Can You Develop Schizophrenia Later In Life? Understanding Late-Onset Schizophrenia

Schizophrenia is a disorder that can affect people’s thoughts and behaviors. It usually starts in young adulthood, but this may not always be the case. Some people may start having symptoms earlier, while others may not notice them until later. When individuals develop schizophrenia after age 40, it’s usually referred to as “late-onset schizophrenia.” Meanwhile, schizophrenia that arises after age 60 is typically called “very late-onset schizophrenia-like psychosis.” Schizophrenia symptoms can generally be managed with the proper professional support. 

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An overview of schizophrenia

Schizophrenia is a serious mental illness that can change the ways people think, feel, and act. Schizophrenic patients may have trouble telling what's real and what's not. This is usually known as "psychosis," a state of being detached from reality. People with schizophrenia may also notice changes in their thoughts and mental abilities. 

Scientists are still trying to figure out exactly what causes schizophrenia. So far, they've identified several possible risk factors:

• Having a relative with schizophrenia
• Being born at a low weight
• Being born in the winter
• Living in an urban area

That said, not everyone who is at risk of schizophrenia will go on to develop it. It’s likely to be triggered by a combination of factors, including environment, genetics, and life experiences. 

The onset of symptoms in men and women

What are the positive and the negative symptoms of schizophrenia?

In general, there are two broad types of schizophrenia symptoms: positive and negative. These terms don't necessarily mean "good" and "bad." Rather, they can refer to experiences that are either present or absent in people with schizophrenia.

Positive symptoms may include the following:

• Hallucinating (seeing, hearing, or feeling things that aren’t real)
• Having delusions (false beliefs that can’t be changed)
• Rambling, mixing up words, or talking in unusual ways
• Moving in unusual ways

Negative symptoms may include the following:

• Losing motivation to do daily tasks
• Having trouble feeling pleasure
• Losing interest in being around other people
• Not expressing emotions

However, not everyone with schizophrenia may experience the same symptoms. For this reason, it’s listed as a “spectrum disorder” in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Late-onset schizophrenia: Can you develop schizophrenia later in life?

As we’ve discussed, schizophrenia usually starts during the early adult years. That said, this isn't always the case. Some people may start having symptoms outside the typical age range. Let’s take a look at a few other periods when this can happen. 

Childhood-onset schizophrenia

Before age 13: Developing schizophrenia before age 13 can be considered rare. Some estimates suggest it happens at a rate of less than .04%. This is generally known as “childhood-onset schizophrenia.” 

Children with schizophrenia may experience developmental delays before their symptoms start. They may also struggle to make friends and may have trouble with mood and behavior. 

Early-onset schizophrenia

Before age 18: Developing schizophrenia before age 18 may be more common than before age 13. This is sometimes called “early-onset schizophrenia," and it often looks similar to typical schizophrenia. Early warning signs of schizophrenia in teens may include academic issues, unusual behaviors, and social isolation.

Late-onset schizophrenia

After age 40: Around 20% of people with schizophrenia develop it after age 40. This is usually known as “late-onset schizophrenia.” Late-onset schizophrenia tends to be more common in women than in men. 

Scientists think this may be due to estrogen, a hormone that may protect the brain from schizophrenia. Women’s bodies normally produce less estrogen with age, which may make them more vulnerable to schizophrenia later in life.

After age 60: Some people may start having psychotic symptoms after age 60. This is typically known as “very late-onset schizophrenia-like psychosis.” You may notice that this diagnosis uses the phrase “schizophrenia-like” rather than “schizophrenia.” This may be because scientists believe that after age 60, psychotic symptoms are likely due to conditions other than schizophrenia. 

Dementia, which often affects older adults, can serve as one example. Dementia may cause symptoms similar to schizophrenia, like delusions and hallucinations. 

As you can see, schizophrenia may not always start at the same age for everyone. But how does age of onset affect the outlook for schizophrenia patients? In a 2017 review, researchers analyzed 81 studies to try to answer this question. They found that an older age of schizophrenia onset was usually associated with the following:

• Fewer hospitalizations
• Fewer negative symptoms
• Better social functioning
• Better work functioning
• Better overall outcomes

Future studies may uncover more insights about how age affects people’s experiences and long-term outlooks with schizophrenia. 

Options for treating typical, early, or late onset schizophrenia

Whether you have typical, early, or late-onset schizophrenia, it can still be challenging. Chronic schizophrenia may contribute to issues at work and in relationships. People with schizophrenia may also be at a higher risk of conditions like depression and anxiety. 

That said, schizophrenia is often manageable. At least one in three people may fully recover from their symptoms with the right treatment, which usually involves the interventions discussed below.

Community support to improve daily functioning

Community resources may help people with schizophrenia live independently and improve their daily functioning. Some examples can include the following:

• Job placement and training programs
• Housing assistance
• Schizophrenia support groups 
• Educational programs
• Social skills training 

Lifestyle changes to improve mental health

While not a replacement for professional treatment, certain daily habits like those listed below may support brain health and general well-being. 

• Getting regular exercise
• Avoiding substances that affect the brain, like alcohol and other substances
• Managing stress
• Establishing healthy routines
• Socializing with friends and loved ones

Drug treatment

Medications are often a first-line treatment for schizophrenia. Your doctor or psychiatrist may suggest the following options:

• Antipsychotics, which may reduce hallucinations and delusions
• Antidepressants, which may help improve negative symptoms
• Mood stabilizers, which may make emotions more manageable

Have concerns about late-onset schizophrenia?

Get support from a licensed therapist

Therapy to support mental health with late onset schizophrenia 

While medications may directly reduce symptoms in people with schizophrenia, counseling can support mental health in the long term. With therapy, it may be possible to improve thought patterns, learn healthy coping strategies, and more. Therapy can also be helpful for managing other mental illnesses besides schizophrenia. 

Sticking to therapy may be easier if you have a good relationship with your therapist. That said, finding a counselor with whom you connect can sometimes take a few tries. Online therapy platforms like BetterHelp usually allow you to switch therapists whenever you want, for no additional charge. This may make it easier to find the right therapist for you. 

Studies show that internet-based treatments may improve symptoms for people with schizophrenia. In 2016, researchers gave a telehealth program to a group of veterans with schizophrenia who were experiencing thoughts of suicide. Within three months, the majority experienced improvements in their symptoms. 

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.