What Are the Phases of Schizophrenia?

Medically Reviewed by Smitha Bhandari, MD on August 31, 2022
2 min read

Schizophrenia is a mental illness whose symptoms usually occur in phases. Phase 1, when they start to show up, is called prodromal. In phase 2, the active stage, your symptoms are most noticeable. The last stage is the residual phase of schizophrenia. In this phase, you're starting to recover, but still have some symptoms.

Schizophrenia is a type of psychosis. That means you can’t always tell the difference between what's real and what's a thought inside your head. Its symptoms can include:

  • Hallucinations: You see or hear things that don’t exist
  • Delusions: Beliefs that aren’t based in reality
  • Muddled thoughts based on hallucinations or delusions
  • Problems speaking clearly
  • Lack of goal-oriented behavior
  • Trouble thinking through information or paying attention
  • Loss of interest in daily life
  • Bad hygiene
  • Desire to avoid people, even friends and family

Often, you don’t realize that your thoughts have become misleading or paranoid. Friends, loved ones, or your doctor must point it out and try to lead you toward treatment.

Schizophrenia tends to happen in episodes, in which you cycle through all three stages in order. These cycles are hard to stop without help from a doctor.

In the first, prodromal phase, friends and family might notice strange behavior. You might want to be alone much of the time and may start to talk only about certain topics, such as religion, the government, or a particular public figure.

This phase can last from weeks to years. Some people with schizophrenia never go past this point, but most do.

The active phase (sometimes called “acute”), can be the most alarming to friends and family. It causes symptoms of psychosis like delusions, hallucinations, and jumbled speech and thoughts. Sometimes, this phase appears suddenly without a prodromal stage.

Doctors sometimes call this the “recovery” phase. In many ways, it mirrors the prodromal phase. The more intense symptoms, like hallucinations, start to fade. But you may still have some strange beliefs. You're also likely to withdraw into yourself and talk less.

You might have trouble concentrating or keeping your thoughts straight. You can become depressed as you become aware of the episode.

The residual symptoms tend to get more and more serious after each new active stage. Some people have residual symptoms that don't go away. Always follow the treatment program your doctors prescribe, so you can avoid another episode of the disease.

Early treatment, with consistent follow-up, works well for many people with schizophrenia. Some people have just one or two active episodes in their lives. A combination of medication, talk therapy, and other support can greatly improve mental health and quality of life.

Talk to your doctor if you suspect symptoms of schizophrenia in yourself or a loved one.