7 Conditions Related to Schizophrenia

If you or someone you know has schizophrenia, you know how challenging this condition can be — not just because of the troubling symptoms or medication side effects but also because of the stigma that surrounds it. Popular media often misrepresents schizophrenia, and many people misunderstand what it really means.

Schizophrenia is a serious mental health condition, but it doesn’t exist in isolation. This article looks at seven other psychiatric disorders that are closely related to or can occur alongside schizophrenia. Some are also psychotic disorders with overlapping symptoms and similar treatment options, while others involve personality or anxiety challenges. However, each has unique features.

1. Schizoaffective Disorder

Schizoaffective disorder shares features with both schizophrenia and mood disorders, such as depression or bipolar disorder. It’s characterized by psychotic symptoms, which affect perception and thought patterns, such as:

• Hallucinations — Sensing objects or events that aren’t there
• Delusions — Holding strong beliefs that aren’t based in reality

These symptoms also occur in schizophrenia. What makes schizoaffective disorder different is the presence of mood symptoms, such as depressive episodes (periods of low mood or energy) or manic episodes (very high mood or energy) lasting at least two weeks. Schizoaffective disorder can be classified as:

• Bipolar type — Involves manic episodes and sometimes depressive episodes
• Depressive type — Involves only depressive episodes

A key feature of schizoaffective disorder is that psychosis can occur even when mood symptoms are not present. This separates it from mood disorders with psychosis, in which psychosis appears only during mood episodes.

Other possible symptoms of schizoaffective disorder include:

• Disorganized speech or thinking
• Unusual or unpredictable behavior
• Trouble functioning in daily life, at work, or at school
• Neglect of hygiene

Treatment often includes a mix of antipsychotic medications, mood stabilizers, and therapy.

2. Bipolar Disorder

Bipolar disorder is a mood disorder that causes extreme shifts in mood, energy, and behavior. People may experience episodes of mania followed by depression.

During a manic episode, a person might feel overly excited or irritable, talk quickly, or make risky decisions. During a depressive episode, they may feel very sad, tired, or hopeless or sleep more than usual. Subtypes include:

• Bipolar 1 disorder — Presence of a manic episode lasting at least a week or severe enough to require hospital care
• Bipolar 2 disorder — Presence of at least one depressive episode and one hypomanic episode (a milder form of mania)

Psychotic symptoms can also appear in bipolar disorder. These can look like symptoms of schizophrenia, but a key difference is that in bipolar disorder, psychosis happens only during a mood episode. In schizophrenia, psychosis can happen even when a person’s mood seems stable.

Doctors diagnose bipolar disorder by reviewing symptoms and medical history. Treatment with antipsychotics, antidepressants, or mood stabilizers tends to be most effective.

3. Major Depressive Disorder

Major depressive disorder — also known as depression — is a mood disorder that affects mood, thinking, and daily life. It can occur on its own or alongside other conditions, including schizophrenia. Studies suggest that between 25 percent and 81 percent of people with schizophrenia may also experience depression at some point, depending on the setting and population.

Common symptoms of depression include:

• Feeling sad or hopeless
• Losing interest in previously enjoyed activities
• Sleeping too much or too little
• Eating too much or too little
• Having low motivation and energy
• Feeling easily frustrated or irritable

Some depression symptoms, such as low motivation or emotional withdrawal, can overlap with the negative symptoms of schizophrenia. A thorough mental health evaluation can help tell the conditions apart. Treatment for depression usually involves therapy or antidepressants.

4. Schizotypal Personality Disorder

Schizotypal personality disorder affects how a person thinks, acts, and relates to others. Although it’s a personality disorder, not a mood or psychotic disorder, it shares some features with schizophrenia. Common symptoms include:

• Odd or magical thinking (like believing you can read minds or influence events)
• Unusual speech patterns
• Social anxiety or trouble forming close relationships
• Suspiciousness or mild paranoia (concern that others are out to get you)
• Flat or limited emotional expression

Unlike schizophrenia, schizotypal personality disorder doesn’t lead to full psychotic symptoms like hallucinations or delusions. The person may seem eccentric but is generally in touch with reality and may even recognize that their thoughts are unusual. People with schizophrenia tend to lack that insight.

Treatment may include talk therapy, such as cognitive behavioral therapy (CBT), which can help with social anxiety. In some cases, antipsychotics or antidepressants may also help. Diagnoses and treatment plans can change over time, so be sure to check in with your healthcare team regularly.

5. Anxiety Disorders

Anxiety disorders are among the most common mental health conditions, affecting up to one-third of U.S. adolescents and adults. In people with schizophrenia, anxiety disorders may be even more common.

Anxiety disorders include several types, including:

• Generalized anxiety disorder — Constant or frequent worry about everyday things
• Panic disorder — Sudden episodes of intense panic or discomfort
• Social anxiety disorder — Deep concern about being judged, embarrassed, or watched in public
• Specific phobias — Intense worry of something that isn’t actually dangerous

Anxiety can happen alongside schizophrenia, making it harder to manage daily life. Treatment often includes therapy and medications such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and beta-blockers. If you need help managing both conditions, talk to your healthcare team or seek additional mental health services.

6. Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition marked by obsessions and compulsions. It’s not just about liking things neat or organized — it can deeply interfere with daily life.

Obsessions are upsetting thoughts, mental images, or urges that won’t go away. Compulsions are actions a person feels driven to repeat to reduce anxiety or feel safe. Examples include:

• Washing hands over and over due to concerns about germs
• Repeatedly checking locks or appliances
• Having intrusive thoughts about hurting yourself or others
• Needing objects arranged a specific way

Researchers estimate that, on average, about 1 in 4 people with schizophrenia also have OCD. These symptoms can appear before, during, or after a psychotic episode. In some cases, obsessive behaviors may be linked to side effects from certain medications.

Having both schizophrenia and OCD can make treatment more complex and may lead to greater challenges with memory, focus, or daily functioning. Therapies like exposure and response prevention (a type of CBT) can be helpful. Medications like SSRIs may also be prescribed. A psychiatrist may adjust antipsychotic medications to treat both conditions safely and effectively.

7. Substance Use Disorder

Substance use disorder (SUD) is a medical condition in which a person uses alcohol or drugs in ways that cause harm. This can include drinking heavily, using recreational drugs often, or taking pills that weren’t prescribed. It’s not just a habit — it’s an addictive disorder that affects how the brain works and makes the activity hard to stop, even if you want to.

When schizophrenia and SUD happen together, symptoms often get worse. This can lead to more hallucinations, delusions, or a higher risk of relapse. SUD can also cause challenges such as family conflict, housing instability, or difficulty following a treatment plan.

Doctors don’t fully understand why these two conditions often co-occur. Some people may use substances to cope with their symptoms or medication side effects. Others may be more at risk because of brain chemistry, genetics, or environmental factors. Researchers estimate that 20 percent to 65 percent of people with schizophrenia may also develop SUD.

Treatment may include therapy and medications. For people with schizophrenia and SUD, switching to a different antipsychotic drug or changing the dose may also help manage both conditions.

Work With Your Healthcare Provider

Understanding how different mental health conditions can overlap with schizophrenia is key to getting the right diagnosis and care. With the right support and treatment plan, people can better manage their symptoms and improve their quality of life.

Talk With Others Who Understand

On MySchizophreniaTeam, the site for people with schizophrenia and their loved ones, people come together to ask questions, give advice, and share their tips with others who understand life with schizophrenia.

Are you or a loved one experiencing symptoms of schizophrenia or a similar condition? Do you have another condition in addition to schizophrenia? Share your experiences in the comments below.