How to Recognize Schizophrenia in Teens

Medically Reviewed by Jennifer Casarella, MD on September 03, 2022
2 min read

Schizophrenia can be hard to spot in teens. Sometimes it can be tough to see the difference between ordinary teenage moodiness and signs of more serious illness, although this disease usually begins in late adolescence or young adulthood.

It helps to know what symptoms to watch for and when you should check with your doctor.

Symptoms in teens can come on gradually over days, weeks, several months or more. This is called the prodromal period. The early symptoms of schizophrenia can sometimes look like those of other problems such as anxiety or depression.

Especially at first, symptoms may look like the stuff of typical teen years: bad grades, changing friends, trouble sleeping, or irritability.

But there are some early warning signs in teens that show up as changes in thinking, emotions, and behavior.

  • Lack of concentration or being able to follow a train of thought
  • Seeing or hearing things that aren't real (hallucinations)
  • Confusing TV and dreams with reality
  • Strange ideas that may not make sense (for example, thinking that parents are stealing things or that an evil spirit possesses them)
  • Paranoia -- thinking that people are after them or talking about them
  • Dwelling unreasonably on the past
  • Being extremely moody or irritable
  • Angry outbursts
  • Severe fearfulness or anxiety
  • Unblinking, vacant expression
  • Awkward or unusual movements of the face or body
  • Talking to themselves, using odd speech that you can't understand, or making rapid shifts in topics
  • Inappropriate responses, such as laughing during a sad movie
  • Trouble "reading" social cues in others
  • Problems making and keeping friends
  • Becoming more and more isolated
  • Poor personal grooming and self-care
  • Substance abuse
  • Threatening behaviors

If you notice symptoms like these, your teen needs to be checked by a doctor right away. That's especially true if anyone on either side of their family has had schizophrenia

The doctor will ask your teen questions about their thinking and behavior, possibly perform a brief physical exam, and give them blood or urine tests to make sure there isn't another medical condition or drug abuse problem that’s to blame.

For a schizophrenia diagnosis, the symptoms have to last for at least 6 months and don’t seem to be due to another medical or psychiatric condition. Sometimes it takes longer than 6 months to make a confident diagnosis, based on how symptoms appear over time.

Your family doctor can refer you to a psychiatrist who works with teens. A psychiatrist has special training in how to diagnose and treat schizophrenia.

If your teen has the condition, a combination of treatments may work best. These might include medication and individual and family therapy.

The diagnosis can be tough news to hear. But with the right treatment, people with schizophrenia do go to college, hold jobs, and have a family life.