Avoiding Undiagnosed Schizophrenia And Seeking Treatment

Diagnosis can be a critical tool for finding support for a physical or mental health condition. With conditions like schizophrenia, which can become severe when untreated, diagnosis is often the gateway to finding adequate support. Exploring the potential consequences of undiagnosed schizophrenia can be a step toward understanding this benefit and finding care for you or a loved one. 

Undiagnosed schizophrenia can be harmful

Seek support from a licensed therapist

What is schizophrenia? 

Schizophrenia is a severe, chronic mental health condition characterized by a range of symptoms that can affect an individual’s thoughts, emotions, and behaviors. Schizophrenia can cause significant distress and impairment in relationships, daily functioning, and productivity. About 50% of people with schizophrenia receive treatment, indicating an area for growth. In addition, approximately one-third of schizophrenia cases go undiagnosed.

The successful treatment of schizophrenia can often be possible with a combination of medication, psychosocial interventions, and ongoing management, particularly in cases with early intervention. If you believe that you or a loved one may be displaying symptoms of schizophrenia, you may benefit from speaking with a licensed mental health professional.

Positive schizophrenia symptoms

Understanding the symptoms of schizophrenia can help you look out for them in yourself and your loved ones. Positive symptoms generally refer to unusual thoughts and behaviors that aren’t usually seen in neurotypical individuals. They are called “positive” because they typically involve adding abnormal experiences to the individual’s mental state. Positive symptoms can include the following:

• Hallucinations can be defined as sensory experiences that may seem real to the individual but aren’t really occurring. The most common tend to be auditory hallucinations, such as hearing voices or noises, but people with schizophrenia may also experience visual, tactile, olfactory, or gustatory hallucinations. 

• Delusions can be described as false beliefs that are strongly held despite evidence to the contrary. Delusions can take several forms, including, but not limited to, persecutory, grandiose, and paranoid. For example, one may believe they’re being followed by someone who wants to harm them, that external forces are controlling them, or that they’re a historical figure.

• Disorganized thinking and speech patterns can involve having trouble organizing and expressing one’s thoughts, leading to incoherent or inappropriate speech. 

• Unusual behavior may involve behavior that appears agitated, unpredictable, or, in some cases, catatonic (a lack of movement or response to outside stimuli).

Negative symptoms of schizophrenia

Negative symptoms of schizophrenia typically include those associated with an individual’s mood and relationships with other people. They often manifest as diminishments in activity or participation in daily life and are sometimes mistaken for symptoms of another mental health disorder like major depression or anxiety. Examples can include those listed below:

• Anhedonia: Inability or reduced ability to experience pleasure or enjoyment

• Asociality:  Reluctance or aversion to engaging in social interaction or relationships

• Blunted affect: Absence of emotional expression through facial expressions, body language, or tone of voice

• Avolition: Significant, sometimes crippling, lack of motivation to participate in or complete usual daily tasks and activities

• Alogia: A notable reduction in the quality of communication and speech; people experiencing this may avoid speaking to others altogether

Cognitive symptoms of schizophrenia

Cognitive symptoms generally refer to other symptoms affecting an individual’s executive brain functions. Impairments in working memory, problem-solving abilities, and concentration are all examples of cognitive symptoms. 

Phases

Schizophrenia typically emerges in adolescence or early adulthood. The presentation of schizophrenia symptoms usually occurs in phases.

• Prodromal: This stage is normally marked by negative and cognitive symptoms like low mood, flat affect, memory troubles, and social avoidance. During this phase of schizophrenia, individuals are often misdiagnosed with another disorder with similar symptoms. 

• Acute: Positive symptoms like delusions and hallucinations may appear during this phase. Individuals may exhibit notably unusual speech and behavior patterns.

• Residual: During the regressive phase, positive symptoms may diminish or disappear, and negative and cognitive symptoms typically present more prominently. 

Diagnostic criteria

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), individuals must meet specific criteria to qualify for a schizophrenia diagnosis, including the following: 

• The individual must present at least two core symptoms (one of which must be a positive symptom, such as hallucinations or delusions) for a significant portion of time for one month. 

• Function in areas like self-care, social interaction, and occupational or academic environment must decrease significantly.

• Signs of disturbance must present continuously for at least six months, with at least one month of active-phase symptoms (including those presenting in the prodromal/residual phase).

• Other medical or mental conditions like depressive or bipolar disorder or schizoaffective disorder cannot better explain the disturbance or symptoms. Additionally, the disturbance cannot be associated with substance use or medication side effects. 

Challenges of diagnosing schizophrenia

Schizophrenia can be a challenging disorder to recognize and diagnose before positive symptoms emerge, and the condition can be mistaken for other mental health disorders or medical conditions. In addition to symptom similarity, several factors may contribute to potential misdiagnosis. 

The rarity of schizophrenia, as a mental illness

Schizophrenia can be considered a relatively rare mental illness, with prevalence rates of roughly one in 300 people worldwide. As such, mental health professionals may not be quick to arrive at a schizophrenia diagnosis, particularly if the individual has no family history of the disorder. 

While underdiagnosis is a potential factor, recent research suggests that schizophrenia overdiagnosis might be on the rise, particularly among the African American community.

Additionally, the stigma surrounding mental health concerns can deter people from seeking professional help, as can a lack of education and understanding about schizophrenia and other mental illnesses.

Potential consequences of undiagnosed schizophrenia

Undiagnosed schizophrenia can have a severe impact on one’s mental and physical health. Symptoms can create strife within an individual’s relationships, especially with family and friends. School or work function may be impaired, or the individual may cease engaging in their responsibilities. 

Higher risk for suicidal ideation in undiagnosed schizophrenia

Perhaps the most serious concern associated with undiagnosed schizophrenia is that individuals with the disorder are usually at higher risk for suicidal ideation or suicide attempts. 

In general, they’re also more likely to engage in risky behaviors, including substance use and risky sexual behaviors. 

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

Schizophrenia resources 

Early detection and diagnosis can increase the likelihood of positive treatment outcomes. Treatment typically involves support and intervention from people regularly involved in the individual’s life, such as family, friends, teachers, and mentors. 

Education, awareness, and resources for finding help are available through organizations like the following:

• The Schizophrenia & Psychosis Action Alliance (S&PAA)

• The National Alliance on Mental Illness (NAMI) 

• The Substance Abuse and Mental Health Services Administration (SAMHSA)

If you suspect that you or someone you care about has undiagnosed schizophrenia, seek guidance as soon as possible. The above organizations feature directories to help you find mental health professionals in your area. You may also receive support in finding psychiatric care through your primary care physician or your child’s pediatrician. 

Types of schizophrenia treatment

Treatment for schizophrenia is typically tailored to the individual’s needs and often involves a combination of methods. 

Medication as a treatment for symptoms of schizophrenia

Medication is often considered the first line of treatment for schizophrenia. Antipsychotics tend to be the most commonly prescribed and most effective medication for schizophrenia. They can manage psychotic symptoms like hallucinations and delusions by blocking certain dopamine receptors in the brain.

Although they aren’t necessarily a primary treatment, mood stabilizers may be prescribed as adjunctive therapy for schizophrenia. They’re most often used to manage symptoms like hypomania, mania, anxiety, and depression by influencing certain neurotransmitters to reduce abnormal activity in the brain.

Depression can be a common comorbidity in individuals with schizophrenia, with prevalence rates of roughly 33%. However, antidepressants aren’t as commonly prescribed for people with schizophrenia. 

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action, including starting, stopping, or changing medications, without consulting a qualified medical professional.

Psychosocial interventions for the mental health of people with schizophrenia

For people with schizophrenia, medications are often only one part of a more comprehensive treatment plan. Psychosocial interventions usually focus on teaching coping, crisis management, and practical skills to help individuals resume their relationships and daily lives as comfortably as possible. Some examples can include the following:

• Individual therapy: Typically, mental health professionals work one-on-one with people with schizophrenia, using methods like cognitive-behavioral therapy (CBT) to teach individuals how to cope with symptoms, manage stress, and navigate potentially challenging social difficulties. 

• Family therapy: Family therapy usually involves working with the family members of the individual with schizophrenia to improve communication and conflict resolution skills. Education about schizophrenia is often a significant factor in family therapy and can cultivate more empathy and understanding. 

• Skills development programs: People with schizophrenia may require support in navigating employment, academic pursuits, or self-care. Programs are available in most communities to teach skills in those areas, such as problem-solving and effective communication. 

• Peer groups: Some people with schizophrenia find it emotionally beneficial to attend group sessions with others diagnosed with schizophrenia. Communication and similar experiences can remind individuals with schizophrenia that they’re not alone and that there are others who understand.

In general, schizophrenia is a chronic disease with periods of relapse and remission. Ongoing treatment is usually necessary for long-term management. 

Additional resources

Resources are available to help individuals connect with mental health professionals, as are alternative therapy options that may alleviate some of the barriers to treatment that people with schizophrenia may experience. 

For example, some people find virtual therapy preferable to in-person therapy because of its convenience. Online therapy platforms often provide more flexibility in scheduling and increased options for therapists with diverse backgrounds and experiences. 

ICBT for schizophrenia

Additionally, online therapy is often more affordable than traditional treatment without insurance, and studies indicate that internet-delivered cognitive behavioral therapy (iCBT) may be just as effective as conventional therapy for some individuals with schizophrenia. However, those experiencing acute psychosis may need to seek in-person care.