Can you recognize schizophrenia? This is more common than you think…

Imagine hearing voices no one else can hear or believing with certainty that your thoughts aren’t your own. For millions around the world, this isn’t fiction—it’s daily life with schizophrenia, a misunderstood and often stigmatized mental illness that challenges our very understanding of reality.

My close-to-home experience taught me that schizophrenia can be complex and subtle. I spent over two decades as a qualified psychologist, but nothing prepared me for watching my closest friend unravel before my eyes. Melissa and I grew up together—we shared college dorms, bridal showers, and even parenting milestones. So when she started withdrawing, talking to people who were not there, and accusing her husband of planting cameras in the walls, I knew it was not just stress or burnout. As both a professional and someone who loved her dearly, it was heartbreaking. Beyond just a clinical diagnosis, schizophrenia is a thief that steals trust, connection, and identity.

The psychiatric condition can be deeply stigmatizing. So, let’s first explore what schizophrenia is and what it is not.

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia often appear as if they have lost touch with reality, which can be distressing both for them and for those around them. It’s a complex condition that requires lifelong treatment, but with proper care, many individuals can manage their symptoms and lead fulfilling lives.

Common social misconceptions generally include:

#1 MYTH: Individuals with schizophrenia behave as if they have multiple states of self or personalities.

TRUTH: They are often split from reality, not from different states of self.

#2 MYTH: Schizophrenia is rare, and chances to have it are slim.

TRUTH: The risk of developing schizophrenia is about 1 in 100.

#3 MYTH: Individuals with schizophrenia are commonly dangerous people.

TRUTH: Most of them are definitely not. But the delusional thinking patterns and intrusive hallucinations may sometimes lead to aggression.

#4 MYTH: There is not much you can do. Individuals with schizophrenia cannot be helped. Better to stay aside.

TRUTH: One can significantly help another’s experience with schizophrenia through empathy and building connection.

If you or someone you know is experiencing symptoms that may suggest schizophrenia—or any other mental health concern—it is important to seek help from a qualified mental health professional. Early assessment and intervention can make a significant difference in managing the condition effectively. This article is for informational purposes only and is not intended to diagnose or treat any medical or mental health condition

Important: Take any talk or signs of suicidal thoughts very seriously. If you or someone you care about is struggling with suicidal thoughts or behaviors, do not wait—help is available. In the United States, you can call or text the Suicide & Crisis Lifeline at 988 or dial 1-800-273-TALK (8255) to speak with a trained counselor. If you are outside the U.S., visit IASP or Suicide.org to find a helpline in your country. You are not alone, and support is just a call or click away.

The exact cause of schizophrenia is unknown, but it is so far believed to result from a combination of genetics (family history increases risk); brain chemistry (imbalances in dopamine and glutamate); brain structure (some with schizophrenia show changes in brain structure); and environmental factors (e.g., prenatal exposure to infections, psychosocial stress).

Here are a few indicators if you are looking to catch signs of schizophrenia early on. These come in handy when it comes to observing young individuals whose brains are still developing. It is important to note that some signs can be confusing and common indicators of other mental health conditions.

• Depression and social withdrawal;
• Apathy, hostility, extreme reactions to perceived danger;
• Negligence of personal hygiene;
• Flat and neutral gaze;
• Inability to express healthy emotions (e.g., unable to cry or genuinely laugh);
• Sleep deprivation or sleeping too much;
• Distracted, unable to focus;
• Odd speech and irrational, confusing statements.

Keep in mind that these early symptoms are aligned with other mental health conditions as well. Nonetheless, exhibiting as few as three of them for a medium period of time can be a serious cause of concern.

Once diagnosed, the appropriate treatment is prescribed by a trained professional. When left untreated, clear schizophrenia symptoms will largely include:

1. Delusions

This is basically a false belief and is not intentional. Delusions occur in more than 90% of those diagnosed. We generally divide schizophrenia-related delusions into

• Delusions of persecution – Someone is out to get me;
• Delusions of reference – Someone is trying to send me a message;
• Delusions of grandeur – I have supernatural powers;
• Delusions of control – Someone is watching me.

2. Hallucinations

These experiences feel very real to the person having them, even though they do not exist in the external world. The most common type of  hallucination in diagnosed people is auditory (e.g., hearing voices), but others can also include visual, olfactory, tactile, and gustatory.

Hallucinations are usually critical and aggressive, and tend to get worse when the person is left alone and unsupervised.

3. Disorganized speech

This is an added disruption to normal thought and communication. It reflects disorganized thinking, which makes it hard for the person to logically connect ideas or respond appropriately in conversation. For instance, the person may jump between ideas without making sense. Or they might make up their own words or phrases that only have meaning to them. They can also repeat the same words and statements over and over again.

4. Disorganized behavior

Cognitive impairment in schizophrenia makes behavior abnormal. If observed behaviors make it hard for independent living and maintaining social norms and relationships, it can be a serious cause of concern. It can vary but can include:

• Unpredictable or inappropriate emotions and actions (e.g., laughing or crying at the wrong times; sudden agitation without a clear cause);
• Incoherent movements (e.g., pacing, unusual gestures);
• Inability to perform daily tasks (e.g., cleaning, cooking);
• Lack of response (e.g., not speaking; rigid posture).

If you or a loved one is struggling, or you just want to learn more, read Schizophrenia: A Guide to Understanding and Managing Schizophrenia by Amanda Allan.

What do you think about schizophrenia and associated symptoms? Let us know what your experience is down below in the comments.

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If you found this useful, continue reading 6 CBT Exercises: Free Therapy At Home.