Stop Confusing Schizotypal with Schizophrenia
Just to clarify, I don’t suffer from Schizotypal or Schizophrenia, I personally have Borderline Personality Disorder. However, I came across Schizotypal recently, and I was surprised that I had never heard of it before. I write articles about mental illness weekly, and always research them meticulously. Moreover, I have a bachelor's degree in Psychology, specialising in clinical and health psychology. How is there an entire mental disorder that I had never heard of? Worse yet, why was I misconstruing it with Schizophrenia?
This had to change. So I made a cup of milky coffee, sat down at my desk and researched the heck out of Schizotypal. I would like to say that I read countless articles and research papers on the matter, but that wasn’t possible, as there was quite limited information on the matter. Mental illness is a minimally discussed topic already, but dive further to Schizotypal and you’ll really struggle to burrow into this topic.
I figured that I might not be the only one ignorant to Schizotypal, and so I decided to put my information digging to use and share my findings. This is a disorder that occurs in approximately 3% of the general population, and so it is the duty of the 97% without it to educate themselves on the matter. Just like Bipolar Disorder needs to stop being confused with Borderline Personality Disorder, after today you’ll no longer confuse Schizophrenia with Schizotypal.
What is Schizotypal?
Schizotypal Personality Disorder is primarily characterised by social anxiety, paranoia and derealisation. Individuals with it struggle to form and maintain close relationships, and they struggle to fit in and appear ‘normal’. The paranoia causes them to misinterpret others motivations and behaviours and thus distrust them. This results in severe anxiety and avoidance of social situations.
Many individuals will not realise that they have this personality disorder, and will instead seek medical attention for their anxiety or depression. There is also a co-occurrence with obsessive-compulsive disorder, which affects the treatment outcome adversely.
Interestingly, the World Health Organisation’s ICD-10 classes it as Schizotypal Disorder, labelling it a clinical disorder rather than a personality disorder like the DSM-V does.
According to the Mayo Clinic, an individual with Schizotypal usually presents at least five of these signs or symptoms:
1. Flat emotions, limited or even inappropriate emotional responses.
2. Limited or no friends outside of immediate family.
3. Dressing in an unusual way, e.g. unkempt appearance and oddly matched clothing.
4. Eccentric or unusual thinking, mannerisms and beliefs.
5. Mistaken interpretations of events, creating a direct personal meaning out of something harmless.
6. Persistent and excessive social anxiety.
7. A peculiar style of speech, for example uncontrolled rambling or vague and unusual patterns of speech.
8. Suspicious or paranoid thoughts, combined with doubts regarding the loyalty of others.
9. Belief in supernatural or special powers, e.g. mental telepathy and superstitions.
10. Unusual perceptions, for example sensing the presence of an absent person or experiencing illusions.
How common is it?
The initial signs can be present in adolescent years, through an increased interest in solitary activities or a heightened level of social anxiety. The individual may be an underperformer in education settings or socially incompatible with peers. This could result in teasing or bullying that heightens the isolation. It is usually diagnosed in early adulthood and can endure across the lifespan. But with treatment, such as medications and therapy, symptoms can be vastly improved.
Approximately 3% of the population have Schizotypal Personality Disorder, and it is more common in males.
What is Schizophrenia?
Schizophrenia lessens an individual’s touch with reality, and if untreated can have persistent and disabling effects. It is characterised by relapsing or continuous episodes of psychosis, as well
Symptoms for Schizophrenia fall into three categories: psychotic, negative and cognitive.
This focuses on their perception and sense of reality. They may experience altered perceptions, abnormal thinking and odd behaviours. There is typically a loss of the shared sense of reality, experiencing the world in a distorted manner. Specifically, individuals with Schizophrenia will experience hallucinations (hearing or seeing things), delusions (firm beliefs that are not supported by objective facts, often paranoid) and thought disorder (unusual thinking and disordered speech).
You could consider these almost as depressive symptoms. They’ll experience reduced motivation as well as difficulty planning and sustaining activities. Diminished feelings of pleasure in their daily life, as well as the “flat affect” (reduced expression of emotions through voice tone or facial expressions).
This can be summarised as their reaction to stimuli, and can include issues with attention, concentration and memory. It varies between individuals, from minor to interfering with daily activities like following a conversation or learning new information. It consists of trouble focusing or paying attention, issues with making decisions and using learned information immediately.
How common is it?
Schizophrenia is usually diagnosed towards the end of adolescence until the early thirties. It emerges earlier in males than females. It is usually diagnosed following the first psychosis episode.
Why do people confuse Schizotypal with Schizophrenia?
Aside from the similar names, both mental illnesses feature the individual losing contact with reality, known as psychosis. But with Schizotypal the psychotic episodes tend to be less frequent, intense or long as those with Schizophrenia. You can expect a brief psychotic episode, and delusions or hallucinations aren’t a given.
Aside from the format of these psychotic episodes is how the individual interprets them. With Schizotypal, the individual can often be made aware of the difference between reality and their distorted ideas. But those with Schizophrenia struggle with this, as they are more adamantly sure of their delusions.
Individuals with Schizotypal Personality Disorder present similar scores for numerous neuropsychological tests as those with Schizophrenia, they also have similar cognitive deficits but milder.
Both disorders are also approached with similar treatments, such as antipsychotic medications and structured group therapy or CBT. It is also possible for individuals with Schizotypal to go on to develop Schizophrenia, but this has been proven to have the same likelihood as the general population developing it.
Many even consider Schizotypal to be on a spectrum of Schizophrenia, simply less severe in symptoms and effects on lifestyle. Even so, it’s important to recognise the differences between them, as this can be vital in knowing how to approach the individual and their psychosis. It’s been shown that the rates of Schizotypal Personality Disorder are far higher with relatives of Schizophrenic individuals.
What can I do with this information?
If you don’t already, cease to use these terms lightly. You should never joke about or call someone “schizo”, “bipolar”, “suicidal” or any other mental illness. Schizophrenia and Schizotypal are mental illnesses recognised by both the DSM V and the ICD-10. They affect millions of individuals annually and you should never use the term lightly nor without caution.
If someone you know fits the symptoms of one of these disorders, or is exhibiting other mental health issues, encourage them to speak to a professional. The same applies if you’re struggling! You and internet sources cannot correctly diagnose someone, so allow a licensed professional to do so. Don’t feel hopeless, both disorders have encouraging rates of symptom improvement and lifestyle satisfaction once the correct treatment is applied.
Keep learning, keep talking about mental health. Whether that is your own, addressing how you’re feeling and not diminishing your own experience, or by sharing what you’ve learned. Next time you’re chatting to a friend, ask them if they have heard about Schizotypal! If not, tell them about it, send them a relevant link and spread awareness.
When we discuss mental health or mental illness in daily conversation, we go further than just acknowledging them, we normalise them, we accept them. You create a space for someone to share, and a space that everyone can feel welcome in. Keep the conversation going.