Key takeaways

  • Doctors categorize schizophrenia symptoms into three types: negative, positive, and cognitive symptoms. All three types can make it difficult for someone to complete everyday tasks.
  • Negative symptoms involve decreased motivation and social withdrawal. Hallucinations and delusions are considered positive symptoms, with auditory hallucinations being the most common type.
  • Cognitive symptoms affect daily functions including memory, attention, concentration, and decision-making abilities.

Schizophrenia is a mental health condition that can change how you think, act, and feel. The symptoms can be severe enough to disrupt a person’s daily life, relationships, and school or work performance. Estimates suggest one third of people who receive treatment for schizophrenia may still experience symptoms, but the majority experience recovery.

Doctors categorize schizophrenia symptoms into three types: negative, positive, and cognitive. All three types may affect your ability to navigate and complete your daily routine.

“Negative” symptoms involve an absence of certain “normal” functions, like motivation, speech, and thinking skills. “Positive” symptoms involve “added” experiences not usually present, like delusions and hallucinations. Cognitive symptoms affect brain functions like concentration, memory, and attention.

Typically, symptoms need to occur for 6 months or longer for a doctor to diagnose schizophrenia.

Negative symptoms of schizophrenia include decreased motivation and social withdrawal. Doctors may sometimes misdiagnose these symptoms as those related to clinical depression.

Below, you’ll find some of the most common negative symptoms of schizophrenia.

Cognitive impairment

“Cognitive impairment” refers to factors that affect thinking. Schizophrenia may affect:

  • processing speed
  • attention
  • memory
  • reasoning
  • social cognition

It can be difficult for a person experiencing these symptoms to keep up with conversations and put thoughts into words.

If a loved one is experiencing schizophrenia, you might notice them not seeming to make much logical sense with their words. This can be confusing if you’ve known them for a long time and it’s not in line with their usual behavior.

Affective flattening

A person with affective flattening may appear stoic or expressionless in their facial appearance. Their voice may also sound “flat” or “blunted”. People may sometimes mischaracterize this symptom as apathy.

Avolition (trouble with daily tasks)

While anyone can experience low motivation from time to time, schizophrenia may cause a more extreme lack of motivation called avolition. This symptom can make everyday tasks, like getting dressed and brushing your teeth, very difficult to accomplish.

Decreased desire to socialize

A desire to withdraw from others is another symptom that can occur in schizophrenia as well as in clinical depression. The person may lack a desire to have conversations or interactions with friends and loved ones.

Positive symptoms of schizophrenia involve additions to the person’s typical behavior that can disrupt their grasp of reality. Some mental health professionals refer to these symptoms collectively as psychosis. People experience positive symptoms on a more “active” basis.

The most common positive symptoms of schizophrenia are:

Hallucinations

Hallucinations refers to sensory experiences that seem to the person like they’re really happening, but don’t actually occur in real life. Types of hallucinations include:

  • auditory, the most common type, in which you hear voices
  • visual, in which vividly see people or items
  • hallucinations of tastes or smells
  • hallucinations of physical or tactile sensations

Delusions

Delusions refer to thinking or fixation around false beliefs. These may seem unreasonable and easy to prove false to others. But, like hallucinations, they are very real to the person experiencing them.

Types of delusions may include:

  • paranoid/persecutory, which cause you to believe others want to harm or follow you
  • grandiose, where you might believe you are rich, famous, or extremely talented
  • referential, which involve a belief that public art or communications are directed towards you
  • delusional jealousy/erotomanic, which can cause you to think a famous person is in love with you or that a partner is cheating on you
  • religious, in which you might believe you have connections with a deity or a demon
  • somatic, where you have delusions about your own body pertaining to an unlikely illness or missing part

Movement disorders

Schizophrenia may cause a state of catatonia, which can manifest as a complete lack of movement. It can also make a person feel unusually jumpy and perhaps engage in different movements repeatedly.

Schizophrenia may also affect daily cognition skills, possibly leading to:

  • difficulties with memory, attention, and concentration
  • having a harder time than others completing everyday tasks
  • disorganized speech
  • difficulty making decisions
  • anosognosia (lack of insight), which can make a person unaware that they have this condition

Like other mental health conditions, schizophrenia doesn’t cause many physical symptoms, but a person might appear more still, jumpy, or expressionless than usual. If they are struggling with everyday tasks due to symptoms, they might appear less groomed than is typical for them.

It’s a misconception that people with schizophrenia are violent. In fact, research shows individuals with this condition are more likely to have violence perpetrated against them than to be violent toward others. At the same time, the chances of violence or self-harm are greater if the person doesn’t receive treatment for the condition.

Symptoms of schizophrenia tend to appear when people are in their 20s or 30s, but they may occur as early as the teenage years or early adulthood, especially in males.

Teenagers may also exhibit earlier symptoms as a precursor to schizophrenia, like new challenges with the following:

  • engagement and motivation at school
  • navigating relationships
  • making decisions

Keep in mind that such symptoms aren’t exclusive to schizophrenia and can be common adolescent behaviors. In teens with schizophrenia, the above challenges typically become apparent over the course of 1 to 2 years. A young person who has always experienced them may be experiencing another condition or circumstance.

Still, it’s important to be aware that subtle changes in mood, social function, and thought processes may occur in schizophrenia before more obvious positive symptoms develop.

If you have concerns about a teen’s mental health, it’s important to talk with them and reach out to their doctor or therapist.

Managing schizophrenia is generally a lifelong process that requires a combination of medications and therapies to help minimize the effects some symptoms may have on everyday life.

It’s also important to have a support system. This may include family or loved ones, friends, or people you might meet in group therapy. You can also talk with your doctor if you’re concerned about any new or worsening symptoms.

Finally, it’s important to take care of yourself. A balanced diet, regular exercise, and relaxation techniques can all promote well-being and decrease stress.

Schizophrenia currently has no cure, so long-term treatment is important to help improve a person’s quality of life and prevent complications. Doctors may classify symptoms as “positive” or “negative,” though this mental health condition can also cause cognitive symptoms that affect daily life.

While it’s important to know the symptoms of schizophrenia, only a mental health professional can provide an accurate diagnosis. If you suspect you or someone you love may have this condition, speak with a doctor.