Cues of Onset and Affliction

Changes in thinking

A person may:

• Become unusually suspicious or mistrustful of others.

• Feel that ordinary events have special personal meaning (e.g., believing strangers are sending them messages).

• Have increasing difficulty distinguishing what is real from what is imagined.

• Become preoccupied with unusual or implausible ideas.

• Have trouble concentrating or thinking clearly.

Changes in perception

These can include:

• Hearing vague sounds, whispers, or one's name being called when no one is there.

• Seeing fleeting shadows or figures out of the corner of the eye.

• Feeling that familiar places or people seem strangely different or unreal.

• Becoming unusually sensitive to light, sound, or touch.

Emotional changes

The person may:

• Become emotionally flat or show little facial expression.

• Lose interest in activities they once enjoyed.

• Seem unusually anxious, fearful, or irritable.

• Have rapid mood changes.

Behavioral changes

Common signs include:

• Withdrawing from family and friends.

• Spending much more time alone.

• Neglecting personal hygiene or appearance.

• Declining performance at school or work.

• Sleeping much more or much less than usual.

• Becoming increasingly disorganized.

Changes in speech

You might notice:

Difficulty following conversations.

• Answers that seem unrelated to the question.

• Speaking in a vague, confusing, or hard-to-follow way.

• Speaking with an unusual speed, pressure or volume

Functional decline

One of the most important red flags is a noticeable drop in day-to-day functioning:

• Missing work or school.

• Difficulty managing finances or household tasks.

• Losing motivation for routine responsibilities.