How Can You Tell if Someone Is Schizophrenic?

People with schizophrenia may lose touch with reality, see or hear things that aren't there, believe things that aren't true, or may not display emotions. Symptoms of schizophrenia include hallucinations, delusions, disorganized speech, lack of basic hygiene, not moving or speaking much, reduced motivation, and others.

Schizophrenia is a brain disorder that affects how a person thinks, feels, and behaves. People who have schizophrenia may lose touch with reality and see or hear things that aren't there, believe things that aren't true, and/or not display emotions. 

It’s not always possible to tell if someone is schizophrenic, but there are certain signs and symptoms that are often present in people who have schizophrenia.

Symptoms of schizophrenia include:

• Abnormal behaviors that occur because of schizophrenia (psychotic manifestations called “positive symptoms”)
  • Hallucinations: hearing, seeing, feeling, smelling, or tasting things that aren't there
  • Delusions: paranoia, believing things that are untrue, irrational fears
  • Disorganized thinking or speech 
• Normal behaviors that stop because of schizophrenia, called “negative symptoms”
  • Lack of emotional display or not showing facial expressions (“flat affect”)
  • Not moving or speaking much
  • Lack of basic hygiene
  • No interest in spending time with others or doing things that once were enjoyable
  • Reduced motivation 
  • Difficulty planning, starting, and sustaining activities
• Cognitive symptoms affecting thinking and memory 
  • This can cause problems with:
    • Learning and remembering
    • Making sense of new information
    • Solving problems
    • Focusing or paying attention
    • Decision making
    • Understanding speech or other types of communication
• Emotional symptoms
  • Anxiety 
  • Depression

Schizophrenia is diagnosed with an assessment by a mental health professional. A diagnosis of schizophrenia is made when a person has two or more of the following symptoms occurring persistently along with reduced functioning:

• Hallucinations
• Delusions
• Negative symptoms
• Disorganized speech
• Disorganized or catatonic behavior

In some cases, tests may be performed to rule out other psychiatric diagnoses such as bipolar disorder, brain tumors, or other medical conditions that may be responsible for the symptoms.

Complications of untreated schizophrenia may include:

• Anxiety disorders 
• Depression
• Suicide, attempted suicide, and thoughts of suicide
  • If you or someone you know are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.
• Alcohol and drug abuse
• Obsessive-compulsive disorder (OCD)
• Financial problems 
• Difficulty keeping a job or attending school
• Health problems
• Homelessness
• Social isolation
• Victimization 

Treatment for schizophrenia includes medications combined with counseling and support.

The main types of medications used to treat schizophrenia are antipsychotics. Patients typically must take these drugs for the rest of their lives. 

Antipsychotics can cause unpleasant side effects and many patients stop taking them as a result. Never stop taking a prescribed medication without first talking to your doctor. It may be possible to change the dosage or regimen, or switch to a different medication to find one that works best for you and also minimize side effects. It usually takes several attempts with different medications to find the right one for each individual patient. 

Counseling and other support for schizophrenia include: 

• Cognitive behavioral therapy (CBT)
• Cognitive remediation interventions to help address the negative and cognitive symptoms of schizophrenia
• Behavioral skills training
• Supported employment
• Family education and support programs
• Coordinated specialty care (CSC), which is recovery-oriented treatment programs for people with first episode psychosis, an early stage of schizophrenia
• Assertive Community Treatment (ACT) for individuals with schizophrenia who are at risk for repeated hospitalizations or homelessness