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I am hearing things
Hallucinations
Lack of motivation
Auditory hallucinations
Change in personality
Unusual behavior
Lack of emotion
Not seeing your symptoms? No worries!
What is Schizophrenia?
A psychotic disorder characterized by disturbances in thinking (cognition), emotional responsiveness, and behavior, with an age of onset typically between the late teens and mid-30s. Hearing voices and/or believing things that aren't consistent with reality are common symptoms. The exact cause is unknown, but a mix of genetic, psychological, and environmental factors are likely responsible.
Typical Symptoms of Schizophrenia
- Difficulty speaking, performing tasks, or recognizing things
- Personality change
- Hallucinations
- Decreased motivation
- Hear voices speaking to or around me
- Hearing voices or noises from unknown sources
- Often feel I am being watched by somebody
- Feeling that others are always talking about me or targeting me with their gestures
Diagnostic Questions for Schizophrenia
Your doctor may ask these questions to check for this disease:
- Have you been experiencing difficulty speaking, performing tasks, or recognizing things?
- Do you feel your personality has changed?
- Have you been experiencing any hallucinations?
- Have you been experiencing decreased motivation recently?
- Do you hear voices around you?
Treatment of Schizophrenia
Regular medication and structured support are important for good disease control. Therapy can be helpful as an additional treatment.
Reviewed By:
Weston S. Ferrer, MD (Psychiatry)
Weston Ferrer is a physician leader, psychiatrist, and clinical informaticist based in San Francisco. With nearly a decade of experience in academia and more recent immersion in industry, he has made significant contributions to the fields of digital health, health tech, and healthcare innovation. | As an Associate Professor at UCSF, Weston was involved in teaching, leadership, and clinical practice, focusing on the intersection of technology and mental health. He recently led mental health clinical for Verily (formerly Google Life Sciences), where he applied his expertise to develop innovative solutions for mental healthcare using the tools of AI/ML, digital therapeutics, clinical analytics, and more.. | Weston is known for his unique ability to innovate and support product development while bringing pragmatism to technology entrepreneurship. He is a strong advocate for patient-centered care and is committed to leveraging technology to improve the health and well-being of individuals and communities. |
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Content updated on May 13, 2024
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Antisocial behavior and language difficulty
- Can't say what I want to say
- Problems remembering
- Outbursts of sudden anger
- Speech is difficult and requires conscious effort
- Can't read words like I used to
- Tactile hallucination
- Sudden personality change
- Can't perform tasks
- Started having reading difficulty as an adult
- Feeling less ambitious nowadays
- Personality and behavior change
- Language disorders
- Hearing sounds that aren’t real
- Lost the ability to read
See full list
Symptoms Related to Schizophrenia
Diseases Related to Schizophrenia
FAQs
Q.
Is it Antisocial Personality Disorder? The Reality & Medical Next Steps
A.
There are several factors to consider; antisocial personality disorder is a persistent pattern of violating others’ rights that usually begins by adolescence, is not the same as being shy, and requires diagnosis by a licensed clinician after ruling out lookalikes such as substance use disorders, bipolar disorder, borderline or narcissistic personality disorders, and schizophrenia. Next steps include scheduling a professional evaluation, writing down long-standing behaviors, being honest about substance use, and seeking urgent care for violence, suicidal thoughts, severe aggression, psychosis, or self-harm. For important details that could change your next steps, see below.
References:
* Rogers, K. A., & Loehr, C. C. (2022). The Conceptualization, Assessment, and Treatment of Antisocial Personality Disorder: A Review. *Psychological Assessment*, *34*(10), 915–928. PMID: 36287878.
* Gibbon, S., et al. (2020). Treatment of Antisocial Personality Disorder: A Systematic Review. *Journal of Personality Disorders*, *34*(Suppl), 162–181. PMID: 32706346.
* Pailing, L. A., & Levenson, J. (2023). Neurobiological aspects of antisocial personality disorder: implications for treatment. *Current Psychiatry Reports*, *25*(6), 461–469. PMID: 37190038.
* Hare, R. D. (2017). Antisocial personality disorder: An overview for clinicians. *Focus (American Psychiatric Publishing)*, *15*(2), 221–228. PMID: 29706782.
* Loeber, R., et al. (2020). Psychopathy and Antisocial Personality Disorder: Differences and Similarities. *Psychological Bulletin*, *146*(3), 195–216. PMID: 31999298.
Q.
Lurasidone Side Effects? Why Your Brain Reacts & Medically Approved Next Steps
A.
Lurasidone side effects include sleepiness, nausea, restlessness or muscle stiffness, and mild weight changes, with rarer serious risks like tardive dyskinesia, neuroleptic malignant syndrome, metabolic changes, and increased suicidal thoughts in young people because it shifts dopamine and serotonin activity. There are several factors to consider. Medically approved steps include taking it with food, tracking symptoms, adjusting dose or timing only with your doctor, routine checks of weight, blood sugar, and lipids, and urgent care for high fever, severe stiffness, confusion, uncontrollable movements, fainting, or suicidal thoughts; do not stop suddenly. See complete guidance below, which can affect the next steps you choose with your clinician.
References:
* Dhillon S, Adis R. Lurasidone: An Updated Review of Its Use in Schizophrenia and Bipolar Depression. Drugs. 2017 Jul;77(10):1083-1105. PMID: 28620835.
* Leucht S, Correll CU, Salanti G, et al. Comparing the Safety and Tolerability of Atypical Antipsychotics in the Treatment of Schizophrenia and Bipolar Depression: A Systematic Review and Meta-Analysis. CNS Drugs. 2020 Jan;34(1):21-39. PMID: 31734898.
* Modestin J, Lang U. Antipsychotic-Induced Extrapyramidal Side Effects: A Systematic Review and Clinical Guidance for Treatment. Clin Ther. 2021 Dec;43(12):e325-e339. PMID: 34863717.
* Ng R, Raskin J, Glick S, Citrome L. Safety and tolerability of lurasidone in bipolar depression: an evidence-based review. Neuropsychiatr Dis Treat. 2015 Oct 13;11:2543-52. PMID: 26500595.
* Potkin SG, Litman RE, Torres R, Campbell SC. Pharmacological profile of lurasidone: a new atypical antipsychotic agent. CNS Neurosci Ther. 2012 Aug;18(8):695-703. PMID: 22827150.
Q.
Am I Delusional? Why Your Mind Distorts Reality & Medically Approved Next Steps
A.
A delusion is a fixed false belief that does not change with clear evidence, and distorted reality can arise from stress, sleep loss, trauma, substance use, medical conditions, or mental health disorders. Medically approved next steps include starting with a primary care evaluation to rule out medical causes, then a mental health assessment, prioritizing sleep and avoiding substances, tracking symptoms, and seeking urgent care for hallucinations, persistent fixed beliefs, or any safety concerns; there are several factors to consider, so see the complete guidance below for important details that can shape your next steps.
References:
* Frith, C. D. (2012). The neuroscience of delusions: a review. *Dialogues in Clinical Neuroscience, 14*(2), 173–182. PMID: 22753796
* Powers, A. R., & Schauder, K. B. (2020). Distorted Reality: How Psychotic Experiences Shape Sensory Perception and Cognition. *Schizophrenia Bulletin, 46*(5), 1083–1092. PMID: 32267866
* de Portugal, E., González-Rodríguez, A., & Peralta, V. (2021). Delusional disorder: A concise review of its diagnosis, classification, and management. *International Journal of Psychiatry in Clinical Practice, 25*(2), 160–166. PMID: 33502859
* American Psychiatric Association. (2020). The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. *American Journal of Psychiatry, 177*(9), 868–872. PMID: 32877134
* Tabet, P., & Parnas, J. (2022). Reality Testing and Delusional Disorders: A Systematic Review. *Comprehensive Psychiatry, 114*, 152293. PMID: 35057134
Q.
Is it Moods or Psychosis? Why Schizoaffective Disorder Mimics Both + Medically Approved Next Steps
A.
There are several factors to consider: schizoaffective disorder includes both psychosis and mood episodes, with at least two weeks of psychosis without mood symptoms, which is why it can look like schizophrenia, bipolar disorder, or depression with psychotic features. Medically approved next steps include prompt psychiatric evaluation to map symptom timing and rule out substances or medical causes, evidence based treatment with antipsychotics plus mood stabilizers or antidepressants along with therapy and support, and urgent care for suicidal thoughts or severe impairment; see the complete guidance below because key details could change which steps you should take.
References:
* Malaspina D, Owen MJ, Heckers S, et al. Schizoaffective Disorder: An Overview. Schizophr Bull. 2021 Jan 18;47(1):112-113. doi: 10.1093/schbul/sbaa164. PMID: 33460497; PMCID: PMC7811776.
* Murru A, Varo C, Popovic D, et al. The treatment of schizoaffective disorder: a systematic review. Int J Bipolar Disord. 2017 Dec;5(1):28. doi: 10.1186/s40345-017-0103-y. PMID: 29110196; PMCID: PMC5673012.
* van der Werf E, van Rossum I, Delespaul P. Distinguishing Schizophrenia, Bipolar Disorder, and Schizoaffective Disorder: A Symptom Network Approach. Schizophr Bull. 2021 Jan 18;47(1):103-111. doi: 10.1093/schbul/sbaa163. PMID: 33460495; PMCID: PMC7811775.
* Coyle JP, Shiber T. Schizoaffective Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. PMID: 30855866.
* Heckers S. Schizoaffective Disorder: Is It a Valid Diagnosis and How Does It Relate to Schizophrenia and Bipolar Disorder? Schizophr Bull. 2021 Jan 18;47(1):1-3. doi: 10.1093/schbul/sbaa184. PMID: 33460496; PMCID: PMC7811777.
Q.
Is Reality Slipping Away? The Science of Psychosis & Medical Next Steps
A.
Psychosis is a treatable medical symptom where reality feels distorted by hallucinations, delusions, and disorganized thinking; it can arise from schizophrenia spectrum and mood disorders, substances or withdrawal, sleep loss, certain medications, or medical illnesses like infections and thyroid or autoimmune problems. There are several important factors to consider, including early warning signs like social withdrawal and decline in work or school; see below to understand more. Next steps include prompt medical evaluation to confirm psychosis, find the cause, and rule out emergencies, especially if there is confusion, fever, severe headache, seizures, or any risk of harm. Evidence based treatments include antipsychotic medicines, therapy, and coordinated specialty care, plus treating any underlying condition; crucial details that could change your decisions about when and where to seek care are outlined below.
References:
* McGuire P, Fusar-Poli P, Pries L, et al. Early psychosis: recent advances and future directions. Transl Psychiatry. 2018 Nov 13;8(1):234. doi: 10.1038/s41398-018-0287-4. PMID: 30425263; PMCID: PMC6233159.
* Howes OD, Murray RM, Fusar-Poli P. The Science of Psychosis: Neurobiology, Pathophysiology, and Clinical Implications. JAMA Psychiatry. 2021 May 1;78(5):547-558. doi: 10.1001/jamapsychiatry.2021.0064. PMID: 33764353.
* Kambeitz J, Kambeitz-Ilankovic L, Leucht S, Dwyer DB, Fusar-Poli P, Falkai P. The neuroscience of psychosis: implications for diagnosis and treatment. Lancet Psychiatry. 2021 Dec;8(12):1098-1111. doi: 10.1016/S2215-0366(21)00249-1. Epub 2021 Oct 29. PMID: 34720173.
* Patel V, Jo PH, Patel A, Jo J, Khan S, Khan Y. Early Psychosis Intervention: A Literature Review. Cureus. 2023 Feb 15;15(2):e35058. doi: 10.7759/cureus.35058. PMID: 36949987; PMCID: PMC10018868.
* Stone J, Veltman DJ, Howes OD, Fusar-Poli P, McGuire P. Management of first-episode psychosis: a review. Psychopharmacology (Berl). 2020 Apr;237(4):947-961. doi: 10.1007/s00213-020-05466-9. Epub 2020 Feb 21. PMID: 32080775; PMCID: PMC7070183.
Q.
Why Do You Defend Them? The Science of Stockholm Syndrome & Expert Next Steps
A.
Defending someone who hurt you can be a survival response called Stockholm syndrome or trauma bonding, where severe threat, isolation, and intermittent kindness activate stress and reward pathways that create powerful, confusing bonds. There are several factors and safety steps to consider, from assessing immediate risk and planning safely to reconnecting with trusted supports and seeking trauma-informed therapy; see below for expert guidance and key details that may affect your next healthcare decisions.
References:
* Namnyak, M., Tufton, D., Biondi, M., & George, S. (2008). Stockholm syndrome: an historical account and current relevance. *Acta Psychiatrica Scandinavica*, *117*(1), 1–16.
* Graham, D. L., Rawlings, E. I., & Rimini, N. (2013). Survival and the Psychology of Intimate Partner Violence: The Stockholm Syndrome and Related Phenomena. *Journal of Trauma & Dissociation*, *14*(3), 317–333.
* Adorjan, A., & Spagnoli, J. (2023). The Myth of Stockholm Syndrome: The Case for a Traumatic Bonding Theory. *Trauma, Violence, & Abuse*, 15248380231154563.
* Reimer, C. (2010). Trauma-induced attachment and dissociative processes. *Psychotherapie, Psychosomatik, Medizinische Psychologie*, *60*(11), 433–440.
* Courtois, C. A. (2010). Complex trauma, complex reactions: Assessment and treatment. *Psychotherapy: Theory, Research, Practice, Training*, *47*(4), 412–425.
Q.
Schizophrenia in Women 30-45: Key Symptoms & Critical Next Steps
A.
Women 30 to 45 may first notice schizophrenia during this stage, with hallmark symptoms such as persistent hallucinations or delusions, disorganized thinking or behavior, and often overlooked negative and cognitive changes like loss of motivation, social withdrawal, trouble focusing, and declining daily functioning. Critical next steps are to complete a structured symptom review, contact a doctor promptly for a full evaluation to rule out medical causes, start treatment early with medication, therapy, and support, and seek emergency care for suicidal thoughts, severe confusion, rapidly worsening paranoia, or postpartum psychosis. There are several factors to consider, including hormonal shifts and common misdiagnosis. See the complete guidance below.
References:
* Riecher-Rössler A, Kulkarni J. Gender differences in symptom presentation in schizophrenia spectrum disorders: A systematic review. Front Psychiatry. 2018 Sep 26;9:435. doi: 10.3389/fpsyt.2018.00435. PMID: 30319502; PMCID: PMC6169970.
* Kulkarni J, Gavrilidis E, Worsley R, et al. Schizophrenia and women: Current understanding and treatment implications. Aust N Z J Psychiatry. 2021 Mar;55(3):250-264. doi: 10.1177/0004867420970007. PMID: 33170068.
* Riecher-Rössler A. Schizophrenia in women: gender-specific aspects of illness and treatment. Dialogues Clin Neurosci. 2010;12(4):425-34. doi: 10.31887/DCNS.2010.12.4/ariros. PMID: 21204423; PMCID: PMC3025066.
* Kulkarni J, Gavrilidis E. Reproductive hormones and schizophrenia: a review of treatment implications in women. Psychopharmacology (Berl). 2020 Jan;237(1):151-163. doi: 10.1007/s00213-019-05393-9. PMID: 31734658.
* Kulkarni J, Gavrilidis E, Esler J, et al. Clinical management of schizophrenia across the female lifespan: a review. Lancet Psychiatry. 2023 Feb;10(2):123-134. doi: 10.1016/S2215-0366(22)00346-7. PMID: 36620701.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
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https://journals.sagepub.com/doi/10.1177/070674379704200204American Psychological Association - Schizophrenia
https://dictionary.apa.org/schizophrenia