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Schizophrenia is a mental health condition that can affect how a person thinks, perceives the world around them, and relates to others. It often involves changes in thoughts, perceptions, and behaviour that can feel confusing both for the person experiencing them and for those close to them. At Central Minds, our psychologists regularly support individuals living with schizophrenia and related experiences.
We understand that what you are experiencing may sometimes feel difficult to put into words. Recognising symptoms is often a meaningful first step towards making sense of what is happening, and towards finding the right kind of support. Whilst there is no cure for schizophrenia, many people go on to live full and meaningful lives with the right combination of care.
Physical Symptoms of Schizophrenia
Schizophrenia is often thought of as a condition that affects thinking and perception, but it can also bring noticeable changes to sleep, energy, and day-to-day routines. These physical shifts often appear gradually and may be among the first things friends or family notice.
Common Physical Symptoms
- Sleep disturbances, including difficulty falling asleep, sleeping at unusual hours, or sleeping much more than usual
- Changes in energy levels, often feeling tired or slowed down even after rest
- Reduced movement or, in some cases, restlessness and difficulty sitting still
- Changes in facial expression, where emotions may show less visibly than before
- Less attention to personal care or daily routines, sometimes without realising it
- Changes in appetite or eating patterns
- A sense of physical disconnection, where your body or surroundings can feel less familiar than usual
If these physical changes are new or unfamiliar, it is worth speaking with a medical doctor first to rule out other health conditions that may produce similar symptoms.
Psychological and Emotional Symptoms of Schizophrenia
Schizophrenia symptoms typically fall into three categories: changes in perception and thinking, reduced everyday experiences, and shifts in cognitive function. Most people experience a mix of these, and the way symptoms present can vary widely from person to person.
Changes in Perception and Thinking
- Hearing sounds or voices that others cannot hear, which may feel as real and immediate as any everyday sound
- Seeing or sensing things that others around you do not notice
- Holding strong beliefs that others find difficult to relate to, such as feeling that something significant is being communicated through everyday events
- A sense that thoughts are being influenced from outside, or that your own thoughts are being shared with others
- Difficulty separating what is happening internally from what is happening in the world around you
Reduced Everyday Experiences
- A noticeable decline in drive or enthusiasm for things you’d normally care about
- Reduced interest in social contact, hobbies, or work
- Speaking less than usual, or finding it harder to express what you are thinking or feeling
- Feeling emotionally flat, even in situations that would normally trigger a clear emotional response
- Difficulty starting or completing tasks that once felt straightforward
Shifts in Cognitive Function
- Difficulty concentrating or holding attention during conversations, reading, or work
- Trouble organising thoughts, where ideas may feel jumbled or hard to follow
- Difficulty remembering things, particularly recent events or instructions
- Finding it harder to plan, make decisions, or follow a sequence of steps
- A sense that thinking feels slower or less clear than it used to
It is also common to experience anxiety, depression, or stress alongside schizophrenia. A psychologist can help you understand which experiences are linked to schizophrenia and which may relate to something else.
How Long Do Symptoms of Schizophrenia Last?
The course of schizophrenia varies from person to person, and symptoms often follow a pattern of change rather than staying the same throughout life.
- Over weeks or months, many people first notice subtle changes, such as shifts in sleep, mood, social interest, or thinking.
- More noticeable symptoms may then appear over time
- With appropriate support and treatment, symptoms can become more manageable, and many people experience longer periods of stability between episodes
- Each person’s prognosis is different, and a psychologist can help you map your own experience over time
Common Signs of Schizophrenia
The signs below may help you identify whether what you, or someone close to you, are experiencing is consistent with schizophrenia, rather than another condition.
| Sign | What It May Look Like |
| Changes in perception | Hearing, seeing, or sensing things that others do not |
| Unusual or fixed beliefs | Holding strong ideas that others find difficult to share or relate to |
| Disorganised thoughts or speech | Conversations feeling harder to follow, or thoughts moving in unexpected directions |
| Reduced motivation or interest | A noticeable drop in engagement with work, study, hobbies, or relationships |
| Social withdrawal | Spending more time alone, or finding social contact harder than before |
| Changes in self-care | Less attention to routines such as eating, sleeping, or personal care |
| Cognitive changes | Difficulty concentrating, remembering, or organising day-to-day tasks |
Psychotic experiences and schizophrenia are sometimes confused. Psychotic experiences can occur in a range of situations, including periods of significant stress or sleep deprivation, and do not always indicate schizophrenia. A psychologist can help you understand what is happening in your specific case.
How Symptoms of Schizophrenia Can Change Over Time
Schizophrenia does not always present the same way throughout a person’s life.
- Symptoms often first appear in late adolescence or early adulthood, although they can begin at other times
- The pattern, frequency, and intensity of symptoms can vary across years
- Many people experience longer periods of stability with appropriate support, including therapy and medication
- Triggers such as significant life changes, sleep disruption, or sustained stress can sometimes precede the return of symptoms
- Co-occurring experiences, such as anxiety, depression, or social difficulties, are common, and professional support can help make sense of how each piece fits together
How the Three Symptom Groups Differ
Schizophrenia symptoms are typically grouped into three categories. The table below outlines how they tend to present.
| Feature | Changes in Perception and Thinking | Reduced Everyday Experiences | Shifts in Cognitive Function |
| What it involves | Hearing, seeing, or believing things others do not share | A drop in motivation, expression, or engagement | Difficulty with attention, memory, or organising thoughts |
| How it may feel | Vivid, immediate, or hard to question in the moment | Flat, distant, or less connected than usual | Foggy, slow, or harder to follow than before |
| When others may notice | Through unusual statements or behaviour | Through withdrawal or reduced communication | Through difficulty in conversation or completing tasks |
| Common impact | Distress and confusion about what is real | Reduced participation in work, study, or relationships | Challenges with daily planning and routines |
All three groups can be supported through psychological therapy, often alongside input from a psychiatrist. You can read more about the difference between a psychologist and a psychiatrist on our FAQ page.
You May Benefit From Support If…
It can sometimes feel difficult to know whether what you, or someone close to you, is experiencing warrants professional input. The following may be helpful indicators:
- You have noticed changes in perception, such as hearing or seeing things others do not
- You have been holding beliefs that feel important to you but that others find difficult to relate to
- You have noticed a drop in motivation, energy, or interest in things you usually care about
- Concentration, memory, or organising thoughts has become noticeably more challenging
- Those around you, such as friends, family, or colleagues, have commented on changes they’ve noticed in your behaviour, speech, or routines.
- Daily life, including work, study, relationships, or self-care, has become harder to manage
- You suspect you may have schizophrenia but have not had the opportunity to speak with a professional
Our Psychologists Who Work With Schizophrenia
Dr. Sharmeen Shroff
Clinical Psychologist
With over 14 years of experience, Dr Shroff has worked in community mental health centres, private psychology clinics, medical clinics and both outpatient and inpatient units in hospitals in Hong Kong, the United Kingdom and the USA. She is one of the few clinical psychologists in Hong Kong that have been intensively trained to practice psychotherapy from a psychodynamic depth perspective.
Dr. Natalie Loong
Clinical Psychologist
Dr. Natalie Loong is a California licensed clinical psychologist with years of experiences working in community mental health, outpatient, residential, and private practice settings in Hong Kong and the United States. As a bilingual psychologist, Dr. Loong provides services in both English and Cantonese and has extensive experiences working with adults, adolescents, and children from diverse cultural.
Josanna Lai
Clinical Psychologist
Born and raised in Hong Kong, being fluent in English and Cantonese, Josanna has worked as a clinical psychologist for over twenty-six years in Hong Kong and Australia in diverse clinical settings including child assessment center, inpatient PTSD wards, outpatient psychiatric center, university counseling service, NGO for special education needs and certainly private practice.
Michael Beckham
Clinical Counsellor
Michael Beckham is a US-trained and licensed psychotherapist with 20 years of experience specialising in anxiety, couples counselling, intimacy, relationship dynamics, self-esteem, problem-solving, sexual exploration, and existential issues. Michael assists his clients to have more clarity on themselves, more clarity on the world, and more clarity on themselves in the world.
Dr. Karen Wai Liem
Clinical Psychologist, Counselling Psychologist, and Aviation Psychologist
Dr. Liem is a Clinical Psychologist, Counselling Psychologist, and Aviation Psychologist based in Hong Kong. She provides psychotherapy for adolescents adults facing psychological or relational challenges. With over 15 years of clinical experience in Hong Kong and overseas, she has worked in diverse settings.
Dr. Edward C. K. Lam
Clinical Psychologist
Edward is a U.S.-trained and licensed Clinical Psychologist in the state of Massachusetts, now bringing his expertise to Hong Kong. With extensive experience across various settings, Edward has helped clients become stronger, more independent, and resilient in the face of challenges. He creates a supportive and non-judgmental environment where clients can explore their struggles and engage more fully in life.
Oliver Ip
Mental Health Counsellor & Psychotherapist
Oliver is a US-trained psychotherapist and Licensed Mental Health Counsellor (LMHC, New York; 014804). He has worked in both community mental health and private practice providing clients of diverse backgrounds with the care, support, and skills they need. He has helped his clients work through issues such as anxiety, depression, relationship issues, neurodivergence, identity exploration (including culture, gender, sexuality), addictions, shame, and trauma (both acute and chronic/complex).
Dr Steven Livingstone
Clinical Psychologist & Systemic Family Therapist
Dr Steven Livingstone is a UK-trained Consultant Clinical Psychologist and qualified Family Therapist with over 20 years’ experience working in the National Health Service and academia. Steven’s clinical work is rooted in systemic and relational approaches, helping individuals, couples, and families make sense of distress in the context of their relationships and life experiences. He draws on evidence-based models including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Open Dialogue, integrating these with compassion-focused and mindfulness-informed principles.
FAQs About The Symptoms Of Schizophrenia
Is schizophrenia the same as having a “split personality”?
No. This is a common misunderstanding. Schizophrenia involves changes in perception, thinking, and behaviour, but it does not involve a split or multiple personality.
Can schizophrenia be diagnosed by a psychologist?
A psychologist can carry out a thorough assessment of your symptoms, history, and patterns, which can be a helpful step towards understanding what you are experiencing.
What is the difference between schizophrenia and a brief psychotic experience?
Brief psychotic experiences can occur in response to significant stress, sleep deprivation, or other temporary factors, and tend to resolve once the underlying cause is addressed and treated. Schizophrenia involves a longer-lasting pattern of symptoms across perception, thinking, and day-to-day functioning. A clinical assessment is the most reliable way to clarify what fits your experience.
Do I need a referral to speak with a psychologist at Central Minds?
No referral is needed to contact us directly. However, if you are planning to use insurance, we recommend checking with your provider beforehand, as some insurers do require a referral letter. You can find more information on our insurance and fees FAQ.
Can someone with schizophrenia live a full life?
Yes. With the right combination of psychological support, medical care, and personal resources, many people with schizophrenia continue to work, study, build relationships, and engage in the things that matter to them. Support tends to be most helpful when it is sustained over time, and a psychologist can play an important role alongside other healthcare professionals.
Can schizophrenia symptoms appear later in life?
While schizophrenia most commonly first appears in late adolescence or early adulthood, symptoms can sometimes emerge later. Significant life events, sustained stress, or sleep disruption can sometimes coincide with the appearance of symptoms. A psychologist can help you make sense of what you are experiencing, whenever it begins.
