What Are the Early Signs of Schizophrenia?

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When Do Symptoms of Schizophrenia Appear?

Early symptoms of schizophrenia vary depending on the person. Symptoms may develop slowly over months or years with several symptoms building sequentially before the diagnosis is made.

A person experiencing schizophrenia symptoms will likely need to see a psychiatrist for an assessment and diagnosis. However, family members and friends sometimes recognize symptoms in the early stages of the disorder. Early signs of schizophrenia usually manifest between the ages of 15 and 30.

What Are the Early Signs of Schizophrenia?

The early signs of schizophrenia are often subtle and may even be mistaken for normal behavior in teenagers, college students, or young adults.

It is not until the symptoms become more pronounced that the disorder is recognized as schizophrenia.

Delayed Development in Childhood

Early signs of schizophrenia may include delays in motor development, speech or language development, and social development.

For example, a child may fail to learn to talk or walk as expected, and they also may not show normal emotional responses.

Struggling in School

A child or teenager may show early signs of schizophrenia by withdrawing from friends and family, avoiding contact with other people, or refusing to go to school.

Students who were once high academic achievers could become chronically truant, eventually dropping out of school altogether.

Later in adolescence, it is common for children with schizophrenia to withdraw socially and start lagging behind their peers in terms of academic and vocational achievement.

Suspiciousness of Others

Early warning signs of schizophrenia may include suspicions about the motives of others. A teen might believe that strangers on the street are "talking" to him through their secret thoughts, for example, or he might think his friends don't like him and want to harm him.

Ideas that people or objects can belong to someone else (called "possession" delusions) may be early signs of schizophrenia.

People with early signs of schizophrenia might stay up all night, believing they are protecting themselves from dangerous forces such as the FBI or CIA. This unusual behavior is called "delusions of reference."

People with early signs of schizophrenia may also experience delusions of grandeur, such as the belief that they are a famous rock star or have special powers.

Inappropriate Social Behavior

Inappropriate social behavior may be an early sign of schizophrenia in teens and young adults.

For example, someone with schizophrenia might stand too close to others during a conversation or laugh at a joke that others do not find funny.

Inappropriate sexual behavior, such as making inappropriate sexual comments to strangers, also could indicate the possible onset of schizophrenia.

If you are a survivor of sexual assault, you can contact the RAINN National Sexual Assault Hotline at 1-800-656-4673 to receive confidential support from a trained staff member at a local RAINN affiliate.

For more mental health resources, see our National Helpline Database.

Moving Slowly

Schizophrenia symptoms may present as a movement disorder such as uncoordinated movements or catatonia. A person with catatonia may move very little or remain in strange postures for hours at a time.

Flat or Expressionless Gaze

Some people with early signs of schizophrenia have a "blank" or "flat" expression on their face. Others may have a blank facial expression when speaking, resulting in a sort of verbal and facial "downtime," which is considered another possible early sign of schizophrenia.

Mood Swings

People with schizophrenia may have noticeable mood swings from being elated one moment to being severely depressed the next.

These mood swings also can include other symptoms such as frantic efforts to avoid real or imagined enemies and a general sense of being overwhelmed by life circumstances.

Delusions and Hallucinations

In the early stages of schizophrenia, a person may have delusions or hallucinations that are short-lived or come and go. A teenager might believe, for example, that his classmates at school are talking about him behind his back, or he might hear a voice that no one else can hear.

Commonly reported hallucinations include hearing voices or seeing things that are not there, while delusions usually involve ideas of persecution or paranoia. A young person with schizophrenia might be preoccupied with a particular delusion and talk about it incessantly.

Associative Problems

Associative thinking problems are among the earliest warning signs of schizophrenia. People with associative thinking problems may have difficulty understanding cause-and-effect relationships.

For example, they often don't recognize that their thoughts influence their feelings or behavior.

Disorganized Thinking

Disorganized thinking is another early warning sign of schizophrenia. The person afflicted with the disorder may struggle to comprehend information and solve problems. He or she may also withdraw socially, act inappropriately for the situation, and behave in a bizarre fashion.

Prolonged Social Withdrawal

People who are experiencing severe anxiety or depression may show signs of withdrawal. A person with early warning signs of schizophrenia often loses interest in friends and activities that were once important.

Decline in Personal Hygiene

In the early stages of schizophrenia, a person may stop caring about his or her appearance or personal hygiene.

For example, a teenager with schizophrenia might not bathe for days and wear dirty clothes despite their obvious appearance to others.

Disorganized Speech (Trouble Communicating)

Early warning signs of schizophrenia often include trouble communicating. For example, a person might get confused when talking to people and forget what they wanted to say in the middle of speaking.

When writing essays for school, they may struggle with grammar, spelling, and putting words in the proper sequence.

A person with early warning signs of schizophrenia also may have a monotone voice and speak in a flat tone. Their facial expressions may be limited, and they might avoid eye contact with others. They might also seem confused, with a vacant stare and unable to hold a conversation.

Drugs or Alcohol Abuse

People with schizophrenia may turn to drugs or alcohol to ease their anxiety. They may abuse these substances during the day despite knowing that they are harmful.

According to a 2018 study in Schizophrenia Research, substance abuse often worsens the symptoms of schizophrenia.

Inability to Maintain Relationships

People with early warning signs of schizophrenia often have trouble maintaining relationships. For example, they may constantly fight with friends and family members or lose friends due to their bizarre behavior. Unable to cope with the symptoms of schizophrenia, they often withdraw from society.

Changes in Behavior and Personality

A person with early warning signs of schizophrenia may show changes in their personality and behavior. These changes often occur before the first psychotic episode. For example, a teenager might become more irritable and hostile than usual and lose interest in activities that they once enjoyed. They might be unable to focus on school or work.

Lack of Energy

In the early stage of schizophrenia, a person may suffer from psychomotor retardation, which involves a decrease in physical activity and a lack of energy.

Physical symptoms include an inability to get up in the morning and sleeping excessively during the day. In some cases, people with schizophrenia have problems with appetite and weight loss, leading to malnutrition.

A Word From Verywell

If you're concerned that you or a loved one might be showing early symptoms of schizophrenia, it's important to see a mental health professional right away. If you are having a difficult time managing your symptoms, know that you're not alone and that schizophrenia can be managed with proper treatment and care.

10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."