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.

1. Hallucinations

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.

• Auditory hallucinations are the most common type of hallucination. Typically, auditory hallucinations involve hearing voices telling the hallucinating person things to do. People may also hear other sounds, like whispering.
• Visual hallucinations involve seeing people, objects, or lights that aren’t really there.
• Olfactory hallucinations can involve tastes that don’t relate to anything being consumed. They can be hallucinations of good or bad tastes.
• With tactile hallucinations, a person might feel as if things are crawling across their skin or inside of them.

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.

2. Delusions

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:

• Persecutory delusions — Beliefs that a person, a group of people, or an organization are out to get you
• Grandiose delusions — Beliefs that involve an inflated sense of self-importance, such as believing one has special abilities or superpowers
• Somatic delusions — Beliefs that something is wrong with one’s body
• Erotomanic delusions — Delusions of love, a common one being the belief that someone in a position of power (such as a celebrity) is in love with you

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.

3. Thought Disorder

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.

4. Suicidal Ideation

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:

• Having a history of substance abuse
• Being young
• Being male
• Having worse symptoms including delusions and hallucinations
• Having a higher education

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.

5. Negative Symptoms

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:

• Blunted affect or flat affect is when someone doesn’t display emotions. They may have reduced facial expressions, gestures, and vocal expressions.
• Alogia (or poverty in speech) is a reduction in the overall number of words spoken.
• Avolition refers to reduced goal-directed activity due to decreased motivation.
• Asociality (social withdrawal) is when a person doesn’t engage in the relationships and activities they used to.
• Anhedonia refers to a reduced experience of pleasure. In other words, activities a person once considered fun no longer brings them joy.

Negative symptoms aren’t limited to schizophrenia. Many of these symptoms also overlap with mood disorders, such as depression and bipolar 1.

Could It Be 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.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and their loved ones. On MyDepressionTeam, more than 142,000 members come together to ask questions, give advice, and share their stories with others who understand life with mental health conditions like depression and schizophrenia.

Are you — or a loved one — experiencing symptoms of schizophrenia or mood disorders? Share your experience in the comments below, or start a conversation by posting on your Activities page.