These symptoms must interfere in how well you function.

There are some symptoms of this condition that doctors call positive. They include changes in your behavior and thoughts, like hallucinations and delusions. There are others that doctors call negative symptoms. This is when you stop functioning as you usually do. For example, you might feel emotionally flat, lose interest in relationships, and withdraw from the world.

The quicker you get a diagnosis, the quicker treatment can begin. And there is some evidence that earlier diagnosis and treatment leads to better long-term management. That means that as you age, it may be easier for you to live well with schizophrenia.

There is some debate whether people with schizophrenia actually age faster. Some research says “yes.” But that might be due to lifestyle factors like substance abuse, poor eating habits, and inflammation. One study has shown that what doctors call “normal” brain aging seems to happen more quickly in someone with a psychotic disorder. But researchers also say that early treatment may improve how well you do over the years.

Schizophrenia treatment involves a combination of medication, psychotherapy, and self-management techniques. Although there isn’t a cure, you can go into remission. With schizophrenia, remission means your symptoms are not as intense. Your doctor may be able to lower your dosage of medication. But this will be only under close supervision, since relapse is very common.

Antipsychotic drugs are generally used to help with symptoms like delusions and hallucinations. Your doctor might also prescribe drugs to help with side effects from antipsychotics.

Psychotherapy may include cognitive behavioral therapy. You may try other approaches like art therapy and drama therapy, among others. You can also get help with strategies that improve your social skills, motivation, and hygiene.

It’s important to remember that schizophrenia affects people of all age groups. And it can affect each person differently, although there are common symptoms. As you age with schizophrenia, your treatment plan will take into account just how it’s affecting you at that point in your life. Your doctor will want to see how well you’re doing with antipsychotic medication. They’ll also look at how well psychotherapy and other types of support are working for you.

Research shows that some people with schizophrenia or other serious mental health conditions have a lower life expectancy compared to the general population. For example, as you age you may be at greater risk of developing other conditions like coronary heart disease. But this could be due to lifestyle issues like smoking or obesity. These things also put you at risk for conditions like diabetes or high blood pressure. That’s why it’s very important to not only take care of your physical health but also your mental health.

As you get older, the positive symptoms of schizophrenia like delusions and hallucinations will likely improve. Also, as you age, self-medicating through substance abuse is less common. How well you function in terms of mental health may also improve. If you are older and have schizophrenia, hospitalizations are more often due to physical problems, not schizophrenia. Some of these may be due to side effects of antipsychotics, like metabolic syndrome and movement disorders.

Your medical team will take a look at how well you’ve been doing and develop a treatment plan that best meets your needs. In general, antipsychotic drug dosage may be lowered. But your doctor will gauge the best dosage for you based on your personal risk and personal benefit. But long periods of remission of schizophrenia after decades of illness are possible, especially if you’ve had the right treatment and psychological and social support. Although it’s rare, some older adults with schizophrenia may be able to stop their medication.

Aging can sometimes be tough even when you’re otherwise healthy. Body parts like knees and shoulders get creaky or you don’t sleep as well as you once did. But lack of social and psychological support when you’re older can make some of these things even harder to deal with. If you’re older and have schizophrenia, it’s important for you to keep up with your support systems.

If you’re middle-aged or older, there is research that shows that certain forms of psychological therapy can be very useful. One is cognitive behavioral social skills training. It combines cognitive behavior therapy with strategies that help improve social skills and problem solving. One study in people with schizophrenia over age 45 found that participants in this approach reported more social activities and better functioning.

Another strategy is called functional adaptation skills training. It helps with tasks of daily living like medication management, social skills, communication skills, organization and planning, transportation, and financial management. Adults over age 40 with schizophrenia reported improvements in all these areas.