Negative Symptoms of Schizophrenia Overview
Schizophrenia is a severe mental illness that affects how you think, feel, and act. It’s a chronic condition that can also have a powerful effect on loved ones.
The disorder is characterized by positive, negative, and cognitive symptoms:
- Positive symptoms: The presence of symptoms most people don’t have, such as exaggerated perceptions and ideas. Hallucinations and delusions can be so vivid that they impair a person’s ability to know what’s real and what’s not, negatively impacting their ability to care for themselves. This is sometimes called a “psychotic break.”
- Negative symptoms: The absence of things present in most people. This includes facial expressions, emotional responses, and interest in the world.
- Cognitive symptoms: Difficulties with concentration, working memory, and decision making.
Let’s take a closer look at the negative symptoms of schizophrenia, how to spot them, and how they’re treated.
List of negative symptoms of schizophrenia
There are two types of negative symptoms. Differentiating between the two can be a challenge.
Primary negative symptoms refer to those that are part of the disorder itself. These can occur during or between exacerbations.
Secondary negative symptoms refer to those due to other things, such as:
- Medication
- Withdrawal from medication
- Substance use
- Hospitalization
- Isolation
- Personality disorders
- Depression
Negative symptoms can be more persistent than positive ones. When it comes to negative symptoms of schizophrenia, there’s often more than meets the eye. For example, a lack of facial or verbal expression doesn’t always mean a lack of feeling. Instead, negative symptoms may mask an actual emotional state. People with schizophrenia tend to have bouts of severe symptoms followed by remissions. But some symptoms may always be present to a certain degree.
Negative Mental Symptoms
- A seeming lack of interest in the world
- Not wanting to interact with other people (social withdrawal)
- An inability to feel or express pleasure (anhedonia)
- A failure to act spontaneously
- A decreased sense of purpose
- Lack of motivation (avolition)
- Not talking much
- Difficulty speaking due to disorganized thinking (alogia)
Negative Physical Symptoms
- An inexpressive or blank face (flat affect)
- Monotone or monosyllabic speech
- Lack of gesturing when communicating
- Lack of eye contact
- Physical inactivity
Examples of Someone Exhibiting Negative Symptoms of Schizophrenia
Negative symptoms can be hard to recognize as symptoms of schizophrenia. Here are some examples of how a person with negative symptoms might behave:
- Spending the day sitting or lying around (may have a hard time coming up with something to do and will be pretty unproductive)
- Not sleeping
- Not eating well
- Neglecting personal hygiene
- Lacking meaningful communication
- Little to no eye contact, facial expression, or gestures
- Unable to respond to questions or follow instructions
- Appearing apathetic in a situation where most people would express emotion
- Showing ambivalence when asked to make a decision
- Social withdrawal and self-imposed isolation
Positive vs. Negative Symptoms of Schizophrenia
Simply put, positive symptoms are those that are added and the term “POSITIVE SYMPTOM” is used to indicate noticeable symptoms. Therefore, they differ from those of most people.
Positive symptoms of schizophrenia include:
- Delusions, false beliefs with no basis in fact
- Hallucinations, seeing or hearing things that don’t exist
- Psychosis, a break with reality
- Agitated body movements
- Disorganized and dysfunctional thinking that shows itself in strange speech patterns
- Bizarre ideas and plans
- Inappropriate emotions for the situation
Positive symptoms are more apparent, so they’re likely to prompt diagnosis and treatment. On the other end of the spectrum, negative symptoms mean something is missing. That makes them easier to overlook as being linked to schizophrenia.
How Doctors Treat Negative Symptoms
Schizophrenia means you’ll always need mental healthcare. Treatment is typically managed by a mental health professional such as a psychiatrist or psychiatric nurse practitioner.
Positive symptoms are treated with antipsychotic drugs. These medications can effectively address positive symptoms. But, unfortunately, most have little effect on negative ones.
Negative symptoms can have a profound effect on the quality of life. They can also affect your ability to live independently. They may have a more significant impact than positive symptoms in this respect. Unfortunately, they’re also more challenging to treat.
Secondary negative symptoms may be easier to treat than primary ones.
Medications
Sometimes, secondary negative symptoms are a side effect of certain medications. In that case, a doctor can change the dosage or prescribe an alternative drug. You’ll be monitored to make certain positive symptoms aren’t getting worse. It may take a few adjustments before you see improvement.
Secondary negative symptoms caused by depression can sometimes be treated with antidepressants. Some people have more success with this treatment than others. More studies are needed to learn which medications can target primary negative symptoms.
Some research[7] suggests that the antipsychotic drugs cariprazine (Vraylar) and amisulpride may help improve primary negative symptoms. Your doctor will consider all your symptoms when choosing medication to manage schizophrenia. Periodic adjustments will likely be needed.
Therapy
Therapy can help you manage the negative symptoms of schizophrenia.
Therapy will probably be in addition to drug treatment for positive symptoms. Your doctor will recommend a particular type of therapy based on your needs. Some of these are:
- Individual therapy
- Group therapy
- Family and marriage therapy
Within these frameworks, your therapist can guide you in:
- Behavioral therapy
- Social skills training
- Vocational support
- Family education
Lifestyle
With any treatment plan, it’s essential to focus on your goals. However, confident lifestyle choices can also help. Avoiding harmful substances is a must. Alcohol, non-prescribed drugs, and nicotine can interfere with treatment. If you have trouble quitting, your doctor can recommend a cessation program. Stress can aggravate symptoms. You can’t eliminate stress, but you can learn to manage it. Try some relaxation and stress management techniques such as:
- Meditation
- Deep breathing
- Yoga
- Tai chi
In general, it pays to take care of your overall health by:
- Maintaining a healthy, balanced diet
- Asking your doctor if you should take any dietary supplements
- Engaging in regular exercise
- Making sure you get adequate sleep
- Talking to your doctor about complementary and alternative treatments
- Adhering to your overall treatment plan
- Reporting new or worsening symptoms
When To See a Doctor
If you have some of the negative symptoms described, it doesn’t necessarily mean that you have schizophrenia. These symptoms could be due to a variety of other causes. The only way to know for sure is to see a doctor as quickly as possible.
Making a diagnosis requires ruling out other causes, such as:
- Medication
- Substance use
- Medical conditions
- Other mental health disorders
This may include:
- A physical examination
- A drug and alcohol screening
- Brain imaging studies, such as CT scan or MRI
- A psychiatric evaluation
Schizophrenia is a severe illness. Negative symptoms can affect every aspect of your life. Without treatment, symptoms will likely worsen and make it difficult to live independently. But there are ways to help manage the condition.
If you’re already being treated for schizophrenia and your symptoms aren’t getting better, talk to your doctor or seek a second opinion.
Negative symptoms can be challenging to spot in a doctor’s visit. That’s why it’s so important to discuss all your symptoms. In addition, it might help to describe a typical day in your life.
Someone with schizophrenia might have a hard time with their working memory. For example, they may not be able to keep track of different kinds of facts at the same time, like a phone number plus instructions.
Along with having trouble paying attention, it can be hard for them to organize their thoughts and make decisions.
Takeaway
Negative symptoms of schizophrenia involve the absence of something familiar to most people. This can include a lack of communication, social interaction, and motivation.
Though less evident than positive symptoms like hallucination and delusions, negative symptoms can be just as hard to cope with.
Treating negative symptoms is a challenge. But with a combination of drug therapy and psychotherapy, schizophrenia can be managed. It’s essential to keep your doctor updated as symptoms change.
We Level Up FL Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. In addition, we work as an integrated team providing information about negative symptoms of schizophrenia and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our specialists know what you are going through and answer any of your questions.
Your call is private and confidential, and there is never any obligation.
Sources
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10.2147/NDT.S201726
[2] Mayo Clinic Staff. (2020). Schizophrenia.
mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443
[3] Mitra S, et al. (2016). Negative symptoms in schizophrenia. DOI:
10.4103/ipj.ipj_30_15
[4] The negative symptoms of schizophrenia. (2006).
health.harvard.edu/mental-health/the-negative-symptoms-of-schizophrenia
[5] Sarkar S, et al. (2015). Conceptualization and treatment of negative symptoms in schizophrenia. DOI:
10.5498/wjp.v5.i4.352
[6] Schizophrenia. (2016).
nimh.nih.gov/health/topics/schizophrenia/index.shtml
[7] DOI – https://doi.org/10.2147/NDT.S201726
[8] Finder – http://finder.psychiatry.org/?
[9] NAMI – https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition
[10] NAMI – https://www.nami.org/Local-NAMI/Programs?classkey=a1x36000003TN9LAAW
[11] SAMHSA – https://www.samhsa.gov/find-help/national-helpline