Schizophrenia is a relatively rare (in comparison) mental health condition hallmarked by several common symptoms. People with schizophrenia often experience psychotic symptoms like hallucinations, hearing voices that aren’t real, and have delusions. These altered perceptions of reality can interfere with the ability to function daily and carry on healthy, rewarding relationships in life.
When trying to understand schizophrenia, it’s important to know that it’s not a “one-size-fits-all” condition. There are actually five distinct types of schizophrenia, which affect an estimated 24 million people in the world. Each subset has its own set of symptoms and optimal treatments.
The 5 schizophrenia types are:
- Paranoid schizophrenia
- Undifferentiated schizophrenia
- Hebephrenic schizophrenia
- Catatonic schizophrenia
- Residual schizophrenia
Keep reading to learn more about each of these subtypes of schizophrenia. You’ll learn how to recognize them by their differences and get recommended treatments for each.
We do want to point out that the American Psychiatric Association (APA) no longer recognizes each of these 5 subtypes of schizophrenia, citing that there can be some overlap that hinders diagnosis. That said, they do concede that understanding subtypes is useful for anyone who receives a schizophrenia diagnosis.
What Are the Different Types of Schizophrenia?
While they’re not all recognized as separate conditions any longer, knowing the 5 different types of schizophrenia can be very helpful in determining the best, most effective course of schizophrenia treatment.
“If you believe you may be experiencing some of the common symptoms of schizophrenia which include: hallucinations, delusions, or paranoia, make an appointment with your healthcare provider or therapist to discuss further. Early treatment leads to best outcomes.”Talkspace therapist Ashley Ertel, LCSW, BCD
1. Paranoid schizophrenia
Paranoid schizophrenia is perhaps the most widely recognized of the 5 subtypes. It’s the “classic” perception most people have of the condition, featuring what are classified as the positive symptoms of schizophrenia. This is the person who’s consumed by a delusion, perhaps thinking of themself as “Napoleon” or the President of the United States. Paranoid schizophrenia also commonly causes someone to feel like others are out to get them.
Characteristics of paranoid schizophrenia can include:
- Obsession with a delusion (that seems very real to them)
- Auditory hallucinations (hearing voices)
- Feelings of persecution
Recommended and effective forms of treatment for paranoid schizophrenia:
- Medication: Antipsychotics
- Therapy: Group and psychosocial therapy
2. Undifferentiated schizophrenia
Undifferentiated schizophrenia is the name given to people who might exhibit symptoms of schizophrenia, but who don’t meet the full criteria for one of the other schizophrenia types.
Characteristics of undifferentiated schizophrenia may include:
- Hallucinations, both visual and auditory
- Neglect of self-care and hygiene
- Unusual or disorganized speech
- Inappropriate emotions or lack of emotion
- Bizarre behavior
Recommended and effective forms of treatment for undifferentiated schizophrenia:
- Medication: Antipsychotics; mood stabilizers; antidepressants
- Therapy: Cognitive behavioral therapy (CBT); family therapy; assertive community treatment (ACT); social skills training
3. Hebephrenic schizophrenia
Sometimes referred to as disorganized schizophrenia, hebephrenic schizophrenia is identified by disorganized speech, thoughts, and behavior.
Characteristics of hebephrenic schizophrenia can include:
- Having trouble with day-to-day tasks like self-care and hygiene
- Moving from thought to thought incoherently or without logic
- Exhibiting emotional responses that are inappropriate to a situation
- Misusing words or using made-up or nonsense words
- Pacing or walking in circles
- Repeating things over and over
Recommended and effective forms of treatment for hebephrenic schizophrenia:
Hebephrenic schizophrenia is usually treated with a multimodal approach that includes:
- Psychotherapy — cognitive-behavioral therapy (CBT)
- Life skills training
- Family education and support
4. Catatonic schizophrenia
People who have catatonic schizophrenia either withdraw physically from the world around them or conversely, they may be hyperkinetic, jumping around and moving constantly. Most of the time, catatonic schizophrenia is marked by an absence of speech.
Characteristics of catatonic schizophrenia might include:
- Unresponsive to most or all external stimuli
- Lack of speech
- Negative responses to virtually all instructions or suggestions
- Rigid limbs and muscles
- Grimacing or otherwise distorting the face
- Repeating verbatim what others say or do
Recommended and effective forms of treatment for catatonic schizophrenia:
- Medication: Anti-anxiety drugs called benzodiazepines (benzos)
- Brain stimulation: Electroconvulsive therapy (ECT); transcranial magnetic stimulation (TMS)
- Hospitalization: In very extreme cases of catatonic schizophrenia, hospitalization may be necessary as temperature, heart rate, and blood pressure can all enter dangerous ranges
5. Residual schizophrenia
Residual schizophrenia is the least severe of the 5 schizophrenia types. Someone with residual schizophrenia doesn’t have the typical psychotic symptoms like delusions, voices, or hallucinations that are the classic hallmarks of the other types of the condition. However, they can still experience negative symptoms of schizophrenia, like unusual beliefs and negative thoughts.
Characteristics of residual schizophrenia may include:
- Difficulty expressing emotions
- Isolation and social withdrawal
- Odd beliefs (i.e. believing in special powers)
- Unusual, not-quite-appropriate perceptions
Recommended and effective forms of treatment for residual schizophrenia:
- Medication: Antipsychotic medication
- Therapy: Cognitive behavioral therapy (CBT); assertive community treatment (ACT)
- Coping skills: Behavioral skills training: family support
How to Treat Different Types of Schizophrenia
Treatment for the different subtypes of schizophrenia is similar, but there are some significant differences. For example, some people with paranoid schizophrenia respond well to antipsychotic medication
s, whereas those with catatonic schizophrenia tend to do better with benzodiazepines.
“Being diagnosed with schizophrenia can be very scary and overwhelming. However, it’s incredibly important that one speaks to their therapist and prescriber about their concerns so they can be addressed instead of avoided. Treating schizophrenia is possible, and the odds of positive outcomes rely heavily on the trust that’s built with treating providers.”Talkspace therapist Ashley Ertel, LCSW, BCD
Treatment for all types of schizophrenia generally includes a combination of approaches, including psychotherapy (talk therapy) and some medication for schizophrenia. Sometimes, holistic treatments, such as high doses of B vitamins, deep brain stimulation (DBS), and CBD, are effective when added to a treatment plan in combination with more traditional forms.
Therapy for schizophrenia
Several types of in-person and online therapy are known for their efficacy in treating schizophrenia. They can include:
- Individual psychotherapy
- Cognitive behavior therapy (CBT)
- Cognitive enhancement therapy (CET)
- Psychosocial therapy
- Support groups
Many different types of medication might be beneficial in treating schizophrenia. The first line of treatment is often antipsychotics.
- Types of antipsychotics: Atypical (second generation, or newer forms of meds that tend to have less severe side effects) and typical (first generation, generally with a higher risk of side effects; typically only used if atypicals haven’t been effective).
- Antidepressants: These can be used to treat depressive symptoms that are common in some people with schizophrenia.
- Mood stabilizers: These aren’t always used; generally aren’t the go-to medication, but can be tried short-term in some cases.
Holistic or self-care techniques
When it comes to treatment for schizophrenia without medication, there are many natural things that might help improve schizophrenia symptoms so someone can live a healthier, more productive, full life. However, these are typically recommended as complementary treatments to medication. Some of the following potential holistic treatment options are easy to implement and can improve health and well-being overall.
- Eating healthy: Eating a diet rich in whole grains, antioxidants, Omega-3 fatty acids, and anti-inflammatory foods is thought to help reduce or improve symptoms of schizophrenia.
- Managing stress: Stress is a known culprit to exacerbating and increasing a plethora of mental health conditions. Learning effective ways to manage your stress can be beneficial in coping with a schizophrenia diagnosis.
- Finding social support: Social support can be wildly effective in learning to manage any type of schizophrenia. They say it takes a village, and knowing people are looking out for you, who you can turn to, makes a huge difference in managing your condition.
- Vitamins and supplements: Several vitamins, especially high doses of B, have been found helpful in reducing symptoms of schizophrenia. They can be even more effective when used in combination with other forms of treatment.
Other Disorders on the Schizophrenia Spectrum
Schizophrenia is one of many disorders that fall under the category of psychotic disorders. These conditions have similar symptoms but are classified differently depending on a number of factors. The American Psychiatric Association recognizes these other conditions that fall under the schizophrenia spectrum:
- Schizophreniform Disorder: Someone with schizophreniform disorder must have 2 or more symptoms of schizophrenia that are present for at least 1 month but less than 6 months.
- Schizoaffective Disorder: Someone with schizoaffective disorder experiences symptoms of both schizophrenia and a mood disorder like bipolar disorder. They must experience psychotic symptoms like hallucinations and delusions for at least 2 weeks when they’re not having a depressive or manic episode. For more on schizophrenia vs bipolar, check out our blog.
- Delusional Disorder: Someone with delusional disorder has never met the criteria for schizophrenia, but has had at least 1 delusion for at least a month.
- Brief Psychotic Disorder: Someone with brief psychotic disorder has experienced schizophrenia symptoms like delusions, hallucinations, disorganized speech, or catatonic behavior for at least 1 day, but less than 1 month.
If you are unsure if you or someone you know is showing signs of schizophrenia or another condition in the psychotic disorders category, reach out to your general healthcare provider or a licensed mental health care provider.
How to Know Which Type of Schizophrenia You Have
If you suspect that you have schizophrenia of any type, it’s important to seek treatment as soon as possible. Early treatment is generally more effective. When symptoms of schizophrenia are allowed to continue unchecked for years, treatment can be more difficult and possibly less effective.
It’s not uncommon for people with schizophrenia to feel that nothing is wrong with them. This classic symptom can make getting treatment challenging. It also makes the role of close friends and family members even more imperative.
Since there are so many different types of schizophrenia, you should seek out a therapist or psychiatrist with specific experience in diagnosing schizophrenia to get an accurate diagnosis and an effective treatment plan in place. They can get you started on a course of treatment that’s best suited to reduce or alleviate the schizophrenia symptoms specific to your subtype. They’ll also offer tips and coping skills.
It’s important to note that staying the course with any treatment plan a healthcare team recommends is essential. Too often, people with schizophrenia start feeling better, so they stop seeing a therapist and/or taking medication. Most often, they’ll end up with the same or worse symptoms than before. Living well with schizophrenia takes a lifetime of treatment.
You don’t have to be held back by schizophrenia symptoms. While there may not be a cure, and we continue to research schizophrenia causes, early treatment can minimize symptoms and give you the skills you need to live a full, happy life. No matter which type of schizophrenia you think you have, seeking treatment is always the right first step.