High Functioning Schizophrenia Symptoms: Coping Methods And Treatments

The presence of schizophrenia symptoms may make it difficult to function in specific settings, including in the workplace, at school, and home. However, some people—whether it be due to lower symptom severity, positive response to treatment, or the assistance of a strong support system—may find it easier to function than others.

These individuals may be referred to as “high functioning.” However, this label is not a clinical term, and high functioning schizophrenia symptoms can be similar to other schizophrenia symptoms. Understanding what these symptoms are, as well as common coping and treatment methods, may be beneficial for those experiencing schizophrenia. 

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What is high-functioning schizophrenia?

According to the World Health Organization (WHO), approximately 24 million people worldwide live with schizophrenia. While not a clinical term nor a diagnosis, high functioning schizophrenia may refer to individuals experiencing schizophrenia who can function well in various parts of their day-to-day lives. Whether or not someone is considered high functioning, a schizophrenia diagnosis requires the same symptoms in all people. One might experience episodic or persistent symptoms when living with this mental health condition. 

High-functioning schizophrenia symptoms

The symptoms of high functioning schizophrenia can be the same as what may be referred to as “low functioning” schizophrenia (though this is not a clinical term). According to the UK National Health Service, schizophrenia symptoms may be divided into two broad categories: positive and negative. 

Positive symptoms refer to those that affect a person’s thought patterns, behavior, and perception of their environment. Individuals might experience the following symptoms: 

• Hallucinations: Individuals with schizophrenia may have sensory experiences that aren’t occurring in real life, known commonly as hallucinations. Hallucinations can affect a person's sense of sight, hearing, taste, smell, or touch, with a common example involving hearing voices from people or entities who aren’t there.
• Delusions: Delusional thoughts can make an individual with schizophrenia believe objectively false versions of reality. In some cases, these beliefs may be influenced by other schizophrenia symptoms, such as hallucinations. The focus of these delusions may vary, with some being directed towards those around the individual (such as perceiving an innocent gesture or comment as threatening) or to larger entities, such as the government.
• Disordered speech and thinking: Individuals experiencing schizophrenia may have disorganized thought and speech patterns, which could impair their ability to communicate their thoughts clearly to others. In some cases, these patterns may cause individuals to use unrelated strings of words that may not make sense or relate to the subject they are discussing. 

Negative symptoms relate to deficits in interpersonal relationships, interests, and emotional expression. These symptoms may manifest in various ways, including but not limited to:  

• Motivational impairment: People with schizophrenia may experience a lack of motivation to complete certain tasks, including those that may be necessary for their well-being or survival. This challenge may cause an individual to stop completing work assignments, attending school, bathing, or feeding themselves. 
• Difficulty showing emotion: Schizophrenia can affect an individual's ability to show their emotions. They may have flat, unaffected speech, which could cause them to talk in a monotone voice without any variation (regardless of the subject). Those with schizophrenia may also have difficulty with facial expressions, which can further complicate their ability to communicate with others. 
• Social withdrawal: Schizophrenia may cause a person to socially isolate and avoid friends and family. They may withdraw due to a lack of motivation, difficulty with communication, or because their other symptoms (such as hallucinations or delusions) make it overwhelming or challenging to interact with others. 

High functioning schizophrenia coping methods

In some cases, the coping methods for high functioning schizophrenia may be similar to the methods used for any level of function. These methods may include the following.

Avoiding substance misuse

Research suggests that those with schizophrenia may be more prone to substance use disorders, regardless of whether someone has mild or severe symptoms. The misuse of substances may be an attempt by individuals living with schizophrenia to cope with symptoms—though doing so may negatively affect their condition. 

People with schizophrenia may experience rates as high as three times greater than the general population for certain substance use disorders, including those that relate to nicotine, alcohol, cannabis, and cocaine. These disorders may worsen symptoms, increase non-adherence rates with treatment, and decrease global functioning. 

To potentially avoid these adverse effects, it may be helpful to abstain from substance use. If you believe you are struggling with a substance use disorder, it could be beneficial to explore resources in your area or online. The SAMHSA National Helpline can be contacted 24 hours a day, 365 days a year, by dialing 1-(800)-662-4357. 

Establishing a support network

Establishing a solid support system of friends, loved ones, and health professionals may be beneficial for individuals with any mental disorder, including schizophrenia. A support network can help you spot the signs of an episode, offer a safe place to discuss your symptoms and prevent the isolation that those with schizophrenia may commonly engage in. In addition, a support network can be instrumental in helping you find care, whether that be during acute episodes of schizophrenia or as an ongoing part of your treatment. 

Social support may also relate to the likelihood of a resurgence of schizophrenia symptoms of a period of remission. One study of 408 patients with schizophrenia assessed the relationship between social support and schizophrenia symptom relapse. Researchers found that the odds of relapse for those with poor social support was 3.102 higher than those with good social support. This result indicated that social support may be a predictor of schizophrenia relapse. Researchers also suggested that caregivers and clinicians increase their support to patients, while hospitals with mental health services should consider increasing psychosocial interventions to enhance the social support system. 

Having a companion animal

Research suggests that individuals living with mental health conditions may benefit from having a companion animal to manage symptoms. An emotional support animal or service dog may be able to help individuals with schizophrenia identify hallucinations, serve as an outlet for socialization, and provide emotional support during symptomatic experiences.

Having a support animal may also provide a wide range of other health benefits. One systematic literature review analyzed studies on emotional support dogs, psychiatric service dogs, and pet dogs to determine their benefits for their handlers' psychosocial health and well-being. Researchers found several positive outcomes, including the significant effects of having an assistance dog on psychological well-being, emotional functioning, self-esteem, and vitality. However, the review also suggested that further research may be required to draw definitive conclusions. 

While these coping methods may be helpful, it can be valuable for those living with schizophrenia to receive an official diagnosis and treatment from a medical or mental health professional. While an individual may be considered “high functioning,” exploring treatment options to maintain psychological and physical well-being may be helpful. 

How can you treat high functioning schizophrenia?

Individuals with high-functioning schizophrenia may receive the same treatments as those with any other level of function or cognitive symptoms. Schizophrenia treatments often include the use of pharmacological approaches, such as antipsychotic medication, or therapeutic approaches, such as cognitive-behavioral therapy (CBT). In addition to the use of antipsychotic medication, the American Psychological Association (APA) recommends the use of CBT for several components of schizophrenia, including psychosis, psychoeducation, and supported employment services. 

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. 

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Alternative support options 

Research suggests that CBT may be particularly effective for the treatment of positive symptoms, such as delusions and hallucinations. A therapist may help an individual with schizophrenia identify thought patterns and determine what situations could cause an episode. In addition, therapy may provide a space for individuals living with schizophrenia to discuss their experiences, concerns, and behaviors. 

However, in-person therapy may not be a feasible option for everyone. In some cases, it may be difficult for an individual experiencing schizophrenia symptoms to attend face-to-face therapy, even if they are considered “high-functioning.” There may also be a shortage of mental health providers, which could lead to longer wait times or insufficient care. In these cases, exploring effective alternatives, such as online therapy through a platform like BetterHelp may be beneficial.

Online therapy platforms allow clients to pick a session time that works for them and access unique resources like support groups and worksheets. In addition, preliminary evidence suggests that the use of treatment modalities involving the telephone, internet, and videoconferencing may improve patient outcomes for those experiencing schizophrenia. 

Online therapy may also be beneficial for those experiencing co-occurring mental health disorders. In one study, researchers reviewed studies concerning the efficacy of online and in-person therapy for the treatment of common mental health conditions, such as anxiety, depression, and post-traumatic stress disorder. They found that there were no significant differences between their effectiveness.