Delusions and hallucinations are altered perceptions of reality that feel very real to the person experiencing them.

People with schizophrenia often face significant stigma, partly due to how certain symptoms manifest. Still, myths that people with schizophrenia are dangerous are false and harmful.

In fact, according to the Mental Health Foundation, most people with schizophrenia are not violent, and are actually more likely to harm themselves or be a victim of violence.

Schizophrenia is a challenging but treatable chronic mental health condition that affects about 20 million people worldwide.

Learning about schizophrenia and its symptoms — like delusions and hallucinations — can help you explore treatment options for yourself or a loved one.

People with schizophrenia sometimes experience hallucinations or delusions. These are both altered perceptions of reality, but they feel very real to the person experiencing them.


Hallucinations are when a person has a physical sensation, sees, or hears something that’s not actually occurring.

Some people may see things or hear voices that others don’t. Other people may smell things that others aren’t able to, or feel things on them.


Delusions occur when a person strongly believes something that isn’t based on reality even when shown evidence.

People can experience a range of delusions.

For example, some people experience paranoia, believing that someone is following them or trying to hurt them. Others believe that someone is controlling their thoughts or listening in on what they’re thinking.

Some people may also experience delusions of grandeur, which is when someone believes they’re famous or have special abilities, or a special connection with someone or something important.

While schizophrenia can happen at any age, onset usually occurs during late teens to early 30s.

Schizophrenia tends to affect males and females equally, but may occur earlier in males.

While it’s rare for the condition to be diagnosed before age 12 or after age 40, one study says that 20% of people with schizophrenia have “late-onset schizophrenia” which is diagnosed after age 40.

Schizophrenia tends to cycle in stages. During the early stage, there may only be small behavioral changes that gradually get more concerning or noticeable.

Early signs of schizophrenia include:

  • isolating more
  • difficulty completing tasks like school work
  • increased irritability
  • sleep issues

Past the early stage, symptoms of schizophrenia usually fall into three main categories:

  • positive
  • negative
  • cognitive

Positive symptoms

Positive symptoms of schizophrenia are behaviors not typically seen in people without the condition.

These behaviors may include:

  • hallucinations
  • delusions
  • unusual body movements like repeating certain movements or being unresponsive (also known as catatonia)

Negative symptoms

With schizophrenia, negative symptoms are behaviors or emotions that are notably absent.

Negative symptoms include:

  • withdrawing from other people
  • seeming “flat” or lacking emotional expression
  • showing little interest in activities or pleasure
  • being unable to start or complete activities

Some of these symptoms can be confused with symptoms of depression.

Cognitive symptoms

Cognitive symptoms affect memory and thinking. People with schizophrenia may have trouble organizing their thoughts or completing tasks.

Cognitive symptoms include:

  • difficulty thinking clearly or paying attention
  • lack of insight about their mental health conditions (i.e., they may not think they have a problem)
  • trouble processing information and using it to make decisions

Even if you’re experiencing one or more of these symptoms, only a medical professional can accurately diagnose schizophrenia.

Delusions and hallucinations are so-called positive symptoms of schizophrenia — behaviors often not seen in people who don’t have the condition. Both symptoms involve altered perceptions of reality.

Hallucinations are mainly connected to a person’s senses, so they may hear, see, smell, or feel something that’s not really there. Delusions occur when a person strongly believes something that isn’t based on reality.

While only a mental health professional can diagnose schizophrenia, you can take this quiz if you want to see if you have any signs of the condition.

If you think you or someone you know may have schizophrenia, it’s important to seek help. Treatment options like therapy and medication can help you live well and manage your symptoms.

Living with schizophrenia may feel overwhelming at times, but you’re not alone. With the right treatment team and supportive allies by your side, successfully managing your condition is possible.