Schizophrenia affects thinking, emotions, and behavior. While symptoms vary, clinicians often group them into five core categories—a mix of “positive” (added experiences), “negative” (loss of function), and cognitive symptoms. These form the foundation of diagnosis and treatment.
1. Delusions
False, unshakable beliefs not based in reality. Common types include:
- Paranoid delusions: “The government is spying on me.”
- Grandiose delusions: “I have special powers.”
- Referential delusions: “TV shows are sending me hidden messages.”
Delusions feel completely real to the person, even when contradicted by evidence.
2. Hallucinations
Sensory experiences that aren’t real—most often auditory (hearing voices). Voices may criticize, command, or comment on behavior. Less commonly, people see, smell, or feel things that aren’t there.
3. Disorganized Thinking (Speech)
Thoughts become jumbled, making speech hard to follow. Signs include:
- Jumping between unrelated topics
- Making up words (“word salad”)
- Giving answers that are off-topic or incoherent
This reflects inner mental fragmentation, not lack of intelligence.
4. Negative Symptoms
These involve a loss of normal function and are often more disabling than hallucinations:
- Avolition: Lack of motivation to act
- Alogia: Reduced speech
- Anhedonia: Inability to feel pleasure
- Flat affect: Little emotional expression
- Asociality: Withdrawal from relationships
Unlike moodiness, these persist and impair daily life.
5. Cognitive Impairments
Often overlooked but critical:
- Trouble focusing or paying attention
- Poor working memory (“Where did I put my keys?”)
- Difficulty planning, organizing, or solving problems
These affect school, work, and independence—even when psychosis is controlled.
Important Note
To be diagnosed with schizophrenia, symptoms must last at least six months, with active symptoms (like delusions or hallucinations) present for at least one month. Other causes—like drugs or medical illness—must be ruled out.
Schizophrenia isn’t “split personality.” It’s a complex brain disorder where reality becomes blurred. But with treatment—medication, therapy, and support—many manage these symptoms and rebuild meaningful lives. Awareness is the first step toward compassion and care.