Schizophrenia Onset: The Signs And Symptoms To Watch For

Medically reviewed by Majesty Purvis, LCMHC
Updated May 28, 2024by BetterHelp Editorial Team

Schizophrenia is a severe disorder that can hamper one’s control of emotions, sense of reality, and ability to relate and communicate with others. It is estimated that roughly 0.25% and 0.64% of the adult population in the United States has schizophrenia, and about 0.33% to 0.75% of the world’s population may be affected by it. While schizophrenia may appear at any age, the onset most often occurs in the patient's late teens or early thirties.

Clarify the onset and symptoms of schizophrenia

For everything we know about this mental disorder, misinformation still runs rampant and feeds many of society's fears about schizophrenia. While it is a serious issue that must be watched for and addressed right away, many who have schizophrenia can go on and live happy and healthy lives.

Treatment typically requires proper medication, counseling, and drug-free living, but recovery is obtainable, and treatment at the onset of the disorder dramatically enhances the health outcomes of schizophrenia.

But to get early treatment for yourself or a loved one, you must be able to recognize the early signs of schizophrenia. 

Understanding the onset of schizophrenia: The signs and symptoms

Noticing the signs, symptoms, and possible risk factors of schizophrenia allows one to manage the disorder better. If you have schizophrenia, the earlier you receive treatment, the better short-term and long-term outcomes you can expect.

Early warning signs of schizophrenia

Diagnosing schizophrenia can be difficult for a few reasons. Those with the disorder rarely feel ill and typically do not independently seek treatment. At the same time, many common outward prodromes of schizophrenia reflect many of the usual social and emotional changes that teenagers and young adults are prone to.

The most common of these onset signs are:

  • Depression
  • Anxiety
  • Paranoia
  • Social reclusion
  • Introverted behavior
  • Insomnia
  • Sudden changing of social groups
  • Neglect of appearances
  • Inappropriate laughter, language, and behavior
  • Emotions that do not fit the given context

While schizophrenia can appear suddenly, most people can expect to see some onset period. Typically, close family and friends can detect some change, even if they cannot label it.

Doctors warn that those with schizophrenia are often unwilling to seek treatment, and their families are often reluctant to suggest treatment. A college may be the one to send a young adult in for treatment following an episode.

Though families may be hesitant to get involved and seek treatment for loved ones with such mental disorders, early and continuous treatment is crucial for someone with this condition to live a productive, healthy life.

Late-onset schizophrenia and early-onset schizophrenia

While rare, schizophrenia can develop after the age of 45. This is referred to as late-onset schizophrenia. It is also rare, but possible, for children to develop schizophrenia before pubescence.

With both late and early-onset schizophrenia, genetics may affect how and when they occur. Late-onset schizophrenia may be more prevalent in those living an isolated or reclusive lifestyle.

The age at which the onset of schizophrenia appears does seem to affect the symptoms and outcomes of schizophrenia. Those who develop schizophrenia later in life are less likely to have the same emotional changes but are more prone to delusions and hallucinations. When children develop schizophrenia, it can cause the late development of crawling, talking, and walking, plus odd behavior, reclusion, and a drop in school performance.

General symptoms of schizophrenia

When schizophrenia is active, it causes thoughts or feelings incongruent with the current reality. The severity and duration of symptoms can vary between people and episodes.

The American Psychiatric Association breaks them down by positive, negative, and disorganization symptoms.

Positive psychotic symptoms

Positive psychotic symptoms refer to sensations that are not real. With schizophrenia, this includes hallucinations, delusions, and incorrect perceptions of reality. Hearing voices and extreme paranoia are commonly used examples.

Negative symptoms

Negative symptoms are those that cause an inability to socialize or express oneself. With schizophrenia, people often cannot feel or express strong emotions, make plans, or feel motivated, and can express other antisocial behaviors.

Disorganization symptoms

Those experiencing an episode of schizophrenia can have disrupted speech patterns and an inability to think clearly or focus. Abnormal behavior or actions can result from this confusion.


Diagnosing schizophrenia

As we touched on earlier, accurately diagnosing schizophrenia can be problematic. Many symptoms can reflect standard antisocial behaviors (with many possible causes), requiring an expert to evaluate each case and make a judgment.

Delusions and hallucinations can lead to a diagnosis of schizophrenia; otherwise, two or more of the core symptoms, in some variation, must be evident for at least one month:

  • Extreme depression or lack of emotional expression, “catatonic behavior”
  • Jumbled and unintelligible speech
  • Confused and disorganized behavior
  • Hallucinations or delusions

A diagnosis of schizophrenia is made if a person has two or more core symptoms, one of which must be hallucinations, delusions, or disorganized speech for at least one month. The other core symptoms are gross disorganization and diminished emotional expression.

The causes of schizophrenia

Presently, we do not know if there is a single cause of schizophrenia. The current consensus with doctors is that schizophrenia results from a complex mixture of gene expression, environmental and psychological factors, and an imbalance of the brain’s chemical systems. Even gut bacteria may play a role in the development of schizophrenia.

A family history of schizophrenia can mean you are more likely to develop it throughout your lifetime. The inheritance pattern is usually unknown, and most people who have a close relative with the condition will not develop it themselves.

Getting help

Being diagnosed with schizophrenia can be the first step toward healthier living and managing your symptoms. Poor health habits and a lack of proper care can often lead to a crisis in one form or another, so it can be helpful to consider several ways to be proactive. If you are caring for a loved one with schizophrenia, these strategies can be helpful as well.

Things you can do for yourself

Avoid drug usage

Substance use and schizophrenia have a high comorbidity. Drug use and alcohol consumption can exacerbate symptoms and interfere with medication.

Stay social

People with schizophrenia tend to withdraw and avoid social interactions. It can be helpful to maintain social ties and build a strong support network. It is hard to understate the benefits of merely having someone to talk to and spend time with. A licensed therapist can be a valuable constituent of your support network. It can be challenging to speak to well-intentioned family and friends about your symptoms whereas talking to a therapist might feel like a safer, more helpful option.

Keep a regular sleeping schedule

Schizophrenia and the medication you may take to treat it can often disrupt your sleep patterns. Try to maintain regular sleeping hours.

Get support

Schizophrenia is a lifelong mental disorder with no known cure; however, with proper treatment and care, many can live productive, healthy lives and see the lessening of symptoms over time. While medication and self-control can be significant factors, the support of doctors and therapists can be crucial.

Clarify the onset and symptoms of schizophrenia

Therapy can help

Your doctor may recommend therapy as part of your treatment. Research into online therapy for schizophrenia is ongoing, but ask your doctor if it could be a fit for you. Caregivers of people with schizophrenia may also consider therapy to learn how to cope with the diagnosis and gain new strategies to relate to and support their loved ones.

Online therapy has many benefits for caregivers. You don’t have to worry about commuting to an office or being on a waiting list. With online therapy platforms, like BetterHelp, you’re matched with a qualified therapist, so you can get started right away. Plus, you can reach out to your therapist anytime via phone, text, email, or instant message, and they’ll get back to you as soon as they can.

Research shows that online therapy is effective at treating a range of conditions. One study showed that online therapy results in a 50% improvement in symptoms of many conditions, including generalized anxiety disorder and depression, and was found to significantly decrease the impact of chronic fatigue and stress. 


Early treatment for schizophrenia may mean better short- and long-term outcomes, so catching the signs and symptoms of the onset is crucial. If you think you’re having symptoms of schizophrenia, talk to your doctor. If you are caring for a loved one who has been diagnosed with schizophrenia, talking to a therapist can help you learn how to help them while also caring for your own mental health.
Understand psychopathy with professional guidance
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started