Diagnosing schizophrenia can be a long and difficult process. Schizophrenia causes people to feel disconnected from reality. It’s a chronic brain disorder that alters how someone thinks and behaves. It can cause psychotic symptoms like paranoia, delusional thoughts, and auditory hallucinations like hearing voices.
Dealing with the symptoms of schizophrenia can be very challenging. This is, in part, because regardless of whatever delusions and/or hallucinations someone may be experiencing, they’ll generally have a very insistent belief that the things they think, see, hear, and feel are truly happening, even if they’re irrational. As a result, getting an accurate diagnosis, finding treatment for schizophrenia, and gaining access to ongoing care are all essential to schizophrenia management.
It’s very important you do not attempt to self-diagnose schizophrenia. Instead, if you’re concerned you or a loved one may be dealing with this mental health condition, make a list of your symptoms and reach out to a doctor or mental health professional for appropriate testing as soon as possible.
Since testing and diagnosing schizophrenia can take time, understanding the process can be helpful as you go through the steps. We’re discussing everything you should know if you think you might have schizophrenia. Read on to learn more about the diagnosis process and to see what you should do if you find out you or a loved one does, in fact, have schizophrenia.
How Is Schizophrenia Diagnosed?
Diagnosing schizophrenia is a comprehensive process that involves interviews, reviewing negative and positive symptoms, and observing behaviors. There’s a concrete diagnostic process for schizophrenia that’s detailed through criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) — the standard diagnosis manual used by mental health professionals.
In the initial stages, schizophrenia typically involves declining functioning and mild psychosis. During this period, someone may begin having strange beliefs or bizarre perceptions. A diagnosis generally isn’t made at this point, until more distinct and obvious symptoms of psychosis emerge. Even then, a diagnosis would only come after dismissing all other possible causes for the symptoms being exhibited.
Doctors diagnose schizophrenia by performing a thorough physical exam and carefully reviewing family, psychiatric, and medical history. They’ll ask about any unusual experiences or distressing perceptions.
Other possible topics of conversation during diagnosis will likely include discussions about cognition, motivation, and life goals. A doctor will also look for any indications of self-harm.
DSM-5-TR criteria for schizophrenia
According to the DSM-5-TR, the diagnostic criterion for schizophrenia requires that someone demonstrates at least 2 of the 5 primary common symptoms, which include:
- Delusions — false beliefs that aren’t based in reality
- Hallucinations — seeing and/or hearing things that aren’t there
- Disorganized or incoherent speech — disorganized speech often suggests disorganized thinking
- Disjointed or other unusual movements — abnormal motor behavior or catatonic behavior
- Negative symptoms — avolition (a near-total lack of motivation), diminished emotional expression, social withdrawal, lack of interest in the world and people around, little or no sense of purpose
According to the DSM-5-TR, the strongest symptom that presents itself must be present for at least 1 month for a diagnosis to be made. Lesser symptoms will have been present for at least 6 months.
Further, the DSM-5-TR also states that an accurate schizophrenia diagnosis can’t be made unless significant disruptions to either professional, family, and/or social life are seen.
Tests that diagnose schizophrenia
There are no specific diagnostic tests for schizophrenia. A diagnosis must be made on a case-by-case basis. There are, however, several tests doctors might run to get a better picture of what’s going on with someone from both a physical as well as a mental health perspective. They can use test results to rule out other potential conditions before determining if any specific symptoms are related to schizophrenia.
Some of these tests can include:
- Magnetic resonance imaging (MRI)
- Urine analysis
- Spinal tap (lumbar puncture)
- Brain scans
“Usually, healthcare providers run tests such as magnetic resonance imaging (MRI), spinal tap, and blood and urine, to rule out other conditions before diagnosing schizophrenia. There are no specific diagnostic tests for schizophrenia.”Talkspace therapist Bisma Anwar, MA, MSc, LMHC
MRI scans create 2- and 3-dimensional images of inner-brain structures. Doctors can use these images to rule out any brain anomalies that could cause symptoms that falsely present like schizophrenia.
Analyzing blood can help a doctor rule out other reasons for symptoms. Things they might screen for through a blood test can include excessive alcohol and/or substance abuse, other physical health conditions, or any potential adverse side effects from prescription medication.
Essentially, they’re looking for anything that might be causing symptoms similar to what is common with schizophrenia. Bloodwork also allows your doctor to get a good picture of your nutrient and enzyme levels, which could also cause or exacerbate certain symptoms.
An EEG records electrical activities inside the brain. This test can help rule out other conditions that might mimic some of the schizophrenia symptoms, like epilepsy, for instance. EEGs are also one of the most common tests used in schizophrenia research.
What to Do if You Get Diagnosed with Schizophrenia
To get an accurate diagnosis, schizophrenia symptoms must be assessed by a trained doctor or psychiatrist. Psychiatrists are specialized in and qualified to assess mental health conditions. Diagnosing schizophrenia is complicated and takes time. It’s important to remain committed to the process and to cooperate with your doctor’s requests.
If you do receive a schizophrenia diagnosis, there are several important things you can do when it comes to how to deal with schizophrenia, including:
- Make notes for your doctor about any new or worsening symptoms
- Comply with taking your antipsychotics or other medications as prescribed
- See your doctor as recommended
- Avoid alcohol and drugs
- Seek support
- Begin therapy for schizophrenia
“Treatment of schizophrenia is usually a combination of therapy and medication management. There are chances of better outcomes when there is early diagnosis and treatment.”Talkspace therapist Bisma Anwar, MA, MSc, LMHC
Successful schizophrenia treatment plans that are most effective in managing the symptoms of schizophrenia involve a combination of antipsychotic medication and either in-person or online therapy.
Early diagnosis and treatment can result in significantly better outcomes for this challenging mental health condition, especially with schizophrenia in children. Don’t hesitate to contact your doctor if you think that you or a loved one is showing signs or symptoms of schizophrenia. Your doctor can refer you to a psychiatrist or other mental health professional for a full, comprehensive assessment.
It’s crucial that you take care of your physical and mental health, whether you have schizophrenia or not. Consider routinely practicing mindfulness meditation, getting daily doses of physical activity, journaling for mental health, eating healthy foods, staying hydrated, and maintaining a positive, motivated attitude.
Life with schizophrenia can be difficult. With the right plan and support, though, it’s something you can gain control over, so you can have a rewarding and enjoyable life.