According to the National Institute of Mental Health, schizophrenia is a disorder of psychosis — that is, a condition characterized by a disconnection from reality. Schizophrenia is often associated with symptoms of hallucinations and delusions. Symptoms of the condition can sometimes overlap with symptoms of depression.
Identifying schizophrenic symptoms in people with depression can be difficult. However, being aware of the different types of schizophrenic symptoms is important. If you recognize them in a loved one or yourself, a proper diagnosis can be helpful to receive appropriate health care and treatment.
Schizophrenic symptoms can be divided into three categories: cognitive, negative, and positive. Cognitive symptoms relate to attention, concentration, and memory. Negative symptoms — which are often mistaken for depression — relate to decreases in mood and motivation. Positive symptoms — also called “psychotic symptoms” — add something to a person’s perception of reality. These are the symptoms people tend to associate most closely with schizophrenia, but they can be difficult to recognize. They include hallucinations, delusions, and thought disorder.
Following are five common signs of schizophrenia.
A hallucination is when a person hears, sees, smells, or feels something that isn’t actually there. Hallucinations are a positive symptom of schizophrenia that are sometimes seen in people with severe depression.
Hallucinations can occur in schizophrenia and other mental health disorders, such as bipolar 1 disorder and depression. Hallucinations can also be a symptom of Parkinson’s disease. People under the influence of drugs or alcohol can hallucinate as well.
Delusions are a common psychotic symptom of schizophrenia that fall under the category of positive symptoms. Delusions are beliefs that conflict with reality.
Delusions tend to fall into one of several types, including the following:
Delusions can also occur as a component of many mental illnesses, including depression and bipolar 1. Like hallucinations, they can occur in people with Parkinson’s disease as well.
Thought disorder refers to speech- and thought-related symptoms. Signs of impaired reasoning or talking may involve a person switching from topic to topic, giving answers that aren’t relevant to the question asked, or expressing what’s known as “word salad” — combinations of words that don’t linguistically make sense. Thought disorder has also been noted in cases of severe depression, though it’s not common.
Although suicidal thoughts aren’t typically thought of as a symptom of schizophrenia, they’re much more common in people with the condition than among the general population. These thoughts may occur with or without depression.
According to a review of 51 studies of people with schizophrenia, the lifetime rate of suicide in people with schizophrenia is 5 percent. Many factors often seen in people with schizophrenia make this symptom more likely:
One protective factor involves adhering to medication and treatment for schizophrenia and depression.
Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.
Negative schizophrenic symptoms refer to when a person no longer exhibits certain normal behaviors related as often, if at all. Health experts consider negative symptoms to have a greater impact on how people with schizophrenia function than positive symptoms do.
There are several types of negative symptoms:
Negative symptoms aren’t limited to schizophrenia. Many of these symptoms also overlap with mood disorders, such as depression and bipolar 1.
Because schizophrenic spectrum disorders and mood disorders share many symptoms, determining a correct diagnosis can be difficult. Therefore, understanding what distinguishes psychotic disorders from mood disorders can be helpful.
The key difference is that a schizophrenia diagnosis requires the presence of delusions, hallucinations, or disorganized speech without simultaneous manic (high-energy or euphoric) episodes or depressive episodes. If a person does experience mood disorders during a schizophrenic episode, they’ll be present for only a small part of the total episode. People with bipolar 1 can also experience psychotic episodes, but they occur during a manic episode.
Sometimes, people may be initially diagnosed with major depression only for a health care professional to later realize that it could be bipolar 1 or schizophrenia. Someone with depression may even be prescribed antipsychotics. These conditions overlap so readily, in part, because they share some risk factors, including stress and abuse.
Researchers are testing ways to diagnose schizophrenia versus a mood disorder based on a functional MRI scan of the brain. Tests like this may one day be used more frequently in the clinic to make a diagnosis.
Only a psychiatrist, a clinical psychologist, or another qualified mental health professional can make an official diagnosis of schizophrenia. However, understanding your own symptoms — or those of your loved one — can help your doctor find the most appropriate treatment options and improve your quality of life. If you or a loved one is experiencing any of the symptoms described in this article, be sure to discuss them with your doctor.
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