The symptoms of schizophrenia fall into three broad categories: positive symptoms, negative symptoms, and cognitive symptoms.
Symptoms are different for different people and someone may have a range of symptoms or just one.
Positive symptoms are psychotic behaviors not seen in healthy people. People with positive symptoms often "lose touch" with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment. They include the following:
Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. "Voices" are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices that no one else can hear. The voices may talk to the person about his or her behavior, order the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem.
Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near.
False Beliefs or delusions are beliefs that are not part of the person's culture and do not change. The person is so convinced of their false belief or delusion that even the most logical arguments disproving their belief cannot change their mind. People with psychosis or schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others.
Sometimes they believe they are someone else, such as a famous historical figure. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. For example, someone may be convinced from the way cars are parked outside their house that the house is being watched by the police.These beliefs are called "delusions of persecution."
Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called "disorganized thinking." This is when a person has trouble organizing his or her thoughts or connecting them logically. Their everyday thoughts become confused or don’t join up properly making sentences unclear or hard to understand. A person may have difficulty concentrating, following a conversation or remembering things. Their throughts can seem to speed up or slow down. Another form is called "thought blocking." This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder might make up meaningless words, or "neologisms."
Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available.2
Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression, bipolar disorder or other conditions because mood swings are common and they may feel unusually excited or depressed. How someone feels may change for no obvious reason with symptoms including the following:
• "Flat affect" (a person's face does not move or he or she talks in a dull or monotonous voice)
• Lack of pleasure in everyday life
• A person may seem to feel less or show less emotion to those around them. Speaking little, even when forced to interact.
• They may feel strange, and cut off from the world with everything moving in slow motion.
A person with psychosis or Schizophrenia may have changes in behavior associated with the changes in feelings described above. For example, a person may stop eating because of concern that food is poisoned, or have trouble sleeping because of being scared of something. A person may be extremely active or have difficulty getting the energy to start on sustain planned activities. The person may laugh when things don’t seem funny or become angry or upset without apparent cause.
People with negative symptoms need help with everyday tasks. They often neglect basic personal hygiene. This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia.
Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Often, they are detected only when other tests are performed. Cognitive symptoms include the following:
• Poor "executive functioning" (the ability to understand information and use it to make decisions)
• Trouble focusing or paying attention
• Problems with "working memory" (the ability to use information immediately after learning it).
Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause great emotional distress.