Does Schizophrenia Get Worse with Age? Exploring the Progression of the Disorder
Schizophrenia is a chronic mental health disorder that impacts a person’s behavior, thought processes, and emotions. Often, symptoms appear during adolescence and early adulthood and impact a person’s ability to function at school or work.
While living with schizophrenia can present challenges, working with a mental health professional over time may help individuals reduce symptoms and their impact on daily life. As a chronic disorder, there is no cure for schizophrenia, which means that it may be helpful to develop coping strategies and take preventative measures for long-term care. Managing schizophrenia may be different for each person, and strategies can change over time as the disorder progresses.
What is schizophrenia?
Schizophrenia is a serious mental health condition that causes a range of different symptoms depending on the individual. In the United States, around 1% of the general population is believed to have schizophrenia.
People with schizophrenia may seem to have lost touch with reality, which can cause significant distress for the individual and those around them. Mental health professionals can diagnose a patient with schizophrenia by identifying qualifying criteria using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Diagnostic criteria for schizophrenia
To be diagnosed with schizophrenia, a person must experience two or more of the following symptoms for at least one month, with at least one of the symptoms being hallucinations, delusions, or disorganized speech:
- Hallucinations: The presence, frequency, and severity of hallucinations (e.g., auditory, visual) can vary based on specific sensory perceptions that are not genuinely occurring.
- Delusions: Delusions are firmly held beliefs that persist despite evidence that they are incorrect, such as the belief that strangers are following someone in the store to hurt them.
- Disorganized speech: The coherence and logical structure of speech can occur in people with schizophrenia.
- Abnormal motor behavior: This symptom involves abnormal movements or behaviors.
- Negative symptoms: In this context, the term “negative” refers to the presence and severity of diminished emotional expression. It can also refer to avolition, alogia, and anhedonia.
Mental health professionals may also consider how symptoms impact a person at school or work and how persistent the symptoms are over six months. A psychologist or therapist may also rule out another mental illness, such as bipolar disorder, before making a formal diagnosis.
Previously, schizophrenia was divided into subtypes, including paranoid, disorganized, catatonic, and undefined. However, research suggests that these subtypes and their associated cognitive symptoms were not reflective of the heterogeneity of schizophrenia. Schizophrenia as a disorder may be complex and impact different people in different ways at different times, leading to their choice to rename the category “schizophrenia spectrum disorder.”
How do schizophrenia symptoms change over time?
When answering the question, “Does schizophrenia get worse with age?” it may be helpful to define the symptoms of schizophrenia first.
Schizophrenia symptoms are broadly divided into two categories: negative and positive symptoms. Negative symptoms include symptoms that are abnormally absent in a person, such as impaired emotional expression, decrease in speech, social withdrawal, and lack of motivation. Contrarily, positive symptoms include symptoms that do not often occur in people without schizophrenia or other psychotic disorders, like hallucinations, delusions, or distorted perceptions of reality.
Depending on treatment, life events, and other environmental factors, these symptoms may change over time. It may be helpful to understand that symptoms can be unique to a person’s situation, and schizophrenia may manifest in different ways over time for different people.
Early symptoms and onset of schizophrenia
Often, the first time schizophrenia symptoms become noticeable is after a psychotic episode. However, subtle signs may occur before this point, often referred to as the “prodromal phase.” These symptoms might include the following:
- Social withdrawal
- Difficulty concentrating
- Paranoia or suspiciousness
- Irritability
- Emotional detachment
- A decline in self-care and physical health
- Cognitive decline
Symptom progression in schizophrenia can be viewed from a developmental lens, with some symptoms and unusual behaviors occurring in adolescents and others developing later in life, marking a progression of the disorder. Although schizophrenia, when left untreated, may get worse with age, it is possible to work with a team of mental health professionals to manage symptoms over time.
Symptom impacts in different age groups
Schizophrenia can impact individuals of many age groups, although it is most commonly first diagnosed when a person is in their late teens through early 30s. Symptoms of schizophrenia can be impacted by neurodevelopmental changes, environmental factors, and genetics; as a person ages, each of these factors may change, which can lead to changes in how schizophrenia symptoms present.
When schizophrenia is diagnosed before the age of 18, it may be considered early onset schizophrenia. For individuals with early onset schizophrenia, symptoms may impact learning and cognitive function at school, which can be linked to unemployment and other challenges as an adult. However, an early diagnosis may be a key to managing symptoms over time. Individuals with early-onset schizophrenia can reduce acute symptoms over time and learn to manage negative symptoms in their daily lives.
Another age-related factor is late-onset schizophrenia, which may apply when schizophrenia is diagnosed after age 45. Individuals with late-onset schizophrenia may experience fewer positive symptoms as they get older compared to younger individuals. For older adults with schizophrenia, antipsychotic medications may have different side effects and impacts on individuals as they get older. For this reason, communicate frequently with your mental health team while taking antipsychotic medication.
Factors influencing symptom progression
While getting older can impact symptom progression for individuals with schizophrenia, other factors may play a more prominent role. Environmental factors, including stressful work or home lives, substance use, and overall physical health, can all impact how frequently a person with schizophrenia experiences symptoms. In some cases, these environmental factors can be controlled by working with a mental health professional.
Another potential key to managing symptom progression for individuals with schizophrenia may be whether a person seeks treatment or not. Mental health professionals such as therapists or psychiatrists can develop a plan for managing symptoms and reducing their impact on daily life. Studies show that psychosocial interventions, alongside medication, can improve client outcomes over time.
Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
The long-term course of schizophrenia
The course of schizophrenia may vary depending on environmental factors and treatment. For some individuals, an acute initial phase may lead to diagnosis. After being diagnosed, an individual may be prescribed antipsychotic medication and work with a mental health professional. Treatment may lead to a remission of symptoms over time.
Although symptoms may move into remission, people with schizophrenia can relapse. Relapse may be caused by various factors that can vary from person to person, such as stress, anxiety, and changes in medication. This relapse and remission cycle may continue for individuals throughout their life. However, by working with a mental health team, periods of relapse may become less impactful and last for a shorter time.
As a person ages, the symptoms of schizophrenia may change, too. For some individuals, symptoms may transition from more positive symptoms, such as hallucinations and delusions, to more negative symptoms, including social withdrawal or lack of motivation. However, these changes are not universal, and people can experience different changes as they age.
Treatment for schizophrenia
Treating schizophrenia often involves a multidimensional approach that includes antipsychotic medication treatments combined with psychotherapeutic strategies and techniques. However, it can be difficult for some people to access in-person therapy for support. In these cases, online therapy through a platform like BetterHelp may be an accessible option.
Online therapy has been shown to be an effective method when managing schizophrenia symptoms in some individuals. In an online environment, a therapist may provide cognitive-behavioral therapy (CBT) to help a client manage the impact of hallucinations and delusions through cognitive reframing.
Online therapy allows a person to search a large database of therapists from various locations, potentially making finding a therapist that matches their needs more manageable. With online therapy, a person can connect from anywhere and at a convenient time, which might be helpful when in-person therapy conflicts with one’s schedule.
Takeaway
Schizophrenia is a mental health disorder that impacts people of various ages and may persist throughout a person’s life. While many challenges can come with living with schizophrenia, such as social isolation, hallucinations, and delusions, it is possible to manage symptoms.
Treatment of schizophrenia may consist of medication and therapeutic techniques designed to manage emotions and reduce psychotic episodes. Consider contacting a therapist online or in your area to receive support.
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