July 27, 2023/Mental Health

8 Early Signs of Schizophrenia

Emotional changes, isolation and unusual behavior could signal the onset of the condition

person on a swing between sun and rain

Life changes during the transition between adolescence and adulthood may reveal something unexpected — early signs of schizophrenia.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

The onset of the mental health condition typically begins in a person’s 20s. Schizophrenia tends to appear earlier in men and people assigned male at birth (AMAB), beginning in their late teens to early 20s. Women and people assigned female at birth (AFAB) usually see it start in their mid-20s to early 30s. (But the disorder can begin at any age.)

Symptoms often show themselves slowly and worsen over a period of months or years, says psychiatrist Minnie Bowers-Smith, MD. Here’s what to look for.

Warning signs of schizophrenia

Schizophrenia changes the way that you think, behave and relate to others. “People with schizophrenia don’t seem to interact with the world in a healthy way,” explains Dr. Bowers-Smith. “There’s a loss of touch with reality.”

Signs of the mental illness can be subtle in the initial (or prodrome) stage and easily attributed to other life changes or activities. Common early symptoms include:

Emotional changes

Mood swings can become more frequent as someone enters the early stages of schizophrenia. They may seem more irritable or angry. Fears of the surrounding world may grow. Suspicions may turn into paranoia.

Disconnecting

Time spent with friends and family may suddenly dwindle. Phone calls stop. Conversations are avoided. “You tend to isolate yourself and seem preoccupied with your own world,” says Dr. Bowers-Smith.

Lack of focus

Schoolwork, jobs and household responsibilities can begin to get neglected as thoughts wander further from reality. Irrational excuses may be offered to explain overlooked tasks or missed appointments. Motivation disappears.

Early and active signs of schizophrenia

The first signs of schizophrenia may last as little as a few weeks or as long as a few years. The “active” stage of the mental illness that follows brings more noticeable symptoms, notes Dr. Bowers-Smith. These can include:

  • Hallucinations or hearing voices.
  • Delusional beliefs.
  • Incoherent speaking.
  • Unusual physical movements ranging from catatonic behavior to excessive motion.
  • “Negative symptoms” such as speaking in a flat tone, lack of eye contact and rigid body language.

Living in denial

Even as schizophrenia sets in, many people will overlook or explain away early signs of the condition. Denial can become a coping mechanism even as you see a loved one not functioning well.

In many cases, a college may be the first to send a young adult to be evaluated because of erratic behavior or a drug overdose. “Families often don’t seek help on their own,” notes Dr. Bowers-Smith.

It’s natural to struggle to understand schizophrenia symptoms or ignore the signs until they escalate, sometimes into violent behavior. But without help, problems will continue — especially when fueled by drugs or alcohol.

Advertisement

“If you find them up all hours of the night, or painting their room black, or too irritable or scaring people, call the doctor,” stresses Dr. Bowers-Smith.

When to seek treatment

The earlier the better when it comes to seeking treatment for schizophrenia once symptoms appear, says Dr. Bowers-Smith. Healthcare providers diagnose the illness based on questioning and observations.

A diagnosis of schizophrenia is life-changing for those affected and everyone who loves them. It’s a step toward treatment and a full life. People with schizophrenia can finish college, work jobs, get married and have families.

There isn’t a cure for schizophrenia, but the condition can often be managed through a combination of medication, supportive therapy and education for the person and their family members.

“If you can manage the symptoms, you can have a reasonably stable life,” reassures Dr. Bowers-Smith. “That’s why it’s key to engage people early on and encourage them to find a doctor they can relate to and a therapist who understands them.”

Research indicates that the earlier the treatment the better the outcome.

The National Alliance on Mental Illness (NAMI) offers support groups for the mentally ill and their families. Other support groups are:

There are many mental health providers who can provide help. They’re trained to eradicate the stigma associated with mental health in general and schizophrenia in particular.

Know this, too: If you’re dealing with schizophrenia in your life, you’re not alone. The condition affects about 0.5% to 1%, or 24 million people worldwide, according to the World Health Organization (WHO).

Advertisement

Learn more about our editorial process.

Related Articles

Teen caged in their own mind
May 24, 2024/Children's Health
The Teen Mental Health Crisis: How To Help Your Child

American teens are facing unprecedented rates of depression and suicide, but you can be there to support and help them

Male sitting on couch with head in hand, looking forlorn
May 23, 2024/Men's Health
Men’s Mental Health: 11 Tips for Taking Care of Your Whole Self

Learn to build a strong support system, identify unhealthy coping mechanisms and tend to your physical health

Sad person holding smaller version of themselves in their hands
May 22, 2024/Mental Health
How To Be More Confident and Improve Your Self-Esteem

Ignore the negative self-talk, practice positive affirmations and remember, you’re not perfect — and that’s OK!

Person observing a loving couple
May 15, 2024/Mental Health
Resentment: How It Can Creep In and Take Hold

The key to letting go of resentment is unpacking complex emotions and learning how to express them

Oversized smartphone with social media comments, with two people feeling dejected
March 29, 2024/Mental Health
What Is Thinspo and Why Is It Dangerous?

While social media content doesn’t create eating disorders, it can easily exacerbate them

Two friends laughing together
March 26, 2024/Mental Health
No Fooling: The Very Real Health Benefits of a (Good) Prank or Joke

A pro-level laugh can release good-for-you oxytocin, dopamine and endorphins

person pulling open blue curtains to sunshine
March 4, 2024/Mental Health
Not Feeling Like Yourself Lately? How To Get Out of a Funk

Connecting with others, going for a walk or focusing on sleep quality can help more than you might realize

person speaking with healthcare provider in office
March 4, 2024/Digestive
Ulcerative Colitis and Your Mental Health

Seeking help through therapy can be an important step in improving your quality of life when you have UC

Trending Topics

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

woman snacking on raisins and nuts
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey

Ad