Schizophrenia is a life-long mental illness that affects the way you think, feel, and act. It is a complex disorder that can have a significant impact on your life, as well as the lives of your loved ones. Before developing all of the symptoms of schizophrenia, you may experience less severe ones. This is called the prodromal phase of schizophrenia.

For most people, the prodromal stage lasts for about one to two years before they receive a diagnosis of schizophrenia. About 80 percent to 90 percent of people diagnosed with schizophrenia experienced prodromal symptoms before entering the active phase of schizophrenia.

In this article, we’ll explore eight symptoms that can occur during the prodromal phase of schizophrenia, and explain why recognizing these early signs can help you receive a diagnosis and get treatment.

1. Cognitive Difficulties

Cognitive symptoms — such as problems with memory, concentration, or decision-making — are common during the prodromal phase of schizophrenia. You may experience difficulty concentrating or focusing on tasks, remembering important details, and solving problems. These symptoms may not be very noticeable at first, but they can still have a big impact on your daily life.

2. Social Withdrawal

One of the earliest signs of the prodromal phase of schizophrenia is social isolation and withdrawal. You may become less interested in activities you once enjoyed and may spend more time alone. This change can be subtle and not very apparent to others at first. But, if social withdrawal goes unnoticed, it can lead to feelings of loneliness and isolation. This loneliness and isolation can make the symptoms of schizophrenia worse.

3. Changes in Work or School Performance

As the prodromal phase continues, you may experience impairment in your ability to function in daily life. These difficulties may also lead to a decline in academic or work performance. You may begin to struggle with tasks that used to be easy for you and may appear less motivated or engaged in your work or school activities. Difficulties with problem-solving or planning may cause you to miss deadlines or fall behind in your work.

This decline in functioning can have a big impact, such as decreased productivity, missed opportunities, financial problems, and tension in relationships with co-workers or classmates.

4. Changes in Personal Hygiene and Grooming

During the prodromal phase of schizophrenia, you may begin to overlook your personal hygiene and appearance. This can mean that you forget to practice basic hygiene like taking a shower, brushing your teeth, combing your hair, or changing your clothes. You may wear the same clothes multiple times without washing them or not care about their overall appearance. These changes can occur due to social withdrawal, lack of energy, or a loss of motivation that may make it challenging to maintain regular hygiene practices.

These changes in personal hygiene and appearance can affect your self-esteem and confidence. You may feel embarrassed or ashamed about your hygiene, which can worsen your symptoms of social withdrawal and isolation.

5. Lack of Emotions or Extreme Changes in Mood

One of the symptoms that can occur during the prodromal phase of schizophrenia is a noticeable lack of emotions. This may include a general disinterest in activities that were previously enjoyable, a lack of motivation, and a decreased ability to experience pleasure. People experiencing this symptom may also display a lack of emotional expression, which can make it difficult for others to read their feelings or understand their reactions to different situations.

Other mood changes may also occur during the prodromal phase. These changes may include depression, anxiety, or irritability. You may feel intense feelings of sadness or hopelessness, experience worry or fear, or become easily agitated or angry. These mood changes can be upsetting and can significantly impact your daily life.

These symptoms can be mistaken for depression or other mental health conditions, but when combined with other prodromal symptoms, they can be an early warning sign of schizophrenia.

6. Perceptual Changes and Unusual or Strange Beliefs

During the early stages of schizophrenia, some people may experience perceptual changes associated with psychosis.

These symptoms include:

• Hallucinations — Seeing, hearing, or feeling things that aren’t there
• Delusions — Holding onto false beliefs
• Distortions — Having difficulty thinking clearly and processing information accurately

These symptoms can be scary and confusing, especially if you’re not aware that you’re experiencing the prodromal phase.

7. Problems With Sleep

Sleep disturbances are another symptom that can occur during the prodromal phase of schizophrenia. These can include difficulty falling or staying asleep, and waking up too early in the morning.

These sleep disturbances can lead to feeling tired and unrefreshed during the day, which can make it harder to concentrate and function in daily activities. Sleep disturbances can also worsen other prodromal symptoms, such as anxiety and social withdrawal, which can make it harder to cope with everyday life.

8. Substance Abuse

During the prodromal phase of schizophrenia, some people may use drugs or alcohol as a way to cope with their symptoms, but this can make their condition worse. Substance use and abuse are common among people with schizophrenia, and it can be particularly problematic during the prodromal phase. A person may turn to drugs or alcohol as a way to cope with the prodromal symptoms they are experiencing. Substance abuse can make the symptoms of schizophrenia worse and may even lead to the development of substance use disorders.

It's important to seek help if you or a loved one is struggling with substance abuse and prodromal symptoms. Treatment can help manage symptoms and prevent the development of more severe problems.

Talk With Your Doctor

The prodromal phase of schizophrenia can be a confusing and challenging time for you and your loved ones. It's important to be aware of the possible symptoms of this phase of schizophrenia and to seek help from a health care professional if you or a loved one is experiencing them.

People who display several prodromal symptoms and have a family history of schizophrenia are considered to be at ultra-high risk for developing a psychotic disorder. However, since prodromal schizophrenia cannot be diagnosed until you develop full schizophrenia, experiencing symptoms does not always mean that you will develop schizophrenia.

Your doctor can determine if you may be in an early stage of schizophrenia and recommend appropriate treatment options. Early detection, as well as early intervention, can greatly improve treatment outcomes and quality of life for those with schizophrenia.

Remember, with proper treatment and support, people with schizophrenia can lead fulfilling and meaningful lives.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and related mental health conditions (like schizophrenia) and their loved ones. On MyDepressionTeam, more than 143,000 members come together to ask questions, give advice, and share their stories with others who understand life with different mental health conditions.

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