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Schizophrenia isn’t just about hearing voices that aren’t there. It’s a serious mental health disorder that affects how a person thinks, feels, and behaves. Many people wonder if schizophrenia gets worse as they get older. Unfortunately, the answer isn’t simple.
In this article, we’ll cover what you need to know about how schizophrenia changes over time. Understanding these factors can help you or a loved one take steps to improve your quality of life and manage symptoms better.
Schizophrenia is a neurodevelopmental disorder. This means it involves differences in how the brain develops and functions, which may be influenced by genetic, environmental, or other factors. It usually begins when people are in their early 20s.
Schizophrenia tends to follow a pattern that occurs in cycles. This means that for most people, there will be periods of active psychosis and periods of remission (when people with schizophrenia experience fewer psychotic symptoms).
You might hear your doctor describe your symptoms as positive or negative. Positive symptoms include hallucinations and delusions. It doesn’t mean your symptoms are good. It means they’re added features of normal thinking patterns. Negative symptoms are parts of normal thinking or behavior that are missing. Feeling less emotion or experiencing social withdrawal are negative symptoms.
Schizophrenia is considered a spectrum of diseases, meaning it affects everyone differently — from how it shows up to how it changes over time.
With proper treatment, some people can fully recover from their first psychotic episode. However, others will develop more episodes (or relapses) later on. The more psychotic episodes a person experiences, the more likely it is that their disease will get worse over time.
Studies suggest that some older people with schizophrenia have fewer positive symptoms. However, negative symptoms may continue or worsen. Some people also develop cognitive symptoms — memory problems and trouble focusing.
The age of onset — which is the age at which a person with this disorder has their first psychotic episode — can affect how schizophrenia progresses.
People with early-onset schizophrenia, which begins before the age of 18, often face more challenges in the long run. Their symptoms may be more severe, and they may have more trouble in school and social situations. Their cognitive functioning can also be more affected, making learning and work more difficult.
Those who develop schizophrenia later — in their 20s, 30s, or even 40s — may have an easier time managing their illness. This could be because they’ve already developed some life skills as adults before their disease onset. Older adults with schizophrenia may even find that some of their symptoms become less severe over time. However, some experience cognitive decline, meaning memory and thinking skills can get worse.
Late-onset schizophrenia describes people who develop this disease after the age of 45. It accounts for about 15 percent to 20 percent of people with schizophrenia and is more likely to occur in women, according to an article in Dialogues in Clinical Neuroscience. People with late-onset schizophrenia tend to have fewer negative symptoms. They may also have less trouble with cognitive issues.
Early intervention is one of the biggest factors affecting how schizophrenia develops. Receiving treatment quickly after an episode can lead to better outcomes over time. When treatment is delayed, symptoms can become more intense and harder to manage. This can also cause changes in the brain that make future treatments less effective.
People who have trouble sticking to their medications are more likely to have more symptoms down the road. This is because poor medication compliance increases the risk of more psychotic episodes, which is associated with substance use disorder and poor cognition.
Substance use can make schizophrenia symptoms worse and interfere with treatment. Drugs and alcohol may interact with your prescribed medications, increasing side effects or reducing how well they work. This combination can raise the risk of hospitalization, relapse, or more intense episodes of psychosis.
Having social support from family members, friends, and caregivers can improve your outcomes with schizophrenia. A strong support system can help you stick to your treatment plan and maintain stability. However, this isn’t always easy to achieve, especially because of the stigma associated with the condition, which can prevent people from reaching out for help.
Fear of judgment or misunderstanding can make people hesitant to seek care, attend therapy, or share their struggles with loved ones. This lack of support can lead to more stress and worsening of symptoms. When people feel ashamed or fear discrimination because of their diagnosis, it can delay treatment. This makes it harder to manage the condition in the long run.
If you’re struggling with stigma, it’s important to know that schizophrenia doesn’t define who you are as a person. It’s a medical condition that can be managed with the right support and treatment.
Although schizophrenia lasts a lifetime, many people find ways to manage it and lead fulfilling lives. A good treatment plan includes antipsychotic medications, therapy, and healthy lifestyle habits.
Regular doctor visits are essential to managing schizophrenia long-term — even when you feel like things are going well. Your healthcare team can help track your symptoms and adjust your medications. They’ll also keep an eye on other medical conditions before they become serious. Regular checkups can also help manage side effects from antipsychotic medications.
Therapy is another key part of managing schizophrenia. Cognitive behavioral therapy (CBT) is one type of psychotherapy (talk therapy). It can teach you coping skills and provide strategies for managing ongoing symptoms. Therapy can also help you recognize when things are getting worse and learn how to respond.
Taking care of your physical health is just as important as managing your mental health. Regular exercise, a balanced diet, and avoiding smoking are important. Doing so can help reduce the risk of heart disease and other conditions. Staying active and making healthy food choices can improve your well-being.
Schizophrenia affects everyone differently. Positive symptoms, like hallucinations and delusions, may get better over time. However, negative symptoms, like low energy and lack of emotion, may stay the same or get worse.
Some people with schizophrenia also experience more difficulty thinking as they get older. This can make it harder to remember thoughts or details, make decisions, and focus. Getting older can raise your risk of having more health issues. People with schizophrenia have a higher risk of developing heart disease, obesity, and diabetes. If left untreated, these added conditions can shorten your life expectancy.
Antipsychotic medications can help control your symptoms. Therapy can teach people how to manage stress and recognize the warning signs of relapse. People who stay on a treatment plan and receive early intervention are less likely to have repeated severe episodes. However, if a person stops taking their medication or faces high stress, their symptoms can return and become harder to control over time.
It’s important to know that not everyone follows the same pattern. Some people will have long periods of stability. Others may go through periods of worsening and improvement.
Many factors can affect whether schizophrenia gets worse over time. One of the most important ways to stay on top of your health is to check in regularly with your healthcare team to make sure your treatment plan is still the right fit for you.
MyDepressionTeam is the social network for people with depression and other related mental health disorders. On MyDepressionTeam, more than 150,000 members come together to ask questions, give advice, and share their stories with others who understand life with conditions like borderline personality disorder and bipolar disorder.
How has the course of your schizophrenia changed as you’ve gotten older? Have you noticed new or changing symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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