Early Signs Of Schizophrenia: Exploring Prodromal Symptoms

Schizophrenia can be defined as a severe mental illness that may cause hallucinations, delusions, mood changes, and more. During the early phase of schizophrenia, people may experience subtle changes in their mood or behavior before more severe symptoms set in. Recognizing these warning signs and seeking treatment can be an important step toward getting the help you deserve. If you think you may be at risk of developing schizophrenia, speaking with a therapist can be beneficial.

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What is schizophrenia?

Schizophrenia is a mental illness that can affect people’s beliefs, emotions, and behavior. People with schizophrenia might hear voices, think and talk in unusual ways, or develop delusional beliefs. These symptoms can make it hard to function in daily life and maintain healthy relationships. 

There’s a lot we still don’t understand about schizophrenia. However, research has found that it can cause changes in brain structure, like reductions in gray matter (a type of tissue that allows the brain to process information). While we don’t know exactly what causes the disorder, it’s likely that both genetics and environment play a role. 

Risk factors for schizophrenia

According to the NHS, possible risk factors of schizophrenia may include the following:

• Having a family member with schizophrenia
• Premature birth or having a low birth weight
• Using certain substances, especially at a young age

Major life stressors like grief, financial troubles, or divorce may trigger schizophrenia. However, although stress may contribute to the emergence of schizophrenia in people who are already predisposed to it, stress alone does not usually cause this disorder. 

The symptoms of schizophrenia

Positive symptoms of schizophrenia

Symptoms of schizophrenia typically fall into two categories: positive and negative. Positive schizophrenia symptoms generally refer to things a person with schizophrenia experiences that other people don’t, such as those listed below.

• Delusions: Delusions can be defined as false beliefs that have no basis in reality. This doesn’t just mean being wrong about something; it usually means continuing to believe something despite having proof that it’s not true. For example, you might believe you can fly, that you’re best friends with a movie star, or that you can read minds. 
• Hallucinations: When you hallucinate, you may experience something that seems real but isn’t. This might mean hearing voices, seeing things that aren’t there, or experiencing sensations with no physical trigger. 
• Disorganized thought patterns: Disorganized thinking can mean thinking in ways that don’t make sense to other people. For example, a person might jump from topic to topic or make random associations that don’t follow logic. These thought patterns may also lead to disorganized speech, which can be hard for other people to follow. 
• Disorganized movements: People with schizophrenia may also display unusual physical behaviors. Some examples include pacing back and forth, mirroring other people’s movements, and sitting or standing in unusual positions. 

Negative symptoms

Negative symptoms are things people without schizophrenia typically experience that are missing in people who have schizophrenia. Some examples include the following:

• Social withdrawal: Social withdrawal can describe a lack of interest in socializing. People with schizophrenia may stop going out, stop participating in their communities, or disconnect from their relationships. 
• Anhedonia: Anhedonia can describe a loss of ability to experience pleasure. For example, you might lose interest in your hobbies or stop enjoying your favorite foods. 
• Avolition: In general, avolition is a term for a complete lack of motivation. For example, someone might stop going to work, neglect their personal hygiene, fail to pay their bills, or spend the whole day in bed. 
• Blunted affect: In psychology, your “affect” usually refers to the way you express emotions. When you have a blunted affect, you might speak in a flat voice, stop using hand gestures, stop making eye contact, or have a flat facial expression.

It may be worth noting that not everyone with schizophrenia may display symptoms all the time. This is largely because schizophrenia tends to happen in phases. In the next section, we’ll explore what this means. 

Phase and early signs of schizophrenia

To understand the early warning signs of schizophrenia, it may help to take a closer look at each of its phases. 

The prodromal phase: 

The prodromal phase of schizophrenia can be classified as the period when symptoms start to emerge, but before a person develops full psychosis. During this phase, people may experience changes in their thoughts, habits, and behaviors, as well as other mental health symptoms, like mood swings, anxiety, and depression. 

The active phase: 

The active phase of schizophrenia (sometimes called the “acute” phase) is typically when a person transitions into psychosis. This is usually when more obvious symptoms, like delusions and hallucinations, tend to emerge. 

The residual phase: 

Although not listed in the DSM-V, the term “residual phase” is sometimes used to describe what happens after the active phase. During this phase, people may still experience a few negative symptoms, but the most severe active symptoms tend to subside. 

Indicators of mental illness: Early signs of schizophrenia

People with schizophrenia often cycle between the active and residual phases throughout their lives. However, the prodromal phase is when the early warning signs usually emerge. Below are a few potential warning signs:

• A loss of pleasure or motivation
• Seeing or hearing things that aren’t there
• Aggression
• Interacting less with others or spending more time alone
• Unusual thoughts or beliefs
• Trouble thinking clearly 
• Paranoia or mistrust of others
• Changes in speech patterns
• Mood swings
• Major changes in job or school performance
• Thoughts of suicide

Treatment for schizophrenia

People with schizophrenia normally require lifelong treatment. That said, recognizing the early warning signs can play an important role in getting help and improving outcomes. If you notice concerning symptoms, it may be a good idea to talk to a mental health professional. They may be able to provide a diagnosis and treatment based on the latest clinical practice guidelines. 

Mental health services for people with schizophrenia

Alongside medication, which must be prescribed by a doctor or psychiatrist, therapy may play an important role in helping people with schizophrenia manage their symptoms and improve their quality of life. A licensed therapist may be able to give advice for improving communication, thought patterns, and daily function. 

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How online therapy can help

However, if you’re living with schizophrenia, symptoms like low motivation may make it hard to leave the house. Online therapy normally enables you to work with a therapist from the comfort of your own home. This may make it a more manageable option for people with schizophrenia. It can be important to note that individuals experiencing acute psychosis may require in-person care.

The efficacy of treatment through online therapy

Research has found that online interventions may be useful for managing schizophrenia. In a 2016 study, a group of veterans living with schizophrenia participated in a three-month-long telehealth program. Researchers found that the online treatment frequently led to positive responses from participants, as well as improvements in suicidal ideation.