Yes, it is possible to have schizophrenia without experiencing hallucinations and delusions. In fact, there are different subtypes of schizophrenia, and not all individuals with the disorder will exhibit the same set of symptoms. Some people may primarily experience negative symptoms, cognitive impairments, or disorganized thinking and behavior, without prominent hallucinations or delusions.
Schizophrenia is a complex and heterogeneous disorder, and its symptoms can manifest differently in different individuals. Some common subtypes of schizophrenia include:
Paranoid Type: This subtype is characterized by prominent delusions and auditory hallucinations. These delusions often revolve around themes of persecution, conspiracy, or grandiosity.
Disorganized Type: Individuals with this subtype may have disorganized thinking, speech, and behavior. They may struggle with self-care and have difficulty maintaining coherent conversations.
Catatonic Type: This subtype involves a range of motor disturbances, from extreme immobility (catatonic stupor) to excessive, purposeless movement (catatonic excitement).
Undifferentiated Type: When symptoms do not fit into any specific subtype but still meet the criteria for schizophrenia, a diagnosis of undifferentiated schizophrenia may be considered.
Residual Type: This subtype is characterized by a history of at least one episode of schizophrenia, but the prominent symptoms have lessened or disappeared, leaving milder residual symptoms.
Regarding delusions, they can indeed take various forms and themes. Feeling connected to fictional characters on a personal level could be an example of a delusion. This delusion is sometimes referred to as "parasocial delusion" or "delusion of connection" and involves the belief that a person has a unique and special relationship with characters from books, movies, TV shows, or other media.
Delusions in schizophrenia can be bizarre or non-bizarre. Bizarre delusions involve beliefs that are clearly implausible and not possible in reality (e.g., the person believes they are an alien from another planet). Non-bizarre delusions, on the other hand, involve beliefs that, while false, could potentially be within the realm of possibility (e.g., the person believes they are being followed or monitored).
It's important to note that the diagnosis of schizophrenia requires the presence of specific criteria as outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition). A mental health professional, such as a psychiatrist or psychologist, is best equipped to evaluate an individual's symptoms and make an accurate diagnosis.
If you or someone you know is experiencing concerning symptoms or distress, it's essential to seek professional help for a proper assessment and appropriate treatment. Early intervention and support can significantly improve outcomes for individuals with schizophrenia or other mental health conditions.