How do you get schizophrenia? Understanding the risks and symptoms

Medically reviewed by Andrea Brant, LMHC
Updated January 2, 2024by BetterHelp Editorial Team

Knowing that you or someone you know may be at risk for schizophrenia can be disconcerting. You likely want to know how or why schizophrenia has appeared in your life. While we know a great deal about this disorder, there is still very little conclusive research about what causes it.

While there is no official consensus on the reasons and causes of schizophrenia, there’s quite a bit of scientific research on the topic. Doctors and mental health experts believe schizophrenia occurs due to a combination of triggers and factors, including genetics, drug use, and stress levels. Some people are more prone to developing schizophrenia in their lifetimes, and a traumatic or stressful event may trigger an episode.

To help you better understand how and why schizophrenia may develop, we will look at a handful of studies on the subject – but before that, it’s important to understand the basics of schizophrenia.

Learn more about managing schizophrenia

What is schizophrenia?

Schizophrenia tends to affect cognitive functions, control of emotions, and perception of reality. Without proper support and medication, people with schizophrenia often have difficulty achieving success at work, school, or relationships and may begin to show worsening symptoms.

Schizophrenia is not a disorder related to having multiple “personalities” (such as dissociative identity disorder). Rather, it is a form of mental illness that can inhibit one’s ability to discern reality. People with schizophrenia can sometimes behave or act in ways that do not seem to make sense to others. Symptoms will often improve, worsen, and improve again. These cycles are known as remissions and relapses. In most cases, symptoms tend to lessen over time with proper care and treatment.

The severity and frequency of heavy-symptom psychotic episodes, as well as the general mental health of the person with schizophrenia between episodes, can vary significantly from one person to another. Some may only experience a single psychotic episode in their life, while others may experience many. Some people have relatively healthy lives between episodes; others encounter challenges with daily life.

People with schizophrenia who can get the proper support and treatment can often begin to live more balanced and healthy lives, including maintaining a job and healthy social connections with friends or family.

Signs and symptoms of schizophrenia

Schizophrenia onset tends to occur in young adulthood (though in rarer cases, it can occur in children and older adults) when a series of natural emotional, social, and physical changes occur. Since the warning signs of schizophrenia often overlap with these natural changes in life, many people with schizophrenia are reluctant to seek treatment, and friends and family may be hesitant to suggest treatment for someone they care about.

Schizophrenia symptoms are characterized by feelings, thoughts, and actions that do not match the current situation or reality. People with schizophrenia may laugh at inappropriate times or exhibit signs of extreme paranoia.

Before the publication of the DSM-5 in 2013, there were unique subtypes of schizophrenia classified by the symptoms the patients exhibited. Due to a large amount of overlap, these subcategories are no longer officially used. Some doctors may still use the classic categories (like paranoid schizophrenia) when referring to the types of symptoms one exhibits.

The symptoms of schizophrenia can be broken down into three basic categories.

  • Positive Psychotic Symptoms. Positive psychotic schizophrenia symptoms typically refer to delusion, sensations that are not real, hallucinations, and a change in behavior and thought patterns. Paranoia and hearing voices are also grouped as positive schizophrenia symptoms.
  • Negative Symptoms. Negative schizophrenia symptoms are characterized by a withdrawal from society and a rise in antisocial behaviors. Emotions and motivations change and decrease.
  • Cognitive Symptoms. Those with cognitive schizophrenia symptoms often show a disrupted ability to have coherent thoughts. Actions and behaviors described as “out of the norm” can result from this confusion.

It should be noted that positive and negative symptoms are not named for how “good” they are. Instead, they are named for whether the symptom is adding something to a person’s perspective (positive symptoms) or taking something away from it (negative symptoms). 

How do you get schizophrenia? Schizophrenia science today

While doctors and scientists are still unsure of the exact causes of schizophrenia, there is quite a bit that we do know. On top of the decades of research papers already cataloged, studies are ongoing to uncover more answers about the factors for schizophrenia development.

Modern research points to a combination of reasons for one to develop schizophrenia. It seems schizophrenia develops due to a complex combination of environmental and physiological factors, with a prevalence in males with a family history of the disorder. Doctors believe schizophrenia appears due to some combination of both nature and nurture.

Multiple studies have shown that schizophrenia tends to run in the family. The more closely related one is to someone with schizophrenia, the higher their chances may be of developing it themselves.

The general risk in the population for developing schizophrenia is roughly 1%, but if you have a genetic twin with it, your chances are nearly 50%. But someone can have a family with schizophrenia and have little chance of developing it themselves.

In 2003, when the human genome was finally sequenced, researchers found no definite causes for schizophrenia. While doctors do not think there is a gene associated explicitly with the disorder, it may be that a combination of some genetics is predisposed to having a chance of developing it. Latent genes, activated by specific environmental triggers (poor health, stressful events, etc.), is where the science is taking today’s researchers. In other words, different people have different latent risks for developing it, but it may require a form of an environmental trigger for the disorder to manifest fully.

Hopefully, in time, we will have a more precise understanding of what genetics and triggers we need to be watch for.

Diagnosing schizophrenia

Early warning signs and symptoms of schizophrenia may overlap or be confused with typical issues faced when growing up and handling life changes. For this reason, families and loved ones who feel they can sense a change in someone need to be proactive in getting an evaluation by a professional.

Some of the common signs of the onset of schizophrenia are:

  • Depression and reclusion
  • Changing of social groups
  • Neglecting physical grooming
  • Increased anxiety and paranoia
  • Emotions becoming incongruent with the surrounding situation

Difficulty in diagnosing based on these signs is further complicated by the fact that drug usage is common in this age group. Stressful living and drug use can exacerbate symptoms and trigger episodes. If you feel you may be at risk or are showing symptoms of schizophrenia, it can be essential to seek the expertise of a medical doctor or psychologist. 

Schizophrenia can appear without any warning, but this is rare. In most incidents, symptoms will begin to show, even if they are masked or hard to detect.


Getting help if you have schizophrenia

While we still do not know how one develops schizophrenia nor how to cure it, getting professional help has shown to be incredibly beneficial to the health and well-being of those with the disorder. Proper medication, good lifestyle choices, and a reliable support network can help someone diagnosed with schizophrenia manage their symptoms and regain a sense of normalcy.

If you want to learn how to support someone who is experiencing the symptoms or challenges of schizophrenia while caring for your own mental health, online therapy can be a great option. Although online therapy may not be suited for more serious mental illnesses like schizophrenia, it is an excellent option for friends and family who need support.

You can avail of online therapy wherever you have a Wi-Fi connection, so it’s easy to fit into your existing schedule. BetterHelp will match you with a licensed therapist, and then you can reach out to your therapist through text, phone, email, or instant message any time, and they’ll get back to you as soon as they can. 

Research shows that online therapy is effective for a variety of conditions. One review found that online treatment led to a 50% improvement in symptoms of anxiety and depression and decreased the impacts of chronic fatigue and stress. 


Doctors do not know exactly what causes schizophrenia, but they believe it results from a mixture of genetic and environmental factors. If you think a loved one is exhibiting signs of schizophrenia and need help learning how to support them while also caring for your own mental health, online therapy can help.
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