Understanding Schizophrenia
What Is Schizophrenia?
Schizophrenia is a chronic mental health disorder that affects how an individual behaves, thinks, and feels.
The symptoms of schizophrenia are grouped into positive symptoms (an excessive or distorted functioning), cognitive issues (memory and thinking processes are affected), and negative symptoms (decrease or loss of function). Often, individuals with schizophrenia don’t know they have it, and their symptoms may go untreated.
What Is Psychosis?
Psychosis can be a symptom of several different mental health disorders; it can be challenging to diagnose.
Psychosis is not a personality disorder. It can be the result of brain injury, traumatic events or experiences, or genetic differences in brain development. People sometimes think that psychosis is a break from reality. For some, it is, but psychotic symptoms frequently overlap with the symptoms of some personality or mood disorders.
Is Schizophrenia the Same as Psychosis?
No, psychosis and schizophrenia are not the same mental health condition.
Schizophrenia is a lasting mental health condition that affects thinking, emotions, and behavior, and can include psychosis.
Psychosis is a condition in which an individual loses touch with reality. Not every individual diagnosed with schizophrenia experiences psychosis. Similarly, not everyone who experiences psychosis has schizophrenia, and other causes.
Does Schizophrenia Develop Over Time?
The symptoms of schizophrenia develop gradually over time.
The first signs of schizophrenia often start to appear during the late teens to early adulthood. The symptoms can start with subtle, barely noticeable changes in thinking and behavior before becoming more severe, like experiencing delusions and hallucinations.
Individuals with early-onset schizophrenia experience changes in how they think and interact with their friends and loved ones. For some, it appears they have lost touch with reality.
What Is the Age of Onset for Schizophrenia?
Most individuals who are diagnosed with schizophrenia begin to exhibit its symptoms as young adults.
While schizophrenia can occur at any age, the average age at which early signs occur is between the ages of late teens to early 20s for men and the late 20s to early 30s for women.
While uncommon, some individuals can develop schizophrenia in later stages of life. When an individual is diagnosed with schizophrenia after their 30s, it is called late-onset schizophrenia.
Even though research is limited, there’s an increase in the diagnosis of individuals with schizophrenia after the age of 40. While researchers aren’t sure why, they believe later-in-life diagnoses could be because an individual had cognitive obstacles that weren’t treated, or their social support system was unaware of the signs of schizophrenia.
Ocean View Psychiatric Health Facility provides acute psychiatric care for those who are 18 years of age or older. You will work with a mental health professional to create a treatment plan tailored to your care needs.
Causes of Schizophrenia
What Causes Schizophrenia?
The National Alliance on Mental Illness (NAMI) states that the causes of schizophrenia can be a combination of possible causes.
Some of those risk factors can include:
- Genetics
- Environment
- Brain chemistry
- Substance use disorder: Studies suggest that using mind-altering substances during the teen or early adult years can increase the risk of developing schizophrenia.
What Genetic Factors Increase Risk for Schizophrenia?
There isn’t one genetic variation that causes schizophrenia. Instead, it can be caused by a combination of genetics and environmental influences.
There’s a greater risk of developing schizophrenia if close family members are diagnosed with schizophrenia. However, while the risk of developing schizophrenia can increase if a parent or sibling is diagnosed with schizophrenia, most individuals won’t be diagnosed with the mental health condition.
What Neurobiological and Brain Changes Are Associated With Schizophrenia?
Issues with the brain chemicals, including neurotransmitters such as dopamine and glutamate, may cause schizophrenia.
Neurotransmitters are the communication center of the brain. They relay messages from parts of the body to the brain. Changes in dopamine and glutamate can affect how the brain receives and transmits signals.
What Environmental or Prenatal Exposures Contribute to Risk?
Your risk of being diagnosed with schizophrenia increases if you were exposed to viruses or malnutrition before you were born.
Exposure to viruses or a lack of nutrition, especially in the first or second trimester, can increase the risk of developing the symptoms of schizophrenia. Furthermore, environmental stressors are thought to act as catalysts for genetic risks, a process known as epigenetics. Recent research suggests that there may be a connection between autoimmune disorders and the development of psychosis.
Understanding Early Signs of Schizophrenia
What Are the Early Signs of Schizophrenia in Adults?
Often, the early stages of schizophrenia include social withdrawal, emotional or behavioral changes.
The symptoms of schizophrenia can be unnoticeable in the early stage and can be mistaken for or thought to be caused by other activities or life changes. The more common early symptoms include:
- Emotional changes: Individuals often experience frequent mood swings. They may be irritable or angry without a known cause. Some may become suspicious of people, places, or things around them. Sometimes their suspicions can become paranoia.
- Social isolation: Individuals will spend less time with friends and family and can seem preoccupied with their own world.
- Inability to focus: Daily life is disrupted as responsibilities are neglected. This can happen as thoughts move farther from reality. Individuals can give irrational excuses to explain their behavior.
Other early symptoms can also include:
- Hearing voices or hallucinations
- Delusional beliefs
- Disorganized speech
- Disorganized thinking
- Lack of personal hygiene
- False beliefs
These symptoms often disrupt an individual’s quality of life. At Ocean View Psychiatric Health Facility, our medical and mental health professionals can guide individuals to understand their mental health condition through psychosocial and recreational group therapies.
How Early Can Signs of Schizophrenia Start?
Early symptoms of schizophrenia can start with mood and behavior changes.
The early symptoms can develop slowly, often going unnoticed, and can be mistaken for common behaviors exhibited by teens. Since the symptoms can go unnoticed or be mistaken, it is often difficult to diagnose someone in the early stages of schizophrenia.
Is Anxiety an Early Sign of Schizophrenia?
Anxiety can be an early sign of schizophrenia.
In the early stage of schizophrenia, anxiety can occur before more severe symptoms show up. Individuals with increased anxiety may be exhibiting a risk for the development of schizophrenia. Anxiety combined with other changes in behavior or mood can also be a sign of schizophrenia.
Is Insomnia an Early Sign of Schizophrenia?
Yes, insomnia can be an early sign of schizophrenia.
Changes in sleeping patterns, like insomnia, can be an early symptom of schizophrenia, and many times it’s linked with the severity of the mental health condition. The presence of insomnia can indicate a worsening of symptoms and harm an individual’s quality of life. Insomnia can also predict the onset of hallucinations and disorganized thinking.
What Behavioral Changes Might Indicate Early Schizophrenia?
Unexplained irritability, social isolation, a change in sleeping patterns, and a decline in work or school performance can indicate early schizophrenia.
Individuals can also have extremely disorganized or unusual body functioning. They are unwilling to listen to or follow instructions, act silly, or become agitated for no apparent reason. Additionally, they may have unusual body movements that aren’t socially acceptable or normal. On the other hand, individuals may not respond to others or move at all.
Sometimes these changes are mistaken for the changes many teens or young adults go through. Since these changes can be mistaken for other physical or behavioral changes, it can be challenging to diagnose schizophrenia.
What Cognitive or Speech Changes Are Early Warning Signs?
Early warning signs of schizophrenia include changes in speech patterns.
Changes in speech patterns can include: Slower speech
- Difficulty finding the right words
- Longer pauses
- Repeating themselves
- Struggle to follow conversations
Some of these symptoms can be mistaken for the early stages of dementia, like Alzheimer’s disease.
What Social or Functional Declines Suggest Early Schizophrenia?
Often, academic or social difficulties, including issues with relationships, work, or school, occur years before the easily recognizable symptoms begin to appear.
These declines in function can be an indication of an increased risk of developing schizophrenia.Furthermore, functional declines can indicate an increased risk of developing schizophrenia. Some of these symptoms can include:
- Lack of motivation
- Social isolation
- Decreased emotional expression
What Are the Early Signs of Paranoid Schizophrenia?
Paranoid schizophrenia is often associated with symptoms that include a change in sleep patterns, withdrawal, difficulty focusing, and irritability.
The early stages of paranoid schizophrenia can mimic common teen or young adult behaviors or stress symptoms. Since the symptoms can mimic common behaviors found in teens and young adults, it can be challenging to determine if an individual is experiencing the early stages of schizophrenia.
What Does Pre-Schizophrenia Look Like?
Symptoms in the prodromal stage (pre-schizophrenia) can include isolation, lack of motivation, and changes in personal hygiene.
Individuals in the pre-schizophrenia stage can also have:
- Unusual behaviors or thoughts
- Difficulty sleeping
- Troubles in school or work performance
- Irritability
Symptoms of Schizophrenia
What Is the First Presenting Symptom of Schizophrenia?
The earliest signs of schizophrenia in adolescents include:
- Depression
- Isolation
- Difficulty focusing
- Behavioral issues
- Unusual thoughts or behaviors
Adults often experience different symptoms than teens. Their symptoms can include:
- Restlessness
- Anxiety
- Lack of personal hygiene
- Suicidal thoughts
- Social isolation
When Are Schizophrenia Symptoms Most Likely to Appear?
Typically, the symptoms of schizophrenia appear in an individual’s late teens to early 30s.
It’s not common for those above 40 to be diagnosed with schizophrenia, although it can happen.
What Are Prodromal Symptoms in Schizophrenia?
The early stage of schizophrenia’s symptoms is often subtle; therefore, its symptoms, such as anxiety and social isolation, can be mistaken for typical changes in behavior during adolescence or for another condition.
Prodromal is the earliest phase of the degeneration that occurs in the brain. However, not everyone has the same symptoms, and the symptoms can often be overlooked or mistaken for something else.
While in this stage, individuals can start having pre-psychotic mild to moderate changes in behavior, thoughts, and perception. At this point, symptoms like hallucinations, delusions, and other severe symptoms haven’t occurred yet.
Related Conditions
What Mental Health Disorders Commonly Co-Occur With Schizophrenia?
The most common co-occurring mental health disorders connected with schizophrenia are:
- Depression
- Anxiety
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
Schizophrenia is a spectrum disorder that includes several related psychotic disorders such as hallucinations, delusions, and disorganized thinking.
How Can Substance Use Affect Symptoms?
The symptoms of schizophrenia can be worsened if an individual uses substances.
Substance use can deepen the effects of symptoms like delusions and hallucinations. The intensification of these symptoms can complicate treatment and increase the risk of a psychotic episode.
What Other Conditions May Present Similarly to Early Schizophrenia?
Several other mental health conditions can have similar symptoms to schizophrenia, including:
- Dissociative identity disorder
- Bipolar disorder
- Schizoaffective disorder
- Substance-induced psychotic disorder
The National Institute of Mental Health (NIMH) reports that these other mental health disorders, as well as others, can have overlapping symptoms with schizophrenia, which makes diagnosing schizophrenia a challenge.
Diagnosis of Schizophrenia
What Are the Diagnostic Criteria for Schizophrenia?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) states that an individual must be experiencing.
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized behavior
- Negative symptoms (apathy, lack of motivation)
To be diagnosed, an individual must also have a significant disruption in their daily life. Additionally, the diagnosis is made if an individual experiences hallucinations or delusions for 1 month and either disorganized behavior or negative symptoms for 6 months.
What Screening Tools Are Used in Diagnosis?
The tools most commonly used to diagnose schizophrenia are:
- Positive and Negative Syndrome Scale (PANSS)
- Scale for the Assessment of Negative Symptoms (SANS)
The other tools used to diagnose schizophrenia include the following:
- Clinical Assessment Interview for Negative Symptoms (CAINS)
- Brief Negative Symptom Scale (BNSS)
- Scale for the Assessment of Positive Symptoms (SAPS)
- Negative Assessment-16 (NSA-16)
- Clinical Global Impression Schizophrenia (CHGI-SCH)
How Long Does Diagnosis Take?
A diagnosis of schizophrenia can take several weeks or months because of the extensive tests done to rule out other physical, substance use, or mental health conditions.
At Ocean View, our medical and psychiatric team will ensure that an individual has a comprehensive exam that includes assessing:
- Mental health
- Physical health
- Family history
Once we have completed the assessment, we can determine your diagnosis and the treatment options that best fit your unique needs. We can also decide which symptoms you are experiencing on the schizophrenia spectrum and ensure you have the proper antipsychotic medications to help control and maintain symptoms.
Treatment for Schizophrenia
When Should I Seek Treatment?
You must reach out for help if you recognize severe changes in:
- Mood
- Unusual thinking patterns
- Hallucinations
- Delusions
The signs you or a loved one needs to seek help include:
- Psychotic Episodes: The inability to distinguish between reality and imagination. These episodes are commonly linked to hallucinations and delusions.
- Suicidal Thoughts: Thoughts of self-harm or suicide require immediate help.
- Substance Abuse: The use of or an increased use of alcohol or drugs to cope with the symptoms of mental health disorders.
- Other Severe Symptoms: Symptoms like disorganized thinking or behaviors that become overwhelming require acute psychiatric stabilization.
Should Families Seek Early Intervention?
Yes, families should seek early intervention once the symptoms of schizophrenia are recognized.
Early intervention helps treat a loved one’s symptoms before they become severe or harmful. Schizophrenia treatment can help a loved one learn how to recognize and manage their symptoms. A mental health professional can use psychotherapy techniques like cognitive-behavioral therapy to guide an individual to discover how to use healthy coping skills to manage their symptoms.
Will Medication Be Used to Treat Symptoms?
Yes, antipsychotic medication is often used to help treat and manage the symptoms of schizophrenia.
What Therapies Treat Schizophrenia?
Psychotherapy, such as cognitive-behavioral therapy and antipsychotic medication, can help manage the symptoms of schizophrenia.
Since there isn’t a cure for schizophrenia, lifelong treatment can help an individual with schizophrenia learn how to maintain their clinical improvement.
When Is Emergency Care Necessary?
If you or a loved one has any of the following severe crisis symptoms, call or text (988) the National Suicide Prevention emergency hotline or crisis lifeline immediately:
- Threatening to harm others
- Threats to harm yourself
- Suicide attempts