How to Set and Use SMART Goals


Key Takeaways

  • SMART goals stand for specific, measurable, attainable, relevant, and time-bound.
  • Writing down your goals and regularly revisiting them can help make them stick.
  • Break large goals into smaller, achievable steps to track and adjust your progress.

Setting SMART goals in therapy or at home helps you define your intentions and put them into practice. The acronym “SMART” means that a goal is specific, measurable, attainable, relevant, and time-bound.

When you’re trying to make changes in your life, setting SMART goals can give you a sense of ownership and personal importance, which helps you stay motivated to make the changes stick.

SMART goals are often used in healthcare, including mental healthcare, but they can also be used in business and educational settings.

SMART: Breaking Down the Parts of the Goal

The letters in “SMART” tell you that the goal is specific, measurable, attainable, relevant, and time-bound. But what does each of those words mean in practice?

Let’s look at an example. You’ve noticed that you’re not feeling rested and want to make sleep more of a priority in your life. Here’s how setting SMART goals can help. 

  • Specific: You make a clear goal instead of coming up with something general. For example, if you want to “go to bed earlier,” that’s a vague goal. To make it specific, you could say, “I want to go to bed by 9 o’clock every night.”
  • Measurable: You need to be able to track your progress and know when you’ve met your goal. So, going to bed every night at 9 is a goal you can measure. You could mark your calendar or use a goal-tracking app to check off each night that you get to bed on time.
  • Attainable: Your goal needs to be something you can reasonably do. A goal of going to bed at 9 every night would not be realistic if you work the night shift—in fact, it would probably be impossible.
  • Relevant: Your goal needs to matter to you and fit into your life and values. If you want to make your health more of a priority, a goal like getting better sleep could be part of making that change. 
  • Time-bound: Your goals need a deadline or at least a timeline. Setting an endpoint helps keep you motivated. So, if you want to fix your sleep hygiene, you could say, “I want to go to bed by 9 every night for the next month” and see how you do. By then, the new routine might have already become a habit.

Why Do SMART Goals Work?

One reason that SMART goals are a popular method is that research has shown they are an effective tool for people who want to make health-related changes in their lives.

Even if you’re very motivated to make changes, it can still be challenging. Setting a SMART goal breaks down the path you have to take into smaller parts—those five factors represented by the letters—and lets you think carefully about each step.

A SMART goal gives you clear, actionable steps and a predetermined endpoint, at which time you’ll stop and reflect to see if your plan needs to be adjusted.

Types of Goals

Some goals seem more likely to succeed than others. For example, “approach” goals tend to be more effective than “avoidance” goals. In other words, try to set a goal for an action that you want to take rather than one you do not want to take.

Research has also shown that “performance” goals may be less effective than “mastery” goals. A performance goal is one where you try to achieve a specific outcome—a common example would be something like “I want to lose 20 pounds.” A mastery goal is one where you learn a new skill or build on an ability you already have—for example, “I will walk every night for 30 minutes after dinner.”

When challenges come up in trying to meet a mastery goal, they are often seen as a natural part of the goal-achievement process. These challenges encourage problem-solving and active engagement.

For example, if your goal is to walk every night after dinner but work tasks have kept you from meeting that goal, you may change up your routine so you can take a walk on your lunch break because it will help you meet your goal.

On the other hand, not reaching a performance goal can feel like a failure because it involves judgment. Think about a goal of losing 20 pounds. If you don’t lose exactly 20 pounds, you may feel defeated and like you’ve failed to meet your goal, even if you’ve succeeded in making some changes to your lifestyle.

If you have a performance goal in mind, it can be easier to break it down into smaller, mastery-based goals in specific, measurable ways. For example, if you want to lose 20 pounds, you could break that goal down into making dietary changes and increasing your physical activity.

How to Set SMART Goals

You can certainly set SMART goals on your own, but you may also want to use them in therapy. Your therapist may also suggest using SMART goals if you’re having trouble getting more detailed and specific about a life change you want to make.

Possible Downsides of SMART Goals

A possible downside of SMART goals is that they can be too specific. For example, let’s say you’ve been having panic attacks every day. You set a goal to have no more than three panic attacks per week. You start working on your goal by using the techniques you’re learning in therapy when you’re feeling anxious.

After a few weeks, you are consistently using these tools to cope with anxiety, and you’re no longer having daily panic attacks—but you’re still having them four or five times a week.

Since you did not meet your exact goal of three a week or less, you feel like you’ve failed even though you’ve made great progress and greatly improved how you deal with anxiety. In this case, setting a very specific goal might have worked against you.

Here are some examples of how you can use SMART goals, either in therapy or on your own. 

S: Specific

  • Think about your overall goals and narrow down your goal to be as specific as possible.
  • “Being less anxious” is a common goal for therapy, for example, but it’s a little too general. How can you make a goal like that more specific?
  • Create a statement for your goal that helps you define it clearly. You may even want to write it down. For example, you might say, “I want to reduce my anxiety attacks to three a week or less.”

M: Measurable

  • Adding measurable (quantifiable) criteria to your goal helps you keep track of your progress.
  • Brainstorm some ways that you can visualize each step of the process. Not only will this help you stay motivated, but accountability can also discourage you from cutting corners.
  • Calendars, phone apps, and journaling are all strategies you can use to track your goals.
  • For example, if you’re trying to reduce stress, your goal might be to take 10-minute meditation breaks twice a day. You can use an app or a notebook to log your meditation sessions and stress levels each day. If you’re in therapy, you and your therapist can look at your records and track your progress.
  • Keeping track can also help you see if you need to make any changes to your goals as you go along. You’ll be able to pick out trends, such as situations that cause you more stress, so that you can avoid them or respond to them differently.

A: Attainable

  • While you might want to “dream big” when you’re first thinking about your goals, it is helpful to take those large goals and break them down into smaller ones.
  • If you’re working with a therapist, they can also help guide you away from setting unattainable goals. Your goals can be ambitious, but they should not be impossible. You want to choose a goal that you are confident that you can reach, but that will also challenge you to follow through with smaller, more attainable actions that are needed to achieve it.
  • Think about what support and resources you need to realistically achieve your goal. For example, do you have the time or supplies needed for the goal? If you don’t right now, can you get them?

R: Relevant

  • Does each step of the goal-reaching process make sense and matter to you? It can help to talk with a therapist about why you want to make a specific change or set a specific goal. How does it fit into your life?
  • Your goal should feel important and inspiring to you. If you don’t feel like the goal matters, you won’t be very motivated or invested in trying to get there.
  • Sometimes, you may have to reframe a goal to make it more relevant to you. For example, maybe you know that reducing your anxiety would have benefits for your mental and physical health, but those benefits feel too vague to be motivating. Instead, it might help to think about how lowering your stress levels would help you enjoy spending time with your loved ones or get back to a hobby that you enjoy.
  • Keep in mind that nobody else can set goals for you. Ultimately, you are the one who will decide what goals to set.

T: Time-Bound

  • Make a timeline for when you want to reach your goal. The timeframe should be realistic but not too far into the future.
  • For example, if you want to use techniques you learn in therapy to reduce stress so you’re having fewer than three anxiety attacks per week, you might give yourself one month to achieve that goal.
  • Once you get to the endpoint, you can review your process and see what worked well and what didn’t. Then, you can revise your strategy and set a new goal.

SMART Goal Template

Here’s a template you can use to define your SMART goal:

“I will [your goal here] by [how you will do the goal]. I will know I am making progress because [how you will measure the goal] for [time goes here].”

For example, “I will reduce my anxiety attacks to three times a week or less by using anxiety management techniques I learn in therapy when I’m feeling anxious. I will do this for the next month and track my progress in my journal.”

How to Make SMART Goals Stick

Once you’ve set and achieved a SMART goal, here are some tips that will help make it stick:

  • Write your goal down and go back to it often.
  • Keep in mind that life happens. Making adjustments to your goal is part of the learning process. Don’t beat yourself up if something has to change. Instead, look at your progress and your goals. Did you miss a step? Is something not working? If you see a stumbling block, readjust your plan and goal and jump right back in.
  • Don’t set yourself up for failure by taking on too much or setting a goal that you probably will not be able to reach. Be realistic about your expectations.
  • Focus on process goals instead of just the outcome. An outcome gives you a target, but it does not address how you will reach the goal. Think about changing behaviors and habits.
  • If you want to make sustainable lifestyle changes, setting longer-term goals helps you keep the big picture in mind. You can still break down a long-term goal into smaller, short-term goals that will be easier to track.
  • Remember that someone else’s goals are not your goals. Your goals have to be meaningful and attainable for you.

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Why Work-Life Balance Is So Important—and How to Nail It


Key Takeaways

  • To improve work-life balance, set boundaries and don’t check work emails or notifications after hours.
  • Talking to your boss about flexible work options can help you manage a healthy work-life balance.
  • If work-life balance is harming your health, consider changing your job for better well-being.

Does it ever feel like your job is taking over your life? Or do you seem to have so many personal obligations that you can’t give 100% at work? We know we need work-life balance, but finding harmony between your professional and personal life isn’t always as easy as it sounds. 

Work plays a major role in our lives. It takes up much of our waking hours during the traditional workweek. That’s why it’s so important to make sure that we are also taking care of the areas of our lives that keep us healthy and happy. 

Professional fulfillment can be a part of that, for sure. But well-being also involves all of the things outside of work that makes your life worthwhile, including your family, hobbies, health, and relationships (not to mention sleep, exercise, balanced meals, and relaxation).

What Do We Mean When We Say “Work-Life Balance”?

Work-life balance is usually defined as an equilibrium between your professional and personal life. When you keep things balanced, no single element of your life dominates and overwhelms the others.

“Work-life balance is the concept that you effectively manage your professional life and responsibilities so that you are productive and successful at work while ensuring you have plenty of dedicated time to live a fulfilling, grounded, personal life,” says Abbey Sangmeister, MS.Ed, LPC, ACS.

That’s a general definition of the concept, but “work-life” balance can also mean different things to different people. Researchers suggest that this is because this balance is all about individual perception. It’s something you feel when your work and non-work activities are in harmony and are compatible with your current goals and priorities.

The things that make your own work-life situation feel manageable may differ depending on your needs and your situation.

For working parents, it often means finding a way to juggle the responsibilities of a career while still finding time for a fulfilling family life. With rising numbers of older workers, work-life balance may focus more on staying active in the workforce while finding ways to manage health issues or disabilities.  

Major shifts in how we work have also helped change the definition of work-life balance for many people. For many people, work-life balance meant clocking out at 5 p.m. and not thinking about work until you showed up at the office at 9 a.m. the next day. 

Being tethered to an office is a thing of the past for many folks. It makes sense that, for many of us, the option for flexible or remote work is an essential part of work-life balance. This means that work-life balance is much more personal and nuanced these days–but it also makes finding a balance harder than ever before.  

Many times people think balance is a 50/50 split but that is not always the case. For each person, the balance may look different and will shift during different seasons of their life. The important part of having balance is that the person does not feel that one area of life is draining and depleting the other.


ABBEY SANGMEISTER, MS.ED, LPC, ACS

What Work-Life Balance Is Not

Work-life balance isn’t about slacking off, skipping work, or putting in less effort. Obviously, we all have our good and bad days, but there are ways to manage the days we’re feeling a little “off” that don’t involve hurting yourself professionally. 

Procrastinating or shirking your responsibilities aren’t effective ways to cope. You might feel a little better for a bit, but it ultimately creates more problems in the future. Work piles up, deadlines fly by, and your employer might start to notice that you’re not putting in your best effort.

The goal is to find a harmonious balance that works for you, between the demands on your time and energy, without neglecting important areas of your life.

You don’t want to ignore your personal life in favor of your job, but you also shouldn’t deal with stress by neglecting your workplace duties.

How Can I Tell If I Have a Healthy Work-Life Balance?

So how exactly can you tell if you have a healthy work-life balance? It can look a little different for everyone (since we all have different work, family, and relationship situations). 

“Lack of regular overwhelm and frustration are good signs that one does have good work-life balance. People who struggle with the Sunday scaries and dread or have a case of [the] Mondays more times than not are most likely struggling with an imbalance,” Sangmeister suggests.

The following are a few signs that you’re striking a good balance between your job and other areas of your life:

  • You don’t feel like the demands of your work roles and personal obligations are constantly in conflict
  • You’re able to meet your deadlines at work without having to work overtime
  • You’re getting plenty of sleep at night and eating a healthy, balanced diet
  • You don’t spend the end of your weekend consumed by the “Sunday Scaries
  • You have plenty of time to relax and enjoy your hobbies
  • You feel like you’re spending enough time with family and friends
  • You don’t worry about your job when you’re not at work
  • You feel like you’re being productive at work and making progress toward your professional goals, but you don’t feel like your whole identity hinges on your job
  • You’re taking your vacation days (and using your sick days when you need them)
  • You’re taking advantage of any work-life benefits your employer offers, like gym memberships, flexible scheduling, and childcare vouchers

Remember that work-life balance isn’t something you can just check off your to-do list. It’s only natural that the demands of your job and outside life shift and change over time. That means that what you need to keep the balance will change over time.

“With a good work-life balance, a person is less likely to be rigid with their schedule,” Sangmeister says. “Instead, they are able to be flexible and can adapt to include demands that may come up professionally or personally without disrupting the feeling of balance.”

To figure out if you have a good work-life balance, think about what’s most important to you. What helps you to feel your best? Are you taking care of yourself personally and professionally? Are you managing your stress and watching for signs of burnout?

Can I Request a Healthier Work-Life Balance (If So, How)?

If you’re struggling to find a balance between work and the rest of your life, it might be time to have a conversation with your supervisor. This includes work-life benefits like hybrid, flexible, or remote work. Flextime, alternative work schedules, child care options, and access to mental health services are important work-life benefits employers offer to attract employees. 

There are things that your employer can do to help foster a better work-life balance. It’s something that benefits them as well. Research has shown that workers with better work-life balance are more satisfied with their jobs, perform better at work, and are more committed to their organizations.

A conversation with your employer might help you find ways to work together to make things more manageable. This might involve reprioritizing your tasks, delegating some work to others, hiring additional help, or allowing you to work remotely when needed.

Unfortunately, these aren’t always options, depending on the nature of your profession or your role in the workplace. In many cases, making a change hinges on how you approach your job. It might mean changing your priorities, delegating tasks at home, or letting your colleagues know you can no longer respond to work-related problems during your downtime.

It’s also important to be aware of your legal rights. If you need certain accommodations because you are pregnant or have a disability, these needs may be protected by the Family and Medical Leave Act (FMLA) or the Americans with Disabilities Act (ADA).

This includes protections if you are dealing with depression, anxiety, or another mental health condition. (You will need to have your condition diagnosed by your doctor, and you may need to provide documentation for your employer when you request an accommodation.)

How to Ask Your Boss for Better Work-Life Balance

Schedule a time to talk to your employer and tell them what you plan to discuss. During your meeting, explain your problem, and share your ideas for how you think you can work together to resolve the issue. 

If you’ve been overwhelmed by your workload and putting in too many hours, you might suggest redistributing some of your tasks to other team members to help lighten the load. 

Remember to stay professional and show respect for your employer’s needs. Reiterate your commitment, and explain that you think finding a better balance will help you feel more productive and satisfied with your job.

How to Improve Your Work-Life Balance

So what’s next if you feel like your work-life balance is in shambles? It’s time to take a step back, figure out what is wrong, and make a plan to fix it. Your health literally depends on it.

Many studies have demonstrated that people who have more conflict between their work and non-work life are more likely to experience health problems, mental health conditions, and poor overall health outcomes.

Make a Plan

Bringing more balance to your life starts with figuring out what’s causing the problem in the first place. Are your work hours too long? Or are work obligations encroaching on your off-time? Do you feel like you have no control over your schedule? Or are you taking on too many demands and need some relief?

Creating a personalized plan for how you are going to tackle your work-life balance can help you figure out what’s wrong and which strategies will be most effective.

Create Divisions Between Your Work and Non-Work Life

Flexible and remote work can be a great way to promote balance in your life, but it often blurs the lines between your personal and professional life. You may find yourself working longer than normal hours, catching up on work when you should be relaxing, or staying up late to answer those last few emails you forgot to send earlier. 

The problem is that, over time, there is a distinct lack of balance. Because you never feel like you have any mental space from your job, it starts to feel like you’re always working. Your home life becomes your work life.

If you are fully or partially remote, there are things you can do to help promote better work-life balance:

  • Create a schedule: Figure out which hours you can work during the day and stick with it. Creating a regular schedule can help you feel more productive. “Start your mornings off with routines and rituals that are grounded. If you start your day sprinting the moment your alarm goes off, that energy carries through the day and leads to burnout,” Sangmeister says.
  • Get ready for work: While you don’t need to wear a suit and tie to work from your home office (unless you want to), consider wearing something other than your favorite ‘lounging around the house’ outfit. Dressing professionally when you are working can help create a mental division between your job and your home life.
  • Let other people know when you’re offline: Use different communication tools to let others know when you are offline. For example, put your work hours on your Google Calendar, set your Slack availability to prevent notifications during your off-time, and set up out-of-office emails when you are on vacation.
  • Plan activities during your non-work hours: Give yourself things to look forward to once you are off work. It might involve getting together with friends, but it can be as simple as preparing a nice meal and settling in to stream an episode of a series you’re watching.

Take Breaks

Taking breaks is also essential. This includes mini-breaks during the work day and periodic days off or vacations.

“Taking an intentional day off periodically is a great way to improve work-life balance,” Sangmeister explains. “On these intentional days off, don’t just tackle a to-do list and chores; instead, work on personal development and mindfulness.”

She also recommends mini-vacations and tech-free weekends. Even scheduling a little tech-free time each day can be helpful.

Don’t Work When You’re Not at Work

It might sound obvious (and simple), but it can be harder to stick with than you might expect. When your workday is over, it needs to be over. That means no checking work emails, looking at notifications, or logging in to finish “one last thing.” 

Even if all you’re doing is reading your messages that you plan to work on tomorrow, you’re letting your work interfere with your personal time. It creates pressure and stress that distracts you from feeling fully relaxed or completely present during non-work hours. 

Set boundaries around the hours you work and create no work zones. That means even when you have “free time,” you aren’t going to open your phone or laptop to do work at certain times or in certain places.


ABBEY SANGMEISTER, MS.ED, LPC, ACS

Know What Burnout Looks Like

When your work-life balance is seriously screwed up (i.e., you’re spending every waking moment working, thinking about work, stressing about work, or dreading work), there’s a good chance you’re headed for burnout.

Being burned out is more than just being tired and unmotivated—it means you’ve reached a state where you feel so exhausted and empty that you can hardly cope with daily life, let alone care about work.

Signs of burnout can be physical, such as headaches, high blood pressure, stomach aches, and frequent illness. But they are also mental and include problems sleeping, depressed moods, loss of interest, fatigue, problems concentrating, and apathy.

If you’ve reached this point, it means you need to make serious changes to your work environment. That might mean taking time off or switching to a different position. Sometimes, it might even mean thinking about changing jobs altogether.

Consider Changing Jobs

So you’ve had a conversation (or more than one) with your boss, but they are refusing to offer any flexibility to make any changes that will help you feel better about your relationship with your job–what now? 

If poor work-life balance is taking a toll on your well-being and isn’t something you can solve on your own or by working with your employer, it might be time to consider taking a more serious step–changing your job altogether. 

Wait until you’ve had time to consider the problem and your options. Spend some time looking at other positions in your field (or even other fields if you’re ready to make a more significant change). Look at job review sites to see what other current and past employees are saying to learn more about what you might find in terms of work-life balance if you take a job with another company.

Finding a job you truly love can be a great way to feel more positively about the balance between your work and your outside life.

What This Means For You

Finding that perfect balance between your work and your life can seem like performing a tightrope act. If you’re struggling, it might be worth talking to your boss about how they can help support your well-being (and foster greater job satisfaction and loyalty).  Remember: the goal is not to have a 50/50 balance—it’s about finding a balance that feels good to you and, most importantly, works for you.

Taking steps to manage your time and boundaries is also essential. Make time for family, friends, hobbies, health, and self-care—the things that help you feel personally fulfilled outside of work. “Schedule, schedule, schedule,” Sangmeister recommends. “Make these appointments just as important as any work meeting.”


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Signs and Symptoms of Schizophrenia

Key Takeaways

  • Schizophrenia symptoms include delusions, hallucinations, disorganized speech, and behavior.
  • It’s essential to consult a doctor if social or work functioning is impaired.
  • Negative symptoms like lack of emotion and reduced speech can make schizophrenia challenging to identify.

The symptoms of schizophrenia can seem peculiar to people who observe them. Some common symptoms of schizophrenia include delusions, hallucinations, disorganized behavior, lack of emotion, reduced and disorganized speech, and memory problems.

However, when people are experiencing symptoms, they may have little or no insight that their thoughts or behaviors are strange. The lack of insight can make schizophrenia very frustrating and frightening for loved ones.

Verywell / Cindy Chung


Schizophrenia: A Psychotic Disorder

Schizophrenia is classified as a psychotic disorder, meaning a person becomes disconnected from reality. This disconnect will affect some combination of a person’s perceptions, thought processes, beliefs, and emotions. These symptoms may come and go episodically.

Three Phases of Schizophrenia

Schizophrenia usually develops in three phases:

1) A prodromal phase when changes in thoughts, feelings, and perceptions begin

2) An acute phase when psychotic symptoms appear

3) A recovery phase where support, medication, and therapy aid in improving the condition

Clinical Symptoms

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) is a clinical resource practitioners use to diagnose mental health conditions. As with other conditions, there are specific clinical criteria involving symptoms and course of illness, that need to be met for someone to be diagnosed with schizophrenia.

Positive Symptoms

Symptoms of schizophrenia are referred to as positive or negative. That doesn’t mean that some are good and some are bad. Positive symptoms are those that are present in someone with schizophrenia that someone without schizophrenia or another mental health condition would not experience. Examples of these symptoms include:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized behavior

Delusions

Delusions are fixed, false beliefs that don’t make sense in the context of a person’s culture. Although everyone has distorted beliefs from time to time, people with psychotic delusions can’t be convinced that their beliefs aren’t real.

Hallucinations

Hallucinations are false sensory experiences that have no basis in the external world. Psychotic hallucinations occur when the person is fully awake and not under the influence of alcohol or drugs.

Auditory hallucinations (hearing voices) and visual hallucinations (seeing things) are the most common, but a person can hallucinate a touch (for example, bugs crawling on the skin), taste, or smell.

Disorganized Speech

Disorganized speech is also known as “loose association.” In psychotically disorganized speech, words are not linked together based on the normal rules of language but may be strung together based on sounds, rhyme, puns, or free associations.

Although everyone makes speech errors, especially when they’re tired or stressed, disorganized speech during a schizophrenic episode is severely abnormal. It can be difficult or impossible to understand.

Disorganized Behavior

Disorganized behaviors for someone with schizophrenia are not goal-directed and don’t make sense in context. For example, while taking one’s clothes off to take a bath is sensible, taking one’s clothes off on a public bus is an example of disorganized behavior.

Laughing at inappropriate times or for no reason is a disorganized behavior. Adopting strange postures or freezing can be examples of catatonic behaviors.

Negative Symptoms

In addition to the positive symptoms that become present in someone with schizophrenia, others are referred to as negative symptoms. This means that the person is experiencing an absence or reduction of certain traits typically present in healthier individuals.

The term negative suggests that something feels as if it is being taken away or disappearing from the person’s daily experience. Examples of negative symptoms can include things like:

  • Flattened affect
  • Anhedonia
  • Reduced speech
  • Lack of initiative

Flattened Affect

People with flattened affect appear emotionless or have a very limited range of emotions. They show little response to emotional or disturbing situations or images. This restricted expression of emotion can be alarming to others, as it can feel like the person with schizophrenia is disappearing from them.

Anhedonia

Someone with the condition of schizophrenia can experience a lack of joy in things that used to bring them pleasure. This change tends to be quite noticeable by others around them and is not simply a change in interests.

Reduced Speech

A negative symptom of schizophrenia can involve someone speaking noticeably less than they used to. This particular symptom could also be observed as someone speaking less fluently than before.

Lack of Initiative

The loss of will to do things is a negative symptom of schizophrenia. Remember that a negative symptom refers to a characteristic that seems to be lessening or disappearing from the person. Loss of motivation and initiative, also known as avolition, is a common negative symptom.

Positive Symptoms

  • Delusions

  • Hallucinations

  • Disorganized speech

  • Disorganized behavior

Negative Symptoms

  • Flattened affect

  • Anhedonia

  • Reduced speech

  • Lack of initiative

Other Symptoms of Schizophrenia

In addition to the formal diagnostic criteria, there are a variety of other symptoms or comorbidities that can often be found in people with schizophrenia. These symptoms include things like:

  • Agitation, anger
  • Anxiety
  • Cognitive Impairment
  • Depression
  • Sleep disturbances
  • Substance use (especially tobacco use)

Myths About Schizophrenia Symptoms

One common misconception is that violence or aggression are common symptoms of the condition. It is important to recognize that this is not the case. Having schizophrenia does not mean that a person is violent or dangerous. While the condition is chronic, it can be managed effectively with medications, therapy, and support.

More About Cognitive Symptoms

Cognitive symptoms of schizophrenia have to do with the way a person thinks. Although cognitive symptoms are not used to diagnose schizophrenia, some are pretty common with the condition, such as:

  • Difficulty maintaining attention: The inability to sustain focused attention makes people with schizophrenia seem spacey or “out of it.”
  • Memory problems: Schizophrenia often affects working memory, the kind of memory you use to keep things in your head for active processing, like the digits of a phone number you’re about to dial.
  • Difficulty planning and structuring activities: This is caused by reduced executive function, a set of mental processes that allows us to identify the steps needed to complete a task and execute them in a proper order. Executive function also allows us to suppress our response to distractions in order to get something done.
  • Lack of insight: People with schizophrenia have a specific cognitive blind spot that prevents them from understanding that they are ill. This means that loved ones and caregivers should remain as vigilant as possible to help the patient maintain their routines and treatment to control symptoms.

Symptoms in Children and Teens

When schizophrenia appears before the age of 18, it is referred to as early-onset schizophrenia. Childhood-onset schizophrenia, which occurs before age 13, is also possible, but it is considered very rare. 

The earliest signs that may appear in childhood or adolescence include strange thoughts, problems differentiating between reality and imagination, difficulty concentrating, extreme moodiness, social withdrawal, and odd behaviors.

Symptoms in children are the same as in adults, but kids are more likely to have auditory hallucinations. Thought disorders and delusions do not emerge until adolescence or young adulthood.

Psychiatric Assessment

Because of the variety of symptoms that can be present, schizophrenia can be difficult to diagnose. In an effort to achieve greater precision in the process of diagnosing, the clinical criteria for schizophrenia within the DSM-5-TR have become more complex over time. There are reasons why it is important to diagnose schizophrenia accurately:

  • It is a more common condition than people might think.
  • People who develop schizophrenia can experience symptoms for the rest of their lives.
  • Often, medication must be taken for the rest of their lives.
  • Symptoms can significantly impact someone’s social abilities and work functioning.

DSM-5-TR Criteria

As outlined within the DSM-5-TR, the clinical features that must be present for the condition of schizophrenia to be diagnosed include the following:

1. Presence of at least two of the following symptom types (with at least one of the symptoms being in the top three listed here):

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized behavior
  • Negative symptoms

2. The symptoms are to be experienced for at least six months, with the psychotic features (the top three listed above) being present for at least one month.

3. The person experiences significant problems with work and social functioning as a result of their symptoms.

4. The diagnosing clinician can determine that the symptoms the person has been experiencing are not caused by another medical or psychiatric condition or substance use.

Other Diagnostic Considerations

In addition to exploring and identifying whether or not someone meets the formal clinical criteria as listed in the DSM-5, there are additional things that a mental health provider will consider in the diagnostic process. These include:

  • Family history of schizophrenia: A close relative with schizophrenia can increase someone’s chance of also being diagnosed with schizophrenia. This does not mean that people are born with the condition. Instead, having a combination of genes may cause people to be more vulnerable to developing schizophrenia. However, having these genes does not necessarily mean that people will develop the condition.
  • Response to medication: People may have taken medication as part of mental health treatment in the past. Depending on someone’s responses to certain medications in the past, it may suggest certain diagnostic possibilities.
  • Age at onset: Typically symptoms become present between the late teens and the mid-30s. If someone’s symptoms are presenting later in life it could suggest there is something else going on. It doesn’t necessarily rule out schizophrenia. It is simply something to consider in the diagnostic process.
  • Situational factors: Experiences that can cause severe emotional distress can lead to brief periods of psychosis. As a clinician conducts their assessment, they will likely be considering any significant life changes or events to determine duration and severity of symptoms and whether or not there are other mental health conditions that should be considered.

Comprehensive exams are an important aspect of diagnosing schizophrenia. A clinician will not rely on limited pieces of information or only on self-reports from the client. They will be gathering information about the client’s family history, substance use and medications, sleep disturbances, appetite changes, and more.

In addition, a clinician needs to explore information related to the person’s values system, perspectives on the world, interests and talents, beliefs, and relationship dynamics. Family and close friends may also be interviewed to help provide helpful collateral information.

Closely Related Conditions

Schizophrenia is a complex diagnosis with a lot of symptoms and variables to consider. What makes things more complicated is that there are also several closely related conditions that involve psychosis. Some of the conditions that are to be ruled out can include:

When to Consult a Doctor

Because of the complexity and variety of symptoms associated with schizophrenia, it can be difficult for people to know if what their loved one is experiencing is concern enough to see a doctor.

Schizophrenia Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor’s appointment.

Mind Doc Guide

Onset and Duration of Symptoms

The onset of symptoms tends to be gradual, building in severity over time. This sometimes slow progression of symptoms can also make it difficult to know if what you, or someone you love, is experiencing is to be of concern.

Some of the most common early warning signs of schizophrenia include anxiety, depression, difficulty thinking clearly, reduced energy, restlessness, and social withdrawal. People may experience such symptoms for years before the condition becomes apparent.

Schizophrenia is a chronic, lifelong condition without a known cure at this time. The symptoms can worsen over time, or they can improve if the condition is well-managed with medication and therapy. Symptoms don’t always get better with age.

Functioning in Social and Professional Situations

When social and work (or school) functioning is impaired, it may be helpful to consult with a doctor. Because the symptoms tend to develop over time, it can be hard to realize that someone is experiencing difficulty in these areas. Noticing that a pattern has developed can be a signal to consult with a professional.

Challenges in Reaching Out

It can be challenging for people with schizophrenia to reach out to a doctor or other health professional about their concerns. This can be particularly tough for people experiencing symptoms that leave them feeling suspicious of others.

Reassurance from people they trust can help encourage and prompt someone to speak with a doctor or other mental health professional.


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