Schizophrenia and schizoaffective disorder are disorders of psychosis best known for symptoms of hallucinations and delusions. Symptoms of schizophrenia spectrum disorders can sometimes overlap with symptoms of depression. People with schizoaffective disorder may also experience mood swings (between mania and depression) or periods of depression.
It can be difficult to identify schizophrenic symptoms in people with depression. However, it is important to be aware of the different types of schizophrenic symptoms. If you recognize them in a loved one or yourself, a proper diagnosis and treatment can be sought.
Schizophrenic symptoms can be divided into three categories: positive, negative, and cognitive. Also called “psychotic symptoms,” positive symptoms add something to a person’s perception of reality — like seeing or hearing something that isn’t actually there. Positive symptoms 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.
A hallucination is when a person hears (auditory), sees (visual), smells (olfactory), or feels (tactile) something that isn’t actually there.
Hallucinations can occur during schizophrenia, schizoaffective disorder, and other mental health disorders, such as bipolar 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. Delusions are beliefs that conflict with reality. Delusions tend to fall into one of several types, including persecutory, grandiose, somatic, or erotomanic.
Delusions can also occur as a component of many mental illnesses, including mood disorders like depression and bipolar disorder. Like hallucinations, they can occur in people with Parkinson’s disease.
Thought disorder, called disorganized speech in the Diagnostic and Statistical Manual of Mental Disorders, 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.” Word salad is when words are combined in ways that don’t linguistically make sense. Although less common, thought disorder has also been noted in cases of severe depression.
Negative schizophrenic symptoms are symptoms that describe typical, normal behaviors which are now absent. Negative symptoms are actually considered to have a greater impact on schizophrenic individuals’ functioning than positive symptoms. There are several types of negative symptoms:
Because there are many shared symptoms between schizophrenic spectrum disorders and mood disorders, it can be difficult to discern the correct diagnosis. Therefore, it is helpful to understand what distinguishes psychotic disorders and mood disorders.
The key difference is that a schizophrenia diagnosis requires the presence of delusions, hallucinations, or disorganized speech without simultaneous manic or depressive episodes. If mood disorders do happen during schizophrenia, they will be present for only a small part of the total episode of schizophrenia. People with bipolar disorder can also experience psychotic episodes, but they occur during a manic episode.
Sometimes, people may be initially diagnosed with major depression only for a doctor to later realize that it could be bipolar disorder, schizophrenia, or schizoaffective disorder. Someone with depression may be prescribed antipsychotics. Individuals who are initially diagnosed with either depression or schizophrenia may end up with a diagnosis of schizoaffective disorder, depending on how their symptoms present themselves. These conditions overlap so readily, in part, because they share some risk factors. Stress or abuse are risk factors for these conditions.
Researchers are testing ways to diagnose schizophrenia versus a mood disorder based on functional magnetic resonance imaging of the brain. Tests like this may one day be used more frequently in the clinic to make a diagnosis.
Only a psychiatrist, clinical psychologist, or other qualified mental health professional can make an official diagnosis of schizophrenia or schizoaffective disorder. However, understanding your own symptoms — or those of your loved one — can help your doctor find the most appropriate treatment. If you or a loved one are experiencing any of the symptoms described in this article, be sure to discuss them with your doctor.
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