Having a thought disorder means you have difficulty processing and expressing thoughts. It’s common in people with schizophrenia.

It’s common to occasionally have difficulty expressing what you’re thinking or feeling. But regularly having trouble articulating thoughts or emotions may be a sign of a thought disorder.

For example, being sleep-deprived can make it tough to think clearly and coherently express your thoughts.

But, frequently having difficulty with verbal or written expression could be a symptom of a thought disorder. Thought disorders can make it more difficult for people to follow what you’re saying. Your speech may also be confusing to people other than you.

Thought disorder, also known as formal thought disorder, causes eccentricities in thinking, language, and communication.

Someone with a thought disorder may have trouble organizing, processing, or expressing their thoughts. They may also have trouble expressing themselves verbally and in writing.

Thought disorder is common in schizophrenia, psychosis, and mania. Someone with a thought disorder may be difficult to understand.

What is the most common thought disorder?

Although schizophrenia isn’t the only form of thought disorder, it’s one with a large body of research behind it.

Thought disorder subtypes

There are two subtypes of general thought disorder or formal thought disorder:

  • positive thought disorder
  • negative thought disorder

Positive and negative don’t refer to good or bad. Positive symptoms are signs of added behaviors, like hallucinations or disorganized behavior. On the other hand, negative symptoms refer to the absence of something. Examples of negative symptoms include limited emotional response or lack of speech.

Various signs could indicate you have a thought disorder. Some are outwardly visible, while others may only be obvious to you.

Outward signs

Many of the outward signs associated with thought disorder are related to disruptions in speech.

Here are some examples:

  • Loose associations or lack of connection between ideas. You have incoherent thoughts or thoughts that are unrelated to one another.
  • Tangentiality or excessive and irrelevant information that doesn’t answer the original question. You may regularly go off on tangents and never answer what was initially asked.
  • Incoherence or speech that doesn’t quite make sense. You may produce “word salad” or a jumble of speech that isn’t coherent.
  • Illogicality or coming to conclusions that don’t follow basic logic. You may think that there are illogical reasons for situations or events.
  • Circumstantiality or long-winded explanations. You may take a long time to get to the point.
  • Pressure of speech or talking very rapidly. You may feel like you can’t stop talking or need to get everything out.
  • Distractability. You become easily distracted, especially if something else catches your attention.
  • Clanging. With clanging, the sound of words dictates word choice. For instance, you may answer a question only with words that rhyme.

Inward signs of thought disorder only you might notice

Inward signs of thought disorder may include:

These symptoms may not be obvious to folks not experiencing them.

Research indicates that sleep disruptions occur in up to 80% of people who have been diagnosed with schizophrenia. Additionally, one study from 2019 involving people with psychosis suggests a link between psychosis and excessive rumination.

There’s a high degree of variability in how thought disorders present. For example, negative thought disorder is sometimes seen in people with depression but isn’t as common as thought disorder with mania and schizophrenia.

Research from 2017 suggests that thought disorders are more common in people with schizophrenia. Certain thought disorder symptoms were also more likely in people with mania, including:

  • circumstantiality
  • pressured speech
  • clanging

There’s ongoing research into why people develop thought disorders, but there’s currently no consensus on the cause.

Some experts suggest that differences in brain structure and genetics may play a role in thought disorders.

Mental health professionals often use assessments to diagnose thought disorders. A few of these include:

  • scale for assessment of positive symptoms (SAPS)
  • scale for assessment of negative symptoms (SANS)
  • formal thought disorder-self scale (FTD-S)
  • thought and language communication scale (TLC)
  • thought and language index (TLI)
  • Rorschach ink blot test

These help clinicians identify symptoms consistent with thought disorder.

Medications and therapy are both helpful tools for treating thought disorders.

Doctors commonly prescribe antipsychotic medications to help with symptoms. They may also recommend cognitive-behavioral therapy (CBT) to treat thought disorders.

In one 2020 paper, researchers used secondary data from large, single-blind randomized controlled trials and found that CBT effectively reduced the frequency of delusions in people with thought disorders compared to supportive counseling.

Thought disorder, or formal thought disorder (FTD), is a symptom of schizophrenia and other mental health conditions. It can affect both verbal and written language.

If you suspect you have a thought disorder, you may feel scared or confused. If your loved one has a thought disorder, you may feel distant from them or have trouble communicating with them.

Help is within reach, and treatment options are available. Because there are many options, working with a mental health professional may help you find the right treatment combination for you.

Feeling overwhelmed by the possibility that you or a loved one is living with a thought disorder? Help is available, and you’re not alone. Consider checking out RAISE for more information and helpful resources on schizophrenia, the most well-researched thought disorder.