Schizophrenia Symptoms

Medically Reviewed by Jabeen Begum, MD on March 11, 2024
6 min read

Schizophrenia changes how you think, feel, and act. It might affect you differently from someone else. The symptoms can come and go, too. No one has all of them all of the time.

They usually start between the ages of 16 and 30. Those assigned male at birth (AMAB) often get them earlier than those assigned female. Often, there is a gradual change in the person before obvious symptoms start. This is sometimes called the prodrome phase.

When the disease is in full swing and symptoms are severe, the person with schizophrenia can't tell when certain ideas and perceptions they have are real or not. This happens less often as they get older.

People with the condition usually aren't aware that they have it until a doctor or counselor tells them. They won't even realize that something is seriously wrong. If they do happen to notice symptoms, such as not being able to think straight, they might blame it on things including stress or being tired.

If you're concerned that you or someone you know is showing signs of schizophrenia, talk to a doctor or counselor.

When you have schizophrenia, typically there are five main categories of symptoms. These include:

Delusions. Strong beliefs that aren’t based on reality, such as fear that you’re being harassed or harmed by someone or are receiving secret messages.

Hallucinations. Seeing or hearing things (such as voices) that aren’t actually there.

Incoherent speech. Stopping mid-sentence, jumping from thought to thought, or using nonsensical words.

Unusual movements. Moving repetitively, having abnormal posture, or agitated movements.

Negative symptoms. Lacking typical behaviors such as bathing, socializing, taking care of basic needs, or showing emotion.

Positive symptoms are highly exaggerated ideas, perceptions, or actions that show the person can’t tell what’s real from what isn’t. Here the word "positive" means the presence (rather than absence) of symptoms. They can include:

Hallucinations. People with schizophrenia might hear, see, smell, or feel things no one else does. The types of hallucinations in schizophrenia include:

  • Auditory. The person most often hears voices in their head. They might be angry or urgent and demand that they do things. It can sound like one voice or many. They might whisper, murmur, or be angry and demanding.
  • Visual. Someone might see lights, objects, people, or patterns. Often it’s loved ones or friends who are no longer alive. They may also have trouble with depth perception and distance.
  • Olfactory and gustatory. This can include good and bad smells and tastes. Someone might believe they’re being poisoned and refuse to eat.
  • Tactile. This creates a feeling of things moving on your body, such as hands or insects.

Delusions. These are beliefs that seem strange to most people and are easy to prove wrong. The person affected might think someone is trying to control their brain through a TV or that the FBI is out to get them. They might believe they're someone else, like a famous actor or the president, or that they have superpowers. Types of delusions include:

  • Persecutory delusions. These may make you feel that someone is after you or that you’re being stalked, hunted, framed, or tricked.
  • Referential delusions. When a person believes that public forms of communication, such as song lyrics or a gesture from a TV host, are a special message just for them.
  • Somatic delusions. These center on the body. The person thinks they have a terrible illness or bizarre health problem such as worms under the skin or damage from cosmic rays.
  • Erotomanic delusions. A person might be convinced a celebrity is in love with them or that their partner is cheating. Or they might think people they’re not attracted to are pursuing them.
  • Religious delusions. Someone might think they have a special relationship with a deity or that they’re possessed by a demon.
  • Grandiose delusions. The affected individuals might consider themselves to be a major figure on the world stage, such as an entertainer or a politician.

Confused thoughts and disorganized speech. People with schizophrenia can have a hard time organizing their thoughts. They might not be able to follow along when you talk to them. Instead, it might seem like they're zoning out or distracted. When they talk, their words can come out jumbled and not make sense.

Trouble concentrating. For example, someone might lose track of what's going on in a TV show as they're watching.

Movement disorders. Some people with schizophrenia can seem jumpy. At times, they'll make the same movements over and over again. But sometimes, they might remain perfectly still for hours at a stretch, which experts call being catatonic. Contrary to popular belief, people with the disease usually aren't violent.

Negative symptoms refer to an absence or lack of normal mental function involving thinking, behavior, and perception. You might notice:

Lack of pleasure. The person may not seem to enjoy anything anymore. A doctor will call this anhedonia.

Trouble with speech. They might not talk much or show any feelings. Doctors call this alogia.

Flattening. The person with schizophrenia might seem like they have a terrible case of the blahs. When they talk, their voice can sound flat, like they have no emotions. They may not smile normally or show usual facial emotions in response to conversations or things happening around them. A doctor might call this affective flattening.

Withdrawal. This might include no longer making plans with friends or becoming a hermit. Talking to the person can feel like pulling teeth; if you want an answer, you have to really work to pry it out of them. Doctors call this apathy.

Struggling with the basics of daily life. They may stop bathing or taking care of themselves.

No follow-through. People with schizophrenia have trouble staying on schedule or finishing what they start. Sometimes, they can't get started at all. A doctor might call this avolition.

Decreased desire to socialize. There’s not much motivation to be around other people, and interactions can be awkward.

Depression has some of the same symptoms, too. They can be hard to spot, especially in teens, because even healthy teens can have big emotional swings between highs and lows.

These symptoms reflect how well the person’s brain learns, stores, and uses information.

Someone with schizophrenia might have a hard time with their working memory. For example, they may not be able to keep track of different kinds of facts at the same time, such as a phone number plus instructions.

Along with having trouble paying attention, it can be hard for them to organize their thoughts and make decisions.

When someone gets a schizophrenia diagnosis before the age of 18, it’s called early-onset schizophrenia. It can be tricky to diagnose schizophrenia in teens because many of the symptoms are typical for normal development, such as:

  • Withdrawal from friends and family
  • Difficulty keeping up with schoolwork
  • Trouble sleeping
  • Irritability or depressed mood
  • Lack of motivation

Teens who use marijuana, methamphetamines, or LSD can also show symptoms similar to those of schizophrenia.

Unlike adults with the disorder, teens with schizophrenia are more likely to have visual hallucinations and less likely to have delusions. Some common complications of schizophrenia are alcohol and drug abuse, other mental disorders, self-harm, and thoughts of suicide.

Being aware of the symptoms of schizophrenia can help you recognize when someone may be dealing with the disorder. If you are concerned someone you love has schizophrenia, have a conversation about what you’re seeing. You can be a support and source of encouragement if they choose to seek medical help.

Although you can’t make someone go to the doctor for symptoms of schizophrenia, there are certain situations where you may need to call on emergency help. If someone is posing a danger to themselves or others, or if they can’t properly take care of themselves, certain support can help, such as 911 or other emergency responders. In some cases, your loved one may need to be hospitalized.

Can a person with schizophrenia have a normal life?

With proper treatment, people with schizophrenia can lead fulfilling and meaningful lives. Although the symptoms of the disease can cause many disruptions and hardships, consistent use of medication, therapy, and social and emotional support can help people manage their disease well and function normally.

What are usually the first signs of schizophrenia?

Some of the earliest signs of schizophrenia can be subtle. You may notice someone is having mood swings, or calling or coming around less often. They may start neglecting things they’re supposed to do such as housework, schoolwork, or personal hygiene. After these early signs, you may start seeing active symptoms such as delusions and hallucinations.