We have covered a lot of information about schizophrenia in general up to this point. We know about some of the possible causes and we know about the broad range of symptoms. But what we haven’t specifically mentioned is that there are sub-types of schizophrenia that are usually experienced. Not everyone’s experience matches, and they are classified as a certain type based on the most predominate symptoms being displayed.
It is important to understand that a diagnosis is not permanent. If a person becomes ill with symptoms that cause a diagnosis of paranoid schizophrenia to be made, it doesn’t mean that the symptoms can’t shift in intensity and prevalence over time. A person can move from one type of schizophrenia to another over time. Becoming invested in one diagnosis can keep the individual, the family, and the doctor from seeing the movement of symptoms as they flux in and out of severity and significance.
The Subtypes of Schizophrenia
Below is a list of the types of schizophrenia we will discuss:
The catatonic subtype of schizophrenia largely is dominated by difficulties in movement. These disturbances affect people in different ways. Some may begin to display a large reduction in movement, sometimes as dramatic as being in a completely still state. This is what is called the catatonic stupor, where voluntary motor movement ceases, but normal autonomous functioning continues as expected. Activity can also be increased to a higher level than normal, called catatonic excitement, however none of this behavior has purpose behind it.
These purposeless movements are often repetitive and almost always meaningless. Their dramatic presence can interfere with productivity, making everyday functioning an impossibility. The rigidity and immobility of the catatonic stupor is a very strange phenomenon. The schizophrenic displaying these symptoms can be extremely resistant to attempts to move them into different positions. If placed into a certain posture, they can remain in this state for a very long time. This maintenance of posture and resistance to movement can take on extraordinary levels of strength.
At times, these movements can mimic other people’s vocalizations and movements, resembling echolalia and echopraxia, respectively. It can also resemble tardive dyskinesia, which is why it is important for a professional to perform the diagnosis, as these symptoms can easily be confused with other disorders.
With this subtype of schizophrenia, the dominating symptoms all involve a disorganization of cognition. Thinking, concentrating, and processing information all become disturbed processes that severely interfere with life, making it difficult to function and take care of the most basic fundamentals, such as feeding yourself, without some assistance.
Hallucinations, delusional thinking, and catatonic behaviors are usually at a minimum with disorganized schizophrenia. It affects the cognition, which in turn has a negative impact on everything related to thinking, including emotional regulation. A person may have a hard time maintaining a stable emotional state, or mustering up any emotion at all. Their emotional responses may seem abnormal, inappropriate, and random to an outsider.
The speech of a person dealing with this cognitive disorganization may seem very confusing. The effectiveness of their communication abilities will be drastically impaired as their thoughts move from topic to topic quickly and often with no logical consistency. The syntax and grammar of the spoken word can become bizarre, leaving others to interpret their speech as “word salad,” a meaningless, jumbled batch of words and phrases.
The most common type of schizophrenia is the paranoid subtype. Paranoid schizophrenia is predominately associated with disturbances with perception. Auditory and visual hallucinations are common, along with the delusional thinking that comes with attempting to comprehend, rationalize, and justify the hallucinations.
In addition, the paranoia leads to delusions of persecution, often with far-reaching implications such as government involvement, their family being replaced, extraterrestrial agendas, and other cosmic phenomenon. These delusions can become very sophisticated and are validated as the schizophrenic deals with his or her delusions of reference, meaning that events and items in everyday life may take on hidden, interconnected meaning for them.
Paranoid schizophrenics can lead successful lives. A person dealing with this mental illness can maintain a career and a family life, but in secret, hidden from the view of others, they may indulge in this paranoid fantasy realm. It can cause significant distress, resulting in much anxiety as they attempt to balance both worlds.
These symptoms can develop slowly, so slow that the sufferer doesn’t realize that anything is wrong or that his behavior is becoming slightly more erratic and bizarre to others. It will likely take an intervention before they gain the self-insight that something is wrong.
The individual dealing with this condition can be fully aware of their diagnosis and symptoms, and can agree outwardly with their friends, family, and doctor that these strange thoughts are truly delusions and not real, but internally may still believe the experiences he or she is having. That is how strong these delusions can be. The person may suddenly have a flare of anger, fear, or anxiety at seemingly inappropriate times. This is an indication that they are responding to internal events surrounding the theme of their delusion.
This is a peculiar type of schizophrenia. The undifferentiated subtype refers to the fact that no set of symptoms is taking precedence over another. Many symptoms associated with other subtypes may be present in equal intensities, restricting the ability of a medical professional to make a subtype classification.
The undifferentiated subtype of schizophrenia may also refer to a person who sways from one subtype to another relatively quickly, from month to month perhaps, making it difficult for there to be a stable diagnosis. That is the main feature, then, of this subtype, being that there is no main feature.
You will not often find residual schizophrenia appearing in lists of the types of schizophrenia, because it is actually the reduction in symptoms that classifies someone as under the subtype of residual schizophrenia. The symptoms of whatever previous diagnosis the person had have lessened in intensity and severity. They may still be exhibited, and delusions or hallucinations present, but they are no longer acute. Their manifestations may be very slight in comparison to prior, difficult times. A person in this state should always be concerned with a relapse of symptoms and should remain on their medication regimen as specified by their doctors. If symptoms are reduced, medication should not be abandoned because it very well could be the medication keeping the symptoms at a minimum.
This describes the types of schizophrenia that are encountered by all of us who either suffer with schizophrenia or have a friend or loved one with this condition. Psychologists and psychiatrists have done their best to determine these classifications, but it is important to remember that these labels describe symptoms, and that’s it. They do not determine symptoms or prognosis at all. Always keep an open mind to the flexibility of schizophrenia.