Negative Symptoms of Schizophrenia: Making Sense of the Symptoms

Negative Symptoms of Schizophrenia

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The negative symptoms of Schizophrenia can be terrifying and make life challenging, both for the person with the diagnosis and their loved ones. 

Schizophrenia is a rare and challenging brain disorder, affecting less than 1% of the population in the United States; however, proper treatment can improve many of the symptoms.

There are positive and negative symptoms of schizophrenia, which are two groupings and specific symptoms. We talk more about what these are below. 

We know that encouraging someone to get treatment can be a challenge. By understanding potential negative symptoms of schizophrenia, you’re in a better position to help someone you care about.

It’s a very complex disorder. Research is giving us better, safer, and more effective treatment options.

Researchers are also delving into what it means to be schizophrenic in terms of genetics, behavior, and the brain’s function and structure.

That indicates the future might hold even better treatments.  

What is Schizophrenia?

Schizophrenia is a complex, severe mental health disorder that can affect your thinking, emotional management, decision-making, and how you relate to other people.

It can occur no matter how old you are, but for most people, onset is in the late teens to early 20s for men and the late 20s to early 30s for women.

In older teens, you might notice subtle early signs and negative symptoms of schizophrenia. For example, they might have a drop in their grades, sleep problems, or irritability. 

The tricky thing about that is that these are common behaviors in teens in general. There can be more apparent symptoms too, such as suspicions and unusual thoughts. This phase is known as the prodromal period in younger people.

We don’t entirely know what causes schizophrenia, but some of the factors, that we know of, that might play a role can include:

  • Genetics: if you have a close relative, like a sibling or parent, with schizophrenia, you’re around six times more likely to develop the disorder. Of course, this doesn’t mean that you will definitely—genetics is just one part of a complex puzzle.
  • Environment: Science links several environmental factors to schizophrenia. For example, malnutrition before birth can increase the risk. Doctors have found associations between autoimmune disorders putting people at a higher risk.
  • Brain chemistry: Neurotransmitters like dopamine may contribute to someone having schizophrenia.
  • Substance use: Someone who used drugs or alcohol when they were a teen or young adult could be at an increased risk of schizophrenia.
Negative Symptoms of Schizophrenia

What Are the Negative Symptoms of Schizophrenia?

Patients with schizophrenia might not realize they’re experiencing or displaying any symptoms at all.

The term negative symptoms refer to the absence of features that are present in most other people.

Positive symptoms of schizophrenia include things that other people don’t usually have.

Then, there are cognitive symptoms.

 These symptoms usually relate to a person’s thinking, emotions and behavior, and can include:

  • Delusions: A delusion is an untrue belief that isn’t based on reality; for instance: if someone is worried they’re being stalked or harmed in some way, that’s not actually happening.
  • Hallucinations: This type of symptom means that a person might be hearing or seeing things that aren’t there-They’re a sensory experience.
  • Disorganized speech: You can tell someone’s thinking is chaotic by how they speak. You may have a hard time communicating, or you might notice that the person answers questions with something unrelated.
  • Abnormal motor behavior: Someone with schizophrenia can display movements that seem excessive or pointless, or they might have strange posture.
  • Negative symptoms: The term negative symptoms can broadly refer to the signs of schizophrenia, but more specifically to a set of symptoms defined by an inability to function in a usual way. Technically, negative symptoms mean that someone might not pay attention to their hygiene or lack emotion. They might not be able to experience pleasure, or they may withdraw from social situations.

When talking about the negative symptoms of schizophrenia, these are the absence of things that you see in most other people, like an interest in the world around you or emotional responses.

Specific Negative Symptoms

There are two categories of negative symptoms we see in people with schizophrenia. There are primary negative symptoms. Those are part of the actual disorder.

Then, there are secondary negative symptoms.

Negative symptoms can include:

  • A lack of interest
  • Not wanting to interact with people
  • Anhedonia, which means an inability to feel or express pleasure
  • Lack of motivation
  • Not talking much
  • Problems speaking because of disorganized thinking
  • A blank face or a face with no expression
  • Monotone speech
  • No gesturing when communicating
  • Lack of physical activity
  • Lack of eye contact

What Are Command Hallucinations?

Command hallucinations are a positive symptom of schizophrenia because they’re an added thing that most other people don’t experience.

A command hallucination is a psychotic symptom that causes a person to have visual or auditory hallucinations that influence behavior, such as a command.

Sometimes these commands might encourage a person to harm themselves or someone else, but not always. 

Auditory hallucinations, or ‘hearing voices,’ are among the most common reported symptoms in schizophrenia and one of the most challenging issues to deal with in any psychotic disorder.

Individuals with schizophrenia or schizoaffective disorder may try to ignore the voices or even try to drown them out by covering their ears as if they physically hear the voices due to an external presence.

Hearing voices for long enough will cause many other symptoms to worsen.

Negative Symptoms of Schizophrenia

Schizoaffective Disorder

A combination of mental illness symptoms could indicate schizoaffective disorder, a mental health disorder with a variety of symptoms of schizophrenia, like delusions or hallucinations, along with symptoms of a mood disorder like depression or mania.

Schizoaffective disorder may sometimes get diagnosed as bipolar disorder.

Still, it usually isn’t until the presence of psychotic symptoms, like visual or auditory hallucinations, when a doctor would diagnose the schizoaffective disorder.

Treating Negative Symptoms of Schizophrenia

If someone you love has schizophrenia, they will need constant ongoing mental health care once there’s a diagnosis given. Psychiatrists or a psychiatric nurse practitioner usually manage treatments on a case-by-case basis.

There are differences in treatment for the positive and negative symptoms.

Positive symptoms are usually treated with antipsychotic medicines. These medicines help symptoms quite a bit for many people, but they don’t affect negative symptoms.

Negative symptoms can be a little harder to treat, and they might even be a side effect of medicine for positive symptoms.

Some negative symptoms are successfully treated or managed with antidepressants and therapy, along with lifestyle changes, such as exercising and eating well.

Final Thoughts

Schizophrenia is a challenging, complex disorder, but you can still live a gratifying life and manage the condition with proper treatment. If you believe that you see symptoms in a loved one, or yourself, we encourage you to reach out to the Mental Health Center of San Diego for help.

A combination of medications and therapy can help manage schizophrenia, and we also hope to see more developments in the future.