Not all people with schizophrenia know they are experiencing it, especially when symptoms first appear.

This is known as anosognosia, a neurological condition in which people are unaware of a medical condition they are experiencing.

However, some people with schizophrenia may be able to recognize prior symptoms as delusions, paranoia, or hallucinations after they have been managed with medication.

“Positive” symptoms that may contribute to anosognosia

Some of the “positive” symptoms of schizophrenia may make it harder for people to recognize what they’re experiencing. These symptoms are categorized as “positive” because they involve added experiences not usually present, such as:

  • delusions
  • hallucinations
  • disordered and confused thinking
  • paranoia
  • psychosis

These symptoms may make people with schizophrenia hear voices or believe far-fetched things.

“Negative” symptoms that may contribute to anosognosia

Schizophrenia can also cause “negative” symptoms. These “negative” symptoms involve the absence of typical functions and may include:

  • cognitive impairment
  • affective flattening, which may cause someone to appear expressionless
  • an extreme lack of motivation, including for daily tasks
  • decreased desire to socialize

For some people, these may first appear during a prodrome phase that occurs months to years before the onset of “positive” symptoms.

Some people may interpret these negative symptoms as having other causes, such as depression. They may not associate these symptoms with schizophrenia or seek treatment for them. Healthcare professionals may also attribute these symptoms to other health conditions before “positive” symptoms develop.

Treatment, particularly medication, can help manage positive and negative symptoms of schizophrenia. However, people may need to try more than one medication to find what works best for them.

Doctors may also recommend psychotherapy, or talk therapy, to cope with distressing symptoms and manage interpersonal relationships. They may also recommend certain lifestyle practices to reduce symptoms or prevent symptoms from worsening. These can include:

It can be hard for people with schizophrenia to seek treatment. The nature of their symptoms may make them distrustful of others or unable to recognize that they need help.

Because some people with schizophrenia may not know they have it or believe they need medication, family members or other loved ones may step in to help them get the care they need.

Medications for schizophrenia typically cause side effects, like weight gain. Side effects, along with symptoms of schizophrenia, may make people more likely to stop taking their prescribed medications.

It’s important to find a doctor they can trust and medications that help manage their symptoms and encourage them to stay on their treatment plan.