Schizophrenia and Depression: Comorbidity and the Value of Comprehensive Treatment

Certain symptoms of schizophrenia can resemble those of depression. When schizophrenia and depression occur together, they can intensify each other’s symptomology and dangerous outcomes. The most effective long-term treatment path is one that embraces recovery approaches for both disorders at the same time in a clinical community setting.

A complex disorder both to understand and to treat, schizophrenia is understood as having a few different categories of symptoms. Positive symptoms include the hallucinations and delusions that make up psychosis, as well as disorganized thinking, interruptions in thought and memory, and disordered movements and gestures. Negative symptoms have more to do with emotional expression and behavior, including a flat affect, apathy, lack of motivation and energy, and poor self-care and hygiene. And cognitive symptoms present as an inability to concentrate, volatile emotions, and poor memory.

They are the negative symptoms of schizophrenia that most resemble depressive disorder and can lead to misdiagnosis. While there is certainly some overlap in symptoms and experience, the negative symptoms of schizophrenia exist as the absence of feeling and expression on some level, whereas depressive symptoms exist more so as the presence of sadness and despair. But schizophrenia and depression can also occur at the same time, compounding each other’s symptoms and dangerous outcomes. When untreated, these two clinical disorders pose enormous risks of harm to oneself or others and intense psychological and emotional distress. When accurately diagnosed and treated, schizophrenia and depression can be managed well for a positive, active lifestyle.

How Do Schizophrenia and Depression Symptoms Interact?


People with schizophrenia have an increased risk of developing clinical depression compared to the general population. Estimates vary, but it is likely that more than 50% of people with schizophrenia also suffer from depression. In fact, evidence has shown overlapping genetic risk factors for schizophrenia and depression, which may help to explain the common co-occurrence of the two disorders. They also share certain environmental risk factors, such as social isolation.

Managing schizophrenia is one thing, but having depression on top of it can complicate an individual’s experience and make treatment much more challenging. The added layer of depressive symptoms aggravates the schizophrenia symptoms even more, and vice versa. The common symptom of apathy in schizophrenia compounds with sadness. The depressive symptoms of despair and hopelessness reach greater depths with the psychosis, confusion, and lack of control that come with schizophrenia.

Let’s look at how someone’s schizophrenia and depression symptoms can interact and create a more distressing and dangerous experience:

  • Even less capable of coping with stress.
  • The feelings of being out of control or trapped are intensified.
  • Hallucinations and delusions may appear darker and more unsettling or scary.
  • Greater risk of self-harm or harming others.
  • Increased risk of suicidal thoughts and attempt.
  • Heightened inability to attend to self-care.
  • Intensified paranoia and anxiety.
  • Greater lack of motivation, in general—lack of motivation to recover, in particular.

People with schizophrenia and depression may feel lost and completely at the mercy of their symptoms—especially if they are not connected with the right kind of help. Clinical treatment is absolutely vital for schizophrenia or major depressive disorder alone. When these disorders occur together, the urgency of comprehensive treatment cannot be overestimated.

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What Can You Expect from Dual-Diagnosis Treatment for Schizophrenia and Depression?


One primary benefit of expert treatment is an accurate diagnosis. It’s important that comorbid schizophrenia and depression can be identified as distinct from schizoaffective disorder or psychotic depression of a number of other disorder with similar symptoms. An accurate diagnosis will ensure the best possible course of treatment.

Treatment for Schizophrenia

The best course of treatment for one person with schizophrenia may be very different from another person’s recovery path. The wide-ranging and complicated symptoms call for a multi-dimensional approach. Most people with schizophrenia benefit from a broad combination of medication, psychotherapy, social and family support, personal care and occupational support, and, of course, treatment for any co-occurring disorders. Because there are so many arms of treatment working together, clients experience the best outcomes in residential treatment programs. Here, they can discover the options that work best in a compassionate and fully supported setting.

Treatment for Depression and Major Depression

Depression and major depression also benefit from the combined effects of medication and psychotherapy. It can take a period of time to find the correct medications and dosages. And it can also take time to develop a positive working relationship with a therapist. Hence, someone with depression faces positive recovery outcomes when they have the opportunity to put treatment first and progress at their own pace with dedicated support.

The Benefits of Comprehensive Dual-Diagnosis Treatment

Recovery from both schizophrenia and depression depends on the management of symptoms, as well as the progressive development of coping strategies and lasting support systems. Because the disorders’ symptoms affect each other so strongly, great care and professional attention is necessary for the most effective treatment for both schizophrenia and depression at the same time.

Following an accurate diagnosis, long-term treatment can allow someone with co-occurring schizophrenia and depression to become more aware of their disordered symptoms so they won’t feel so overcome and disempowered by them. While medications help to stabilize their experiences and psychotherapy brings their thoughts and feelings into clearer focus, clients can learn new and constructive coping mechanisms for dealing with stress and any flare-up of symptoms. Equally importantly, a system of long-term support from clinicians and informed family and friends is critical for someone with schizophrenia and depression to maintain their ideal treatment path and to believe in the possibility of a brighter future.

BrightQuest is a long-term residential treatment program for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned San Diego-area program and how we can help you or your loved one begin the journey toward recovery.