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Mental Illness Guide: Care, Support, and Education
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How do I know if I have schizophrenia?

There is no blood test, x-ray or brain scan from which a doctor can say for sure, “Yes, you have schizophrenia.”  So doctors look at people’s symptoms to figure out if they have schizophrenia.  This is a hard illness to diagnose because symptoms may not show up at the beginning of the illness.  Symptoms must be present for at least six months for a doctor to diagnose schizophrenia.

Remember that medications may help reduce or eliminate the symptoms of the disease so that improvement is possible.  In addition, some people recover spontaneously from schizophrenia in due course. 

What are the symptoms of schizophrenia?

Doctors have divided the symptoms of schizophrenia into the following two types.

1.   Positive symptoms (Experiences that should not be present) 

These are the symptoms that are there, but should not be, such as hearing voices, believing things that are not true, making up words.   People with schizophrenia who have positive symptoms are experiencing thoughts and perceptions that are very different than those experienced by people without schizophrenia.

Here is a list of some of the positive symptoms that people with schizophrenia may experience.

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Delusions

Sometimes people with schizophrenia believe things that do not make sense.  For example, people with schizophrenia may believe they are being spied on, or plotted against, or that they have special powers.

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Hallucinations

They may see, hear, smell, taste or feel something that does not exist.  For example, people with schizophrenia may hear voices that say nasty things to them or command them to do things.

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Thought disorders

People with schizophrenia may have a hard time organizing their thoughts.  Their thinking may be blocked or jumbled and may not make sense to anyone else.  They may feel that their thoughts are broadcast so that others can hear them on that unseen forces are temporary with their thoughts.

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Aditation

They may be overactive and restless, angry and violent their emotions may change very quickly for no apparent reason.

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Grandiosity

People with schizophrenia may believe they have great wealth, power or fame.  For example, they may believe they can stop bullets or fly over buildings.

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Suspiciousness

They may think people are out to get them.  For example, they think their family members are trying to hurt them or that strangers are slipping poison into their food.

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Hostility

People with schizophrenia may become abusive, mean and uncooperative with their family and friends.  This may in part be due to their false beliefs that people are following them or trying to hurt them.

2.   Negative symptoms (Features that are present and should not be)

These are the symptoms that are not there but should be, like energy to do things, wanting to be with others, clear thinking.  As a result of these symptoms, people with schizophrenia often withdraw from the world around them and every-day life.

Here is a list of some of the negative symptoms that people with schizophrenia may experience.

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A lack of emotions

People with schizophrenia may be unable to have or show emotional feelings.  The face may show little emotion and the voice maybe monotonous.

The person with schizophrenia usually has very few or no interests and has few personal friends.

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Unable to get along with people

People with schizophrenia often avoid eye contact with others.  In talking with others, they are likely to show they are bored and appear to have no warmth or caring.

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Passive/no interest

They may show no interest in anything going on around them.  They often have no energy to complete simple tasks and are unable to do anything except eat and sleep.

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Social withdrawal

People with schizophrenia may only feel safe and calm when alone.  They will likely have no interest in the feelings and lives of others and will avoid the company of others.

3.  Cognitive Symptoms

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Difficulty thinking in general terms

They may only be able to think about specific things, making them unable to understand general ideas.  For example:  “Can you take out the garbage?,” may only result in a “yes” or “no” answer, and would not lead to the garbage actually being taken out.

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Rigid or fixed thinking

People with schizophrenia can hold very rigid attitudes and beliefs that may seem unreasonable to those around them.  They may have repeated thoughts that interfere with their ability to function. 

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Inability to process information

People with schizophrenia may hesitate in speech or action due to difficulty in processing information.  Their body movements may also be stiff and unnatural.  They may work at tasks more slowly then others.

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Poor working memory

People with schizophrenia may be unable to retain a list of instructions and complete the tasks.  For example, go to the office, get envelopes and put them out for the mailman.