People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, people with this condition may feel frightened, angry, anxious, depressed, or confused.
Symptoms of schizophrenia usually start in adolescence or early adulthood. They often appear slowly and become more pronounced, disturbing, and bizarre over time. The first signs of schizophrenia often appear as confusing—or even shocking—changes in behavior. To fit the diagnostic criteria, symptoms of the illness must be present for at least six months, and there must be deterioration from the patient’s previous level of functioning.
The sudden onset of severe psychotic symptoms is referred to as an acute phase of schizophrenia. Psychosis, a common condition in schizophrenia, is a state of mental impairment marked by hallucinations. Less obvious symptoms (such as social isolation and/or withdrawal, unusual speech, bizarre thinking, or strange behavior) may precede, coincide, or follow the psychotic symptoms.
People with schizophrenia may behave differently at unpredictable times. This unusual behavior usually occurs as a result of the unusual realities they are experiencing. People with this condition may seem distant, detached, or preoccupied. They may be very restless and/or hypervigilant and unable to sit or stand still, or sit as rigidly as a stone (catatonia) without moving or speaking for hours.
Common symptoms of schizophrenia include:
Some people have only one psychotic episode. Others have many episodes during a lifetime, but lead relatively normal lives between these periods. A person with chronic schizophrenia, with a continuous or recurring pattern of illness, often does not fully recover normal functioning. This person typically requires long-term treatment, including medicine to control the symptoms.
People with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal even while they experience hallucinations or delusions. A person’s behavior may change over time—often becoming strange or bizarre if medication is stopped, then returning closer to normal when receiving and complying with appropriate treatment.
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National Institute of Mental Health website. Available at: http://www.nimh.nih.gov.
Schizophrenia. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 4, 2010. Accessed September 6, 2010.
Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Mosby Elsevier; 2008.
Last reviewed November 2012 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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