An Overview Of Negative Symptoms Of Schizophrenia

Schizophrenia is a mental illness that can cause hallucinations and delusions. You may already be familiar with these symptoms, which are sometimes known as “positive” symptoms. However, schizophrenia can also cause “negative” symptoms, like a loss of pleasure or motivation. 

Although these symptoms may be less obvious than others, they can still cause challenges in life, work, and relationships. Often, negative symptoms of schizophrenia can be treated with a combination of doctor-prescribed medication and therapy.

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An introduction to schizophrenia

Schizophrenia is a mental illness that’s estimated to affect around 24 million people worldwide. Although we don’t yet know exactly what causes it, it’s likely that both genetics and environmental factors play a role. People with schizophrenia may experience unusual thought patterns, behaviors, and beliefs. They may also go through periods when they lose touch with reality. This is sometimes referred to as having a psychotic episode.

In most cases, schizophrenia starts in early adulthood. Men often start to experience symptoms during their late teens to early twenties. Women tend to start showing signs between their early twenties and early thirties. 

Schizophrenia can make it hard to function in daily life and relationships. It often occurs alongside other mental health challenges, like depression, anxiety, OCD, and substance use disorders.

Understanding the negative symptoms of schizophrenia

Schizophrenia can cause what are known as “positive” and “negative” symptoms. Despite the names, positive and negative symptoms are not considered “good” or “bad.” Instead, they are generally defined as thoughts and behaviors that are either “present” or “absent” in people with schizophrenia. 

Positive symptoms of schizophrenia can refer to behavioral or cognitive symptoms that are present in people with schizophrenia, but not in other people. Some examples include the following

• Delusions: Delusions are typically false or impossible beliefs that you're convinced are real. For example, you might believe that the government is spying on you or that you have superhuman powers. 
• Hallucinations: Hallucinations usually refer to perceptions of things that aren’t really there. For instance, you might hear voices or see things that other people don’t. Although rarer, it can also be possible to taste, smell, or feel things that aren’t there. 
• Disorganized thinking and speech: These generally involve patterns of thinking and speaking that don’t follow logic. For example, a person might go off on tangents, bounce between topics, or make connections that don’t make sense to others. 

Negative symptoms can refer to feelings, thoughts, and behaviors that are present in most people but absent in people with schizophrenia, such as those listed below.

• Lack of motivation: It can be common for people with schizophrenia to lose motivation to do things. For example, they may stop showering, going to work, keeping their living spaces clean, or going to the doctor.  
• Lack of socialization: People with schizophrenia may also lose interest in interactions and relationships. They might spend all day at home, withdraw from social events, or become disconnected from their loved ones. 
• Lack of pleasure: Schizophrenia may also make people struggle to feel pleasure. This may cause them to lose interest in things like hobbies or their favorite foods. 
• Lack of emotional expression: This symptom can also be called “blunted affect,” and it can happen when someone stops showing emotion. For example, they might stop using hand gestures or displaying facial expressions. They might also speak in a flat tone of voice. 

In general, there are two types of negative symptoms: primary and secondary. Primary negative symptoms can be thought of as symptoms directly caused by schizophrenia. 

Meanwhile, secondary negative symptoms can be seen as symptoms caused by other factors. For example, some antipsychotic medications may cause fatigue or low motivation. Even though low motivation can be a symptom of schizophrenia, in this scenario, it would generally be considered a secondary symptom because it was caused by the medication, not the schizophrenia itself. 

How are symptoms of schizophrenia treated?

Treating symptoms of schizophrenia tends to involve a combination of treatments. 

Antipsychotic medications are often used to treat positive symptoms. These may be taken as a pill or an injection. Conventional antipsychotics (sometimes called “first-generation” antipsychotics) are usually older medications that may cause side effects like muscle spasms and restlessness. 

These effects may be less likely with newer medications (sometimes called “second-generation” antipsychotics). However, newer medications may be more likely to cause other concerns, like weight gain. 

It tends to be harder to treat negative symptoms of schizophrenia with medication. However, second-generation antipsychotics may lead to some improvements. For persistent negative symptoms, your doctor may also prescribe supplemental medications, like antidepressants. 

Please note that the information in this article is not a replacement for medical advice. Never start, stop, or change the way you take medication without consulting your doctor or psychiatrist.

Various types of therapy may also be useful for treating negative symptoms:

• Cognitive behavioral therapy (CBT): This is a form of therapy that usually focuses on identifying and changing negative thought patterns. CBT may help people with schizophrenia develop healthy coping strategies and change unhelpful beliefs related to negative symptoms. 
• Social skills training: This form of therapy normally centers on teaching people social skills, like how to maintain eye contact, communicate effectively, and express emotions in a healthy way. This may help people with schizophrenia have better interactions with others.
• Family therapy: Family therapy is a type of group therapy that tends to focus on improving relationships with loved ones. This may be useful for people whose negative symptoms like social withdrawal are affecting their relationships. 
• Occupational therapy: Occupational therapy typically aims to help people develop the skills they need to function in everyday life. For people with negative symptoms, this can be an important step toward living independently, maintaining a job, taking care of daily needs, and connecting with others. 

Get expert help managing negative schizophrenia symptoms

Connect with a licensed therapist online

If you’re living with schizophrenia, negative symptoms like a lack of motivation may make it hard to leave the house for therapy appointments. Online therapy may be a solution. With platforms like BetterHelp, you can work with a therapist from the comfort of your own home. This may make it more accessible than in-person therapy. Please note that those experiencing acute psychosis may require in-person care.

Online therapy has been found to be effective at treating mental health concerns that often occur alongside schizophrenia. In a 2017 study, researchers analyzed data from 373 articles on internet-based CBT. They found that online therapy could be effective at reducing symptoms of depression, anxiety, OCD, and more.