Schizophrenia types: How are they different?

Schizophrenia is a psychological disorder that affects the way people interpret reality. It’s a chronic disorder that requires lifelong treatment. Untreated schizophrenia can result in serious challenges related to daily functioning, relationships, and overall well-being and even harm to self or other. However, seeking and sticking with the recommended treatment can allow those who experience this illness to live healthy lives. 

Getting familiar with this disorder’s key symptoms can help you know when to seek help if you’re experiencing them. Since research suggests that early intervention could help improve long-term outcomes, this type of information can be important to become familiar with. If you’re wondering, “Do I have schizophrenia?” or are simply interested in educating yourself, read on for an overview of this illness and its former type classifications along with risk factors and treatment options.

What is schizophrenia?

First, let’s begin with a brief overview of this condition. Schizophrenia is a serious mental illness that affects less than one percent of the US population. It’s characterized by episodes of symptoms that significantly affect thoughts and behavior by making it difficult for a person to tell the difference between real and unreal experiences. The frequency and intensity of these episodes can decrease with treatment and with age, and they may increase with stressful experiences and substance use. 

Key symptoms of schizophrenia

Symptoms that those with clinical schizophrenia may experience typically fall into four key categories: 

• Hallucinations, or seeing or hearing things that are not there and being unable to tell that these things are not there. Hallucinations can affect any of the senses, but hearing voices is the most common manifestation in those with schizophrenia.
• Delusions, or false beliefs that are not reality-based. Examples could include the individuals with schizophrenia believing that a celebrity is secretly in love with them, that they have an extraordinary ability or superpower, that someone wants to harass or cause them harm, or that a catastrophe is about to occur.
• Disorganized thoughts or speech, resulting in ineffective communication that is not understandable to others. For example, an individual exhibiting this symptom may make statements or answer questions in a way that is unrelated to the original conversation. 
• Disorganized/abnormal movements, which can range from childlike behavior to extreme and unpredictable agitation. It can manifest as inappropriate or bizarre postures, defiantly resisting instructions, a lack of response, or excessive and/or useless movements.

Are there various types of schizophrenia?

Instead, it classifies schizophrenia as a single disorder, now listing the former types simply as features of a general schizophrenia diagnosis. The reason for this is that the subtypes tended to have overlapping symptoms and that diagnostic precision was low. 

You can still familiarize yourself with symptoms of the former types since any of them can indicate potential signs of schizophrenia:

• Catatonic symptoms involve disturbances in movement and motor function. These may cause an individual to alternate between catatonic stupor—in which they are immobile and resistant to efforts to help them move—and catatonic excitement, in which they may suddenly increase movement and appear to be hyperactive.
• Paranoid symptoms primarily include delusions and hallucinations.
• Disorganized symptoms tend to include atypical or disorganized speech, thinking, and/or behavior, resulting in trouble communicating and completing daily tasks like basic hygiene.

In the previous classification system, “undifferentiated schizophrenia” referred to a type that didn’t fit into any of the other classification categories. The “residual” type was applied to an individual who had been diagnosed with schizophrenia in the past, but who hadn’t experienced any further symptoms in at least twelve months since treatment, or where the symptoms were so mild that they did not interfere with daily functioning. 

Information on schizophrenia onset

Other information that could help you recognize if you or a loved one may be experiencing schizophrenia relates to onset. First, note that the average onset of schizophrenia is usually in the late teens to early 20s for those assigned male at birth, and late 20s to early 30s for those assigned female at birth. As the National Alliance on Mental Health says, it’s rarely diagnosed in someone younger than 12 or older than 40.

In some, though not all, individuals who will go on to develop schizophrenia, there will first be a period of gradual change before the more pronounced symptoms of schizophrenia begin. This is known as the prodrome phase. It most often occurs one to two years before the onset of more serious symptoms. Symptoms are often nonspecific and can vary from person to person, if they appear at all, but generally represent a concerning change in behavior or habits. If you note any of the following in yourself or a loved one, it could be worth getting evaluated by a mental health professional: 

• Cognitive deficits (especially in memory, attention, and concentration)
• Disturbances in verbal memory
• Disturbances in social reasoning
• Issues with emotional processing
• Mood swings
• Sleep disturbances
• Irritability and anger
• Social withdrawal
• Deterioration in work or school performance
• Suicidal ideation

If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The 988 Suicide & Crisis Lifeline can be reached 24/7 by dialing 988.

Possible causes of schizophrenia

As is the case with most mental illnesses, the causes of schizophrenia are thought to be a combination of factors. Some that are believed to potentially contribute to its development include the following. If any of these apply to you, it may be worth watching more closely for potential symptoms.

Genetics

A family history of mental illness is believed to increase the chances of an individual developing schizophrenia. However, note that family history alone does not guarantee that one will develop this or any other condition.

Hormone changes

Since symptoms of schizophrenia often begin in young adulthood, some researchers believe that certain hormone changes in the body may affect one’s risk of developing mental health conditions like this.

Complications during fetal development

If there are complications related to fetal growth or intrauterine starvation in the womb, this can result in later problems with brain function. Maternal illnesses, especially those that relate to viral infections, premature labor, or loss of oxygen, may all increase the risk of the child later developing schizophrenia as well.

Childhood illness

Infections and illnesses during childhood have the potential to harm the developing brain. This could leave an individual at risk of developing a mental illness such as bipolar disorder or schizophrenia later in life.

Chemical imbalances in the brain

Neurotransmitters are chemicals in the brain that facilitate communication between nerve cells. If there is an imbalance of these chemicals within an individual’s brain, they may be more vulnerable to developing schizophrenia than a person without such an imbalance might be.

Emotional and physical abuse

Abuse of any type and at any stage of life may be a trigger for onset or relapse in people who already have or have a susceptibility to developing schizophrenia. When abuse occurs during early childhood development, the individual is likely to be at an even greater risk of developing the disorder.

If you or someone you know is experiencing abuse in any form, you can contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233) for immediate support, advice, and assistance.

Treating schizophrenia

Even if symptoms appear to have resolved, schizophrenia requires lifelong treatment in order to prevent a relapse. Medications and psychosocial therapy are often effective in managing the disorder. For some, hospitalization may be required at first. Mental health care teams for an individual with schizophrenia usually include a psychologist and a psychiatrist and sometimes a social worker, nurse, and/or a case manager to help coordinate care as well. Adopting healthy lifestyle habits—such as eating well, getting enough sleep, managing stress, and avoiding substance use—will also likely be recommended to help prevent relapses. 

Again, if you or a loved one is experiencing symptoms of schizophrenia or another mental health condition, it’s typically recommended that you seek professional medical support as soon as possible.

Medications

Antipsychotic medications are the most commonly prescribed type for treating schizophrenia. The goal of treatment with this type of medication is to manage symptoms, preferably with the lowest possible dose. Anti-anxiety and antidepressant medications may also be used in some cases. Medication types and dosages depend on a given individual’s health and circumstances, so a doctor or psychiatrist must be consulted before starting or stopping any regimen.

Psychosocial interventions

In addition to medication regimens, psychosocial and psychological interventions can be crucial in helping an individual learn to manage schizophrenia. These options include individual and family therapy, social skills training, and vocational rehabilitation. Therapy can help an individual and their loved ones learn to healthfully cope with their illness. Social skills training focuses on improving social and communication skills to help improve an individual’s ability to participate in daily activities. Vocational rehabilitation supports people with schizophrenia in finding, preparing for, and keeping jobs.

Hospitalization 

To ensure the safety of the affected individual and others and to provide an environment conducive to adequate sleep, basic hygiene, and proper nutrition during times of severe symptoms or crisis, temporary hospitalization is sometimes necessary. The goal of hospitalization is to help the individual get through the crisis period and begin a treatment regimen to manage symptoms going forward.

Seeking therapeutic support for schizophrenia

A therapist is often an integral part of the care team for a person living with schizophrenia. They can provide emotional support for the challenges the individual may face, and they can help them cultivate healthy habits and coping mechanisms. In general, this work can be done in person or online depending on the individual’s needs and preferences. 

Those who prefer to receive treatment from the comfort of home or who have trouble leaving the house or finding transportation, for instance, may choose online therapy. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging. Research suggests that online therapy can be as effective as in-person sessions in treating psychiatric disorders, so you can generally feel confident in whichever format you choose.