Mental Health Disorders Similar To Schizophrenia

Schizophrenia is a mental illness that usually involves a disconnection from reality, which is often referred to as psychosis. According to the National Institute of Mental Health, people with schizophrenia may experience hallucinations, one or more delusions (i.e., irrational, fixed beliefs), disordered thoughts or movements, and negative affect. They may sense stimuli that aren't present, or they may hold beliefs that aren't true. They may think illogically, have a hard time speaking normally, make abnormal body movements, or show a lack of emotion or interest in social interaction.

Disorders similar to schizophrenia

Sometimes, schizophrenia's psychotic (or “positive”) symptoms can overlap with symptoms of other mental and physical illnesses, such as brief psychotic disorder, schizoaffective disorder, avoidant personality disorder, substance-induced psychotic disorder, and more. To determine the root of any symptoms you’re experiencing, it can be helpful to work with a licensed therapist or another mental health professional.

Brief psychotic disorder

In a brief psychotic disorder, a person generally experiences psychotic symptoms for less than one month. Usually, the symptoms are brought on by extreme stress, but once resolved, they normally don’t recur. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this disorder is categorized as a schizophrenia spectrum disorder.

Schizophreniform disorder

Schizophreniform disorder usually involves psychotic symptoms identical to those in schizophrenia and brief psychotic disorder. The difference is that this disorder typically only lasts between one and six months. If a person has the symptoms for over six months, they are normally diagnosed with schizophrenia or a similar disorder. Schizophreniform disorder is also considered a schizophrenia spectrum disorder.

Dissociative identity disorder

Dissociative identity disorder (DID) was once called “multiple personality disorder” or “split personality disorder.” People who have this disorder may have multiple identities or personalities. Experts think these may develop as a coping mechanism, allowing individuals to dissociate during severe childhood trauma. Dissociative identity disorder can be rare and is usually considered a dissociative disorder rather than a schizophrenia spectrum disorder.

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Schizoaffective disorder

Schizoaffective disorder is another rare mental illness that is often misdiagnosed as schizophrenia. Like people with schizophrenia, those with schizoaffective disorder may hallucinate by sensing stimuli that aren't actually there. They may also have delusions or disorganized thoughts. Schizoaffective disorder is categorized as a schizophrenia spectrum disorder.

Unlike schizophrenia, schizoaffective disorder usually includes mood changes as part of its diagnostic criteria. People who have schizoaffective disorder can have one of two types: depressive type or bipolar type. Those who have the depressive type may also experience depression symptoms, such as sadness, feelings of worthlessness, or trouble sleeping or eating. Meanwhile, those with the bipolar type may experience symptoms of mania, such as: 

• Racing thoughts
• Risk-taking behaviors
• An extremely high mood
• Lots of energy
• Little need for sleep

For these reasons, schizoaffective disorder may initially be misdiagnosed as depression or bipolar disorder.

Mood disorders with psychotic features

Schizophrenia and schizoaffective disorder can be difficult to distinguish from mood disorders with psychotic features. Mood disorders generally include major depression and bipolar disorder, among others. Most people who have mood disorders do not experience psychotic symptoms. However, some people can experience psychotic episodes or features alongside severe symptoms of depression or mania. 

Personality disorders

Symptoms of many personality disorders can overlap with schizophrenia. The biggest difference between personality disorders and schizophrenia may be that personality disorder symptoms tend to be consistent across many years or decades of a person's life. The symptoms are usually a core aspect of a person's personality, and they normally do not wax and wane over time, the way schizophrenia symptoms can.

Schizoid personality disorder

When a person has schizoid personality disorder, they usually experience the negative affective symptoms that can be seen in some people with schizophrenia. These negative symptoms usually involve an absence of expected emotions or behaviors. The negative symptoms can present differently in schizoid personality disorder versus schizophrenia.

In schizophrenia, negative symptoms may involve:

• Having difficulty sticking to social plans
• Not experiencing pleasure
• Talking in a monotone voice
• Not making any facial expressions or body gestures
• Experiencing low energy
• Avoiding social interaction
• Moving and talking very little

These symptoms can come and go and are usually temporary.

In schizoid personality disorder, a person usually has long-term patterns of disinterest in close relationships. People with the disorder usually prefer to spend their time alone. They may not desire romantic or sexual relationships and typically don't experience pleasure in social situations. When given compliments or criticism, they may feel no emotion in response. They may also exhibit unusual behavior and appear emotionless most or all of the time.

Mental health professionals may struggle to diagnose this disorder since schizophrenia and depression can both cause similar symptoms. In schizoid personality disorder, these symptoms tend to be long-lasting and can form a major part of a person's personality. With other psychotic disorders, these symptoms may only last for days, weeks, or months amid a life that otherwise involves emotional expression and relationships with others.

Avoidant personality disorder

A person with avoidant personality disorder tends to avoid social interactions out of fear of being rejected or criticized. They may have few close relationships and only feel comfortable forming a relationship with someone when they believe they will not be hurt or rejected. People with this personality disorder may often remain silent because sharing their emotions seems too vulnerable or risky, as this could lead to rejection. They may also show little emotion in social situations or avoid social situations altogether.

On the surface, avoidant personality disorder symptoms may look like the negative affective symptoms of schizophrenia or schizoid personality disorder. However, what is going on in the person's mind is usually much different. In schizophrenia and schizoid personality disorder, a person may display little emotion because they feel little emotion. In avoidant personality disorder, a person often feels fear and hypersensitivity, rather than a lack of emotion or interest.

Schizotypal personality disorder

Schizotypal personality disorder often involves social withdrawal. People with this disorder may only interact with their immediate family or a few select people. They may rush home to avoid others and may assume people are out to get them. Schizotypal personality disorder can also involve erratic thoughts and behavior. A person who has this disorder may believe they can magically control others. They may speak in unusual patterns, wear eccentric clothes, and exhibit strange mannerisms. This disorder usually begins in early adulthood. Schizotypal personality disorder’s symptoms are normally consistent, rather than waxing and waning, and they usually aren't as severe as schizophrenia symptoms.

Paranoid personality disorder

In paranoid personality disorder, a person may distrust others and assume they have negative intentions. Although this is a separate disorder from schizophrenia, some individuals may receive both diagnoses. Most people who have paranoid personality disorder alone do not experience the psychotic symptoms associated with schizophrenia.

Delusional disorder

Sometimes, people with paranoid personality disorder also have delusional disorder. In delusional disorder, a person usually has delusions but no other symptoms of psychosis. For example, a person with paranoid personality disorder who also has delusional disorder may be paranoid that their neighbor is out to get them and experience a delusion that their neighbor has attempted to harm them, even if that hasn't actually occurred.

Delusional disorder can also be similar to schizophrenia and is generally considered a schizophrenia spectrum disorder or psychotic disorder, though delusional disorder is rarer and generally less severe. Sometimes, delusional disorder occurs in people with dementia.

Substance-induced psychotic disorder

Medications and recreational substances can induce psychotic symptoms in some people. This substance-induced psychosis may look like schizophrenia. Often, the symptoms recede if the person stops using the medication or substance, but in some people, the symptoms can trigger longer-lasting problems. 

Substance-induced psychosis has been recorded in association with the following:

• Cannabis and synthetic cannabis
• Cocaine
• Methamphetamines
• Hallucinogens, like LSD, DMT, and psilocybin
• Ketamine
• MDMA
• Anti-malaria medication
• Pain relievers
• Parkinson's disease medication
• Heart medications
• Corticosteroids
• Antibiotics
• Antihistamines

Neurodevelopmental disorders

Some people with neurodevelopmental disorders may go undiagnosed in childhood and then experience psychotic symptoms in adulthood. They may be at risk of being misdiagnosed with schizophrenia, even if a neurodevelopmental disorder is at the root of their symptoms. 

Neurodevelopmental disorders can include intellectual developmental disorders and autism spectrum disorder. People with these disorders may act in ways that are considered unusual in social situations, prefer to keep to themselves, or behave in ways that others consider to be erratic. They may also experience disorganized thinking or speech.

Psychotic disorder due to another medical condition

Psychotic disorders due to another medical condition can fall under the umbrella of schizophrenia spectrum disorders. In these cases, a person may experience a physical disease or injury that causes or triggers psychotic symptoms. Conditions known to potentially cause psychosis can include brain tumors, traumatic brain injuries, syphilis, thyroid disorders, neurological disorders, an autoimmune disease called anti-NMDAR encephalitis, and rare metabolic disorders.

Shared psychotic disorder

In some cases, when a person experiences psychotic symptoms, someone with whom they are close begins to share in their beliefs or mannerisms. This is usually called shared psychotic disorder. Shared psychotic disorder tends to be more common among two people in a romantic relationship, but this disorder can also occur within an entire family unit. In this rare disorder, those closest to the person with a psychotic disorder may begin believing their delusions to be true.

Therapy for symptoms of schizophrenia or related conditions

If a person is experiencing psychotic symptoms due to schizophrenia or another disorder, remote therapy may be an option as one part of a broader treatment plan that may also include doctor-prescribed medication and lifestyle changes. 

Benefits of online therapy for mental health

Many people with schizophrenia or similar disorders prefer to avoid the stress of social interaction with people they do not know or trust. Online therapy can address this concern, as this format can be completed from any location with an internet connection.

A large body of research has investigated the efficacy of online therapy for treating various mental health disorders. Studies suggest that online and in-person therapy tend to produce the same client outcomes. Please note that individuals experiencing acute psychosis may require in-person care.