Schizophrenia has three types of symptoms: negative, positive, and cognitive. Negative symptoms indicate an “absence.”
Negative symptoms in schizophrenia aren’t negative as in bad. These are symptoms that indicate the absence of something, like pleasure, motivation, or speech.
For example, an absence of pleasure — known as anhedonia — is a common negative symptom associated with schizophrenia.
Negative symptoms often take away from daily functioning. On the other hand, positive symptoms add to daily thoughts, feelings, and behaviors. Cognitive symptoms affect a person’s mental functioning, like attention, concentration, and memory.
Positive and negative symptoms of schizophrenia require different types of treatment.
There are plenty of resources, tools, and treatments available — but what works for one person may not be the best option for another, so you might need to try a few approaches to see what works for you.
When you experience negative symptoms, you may have difficulty with emotions, motivation, and socializing. Negative symptoms typically reduce expression and are characterized by a lack of interest, motivation, or both.
These symptoms can cause significant challenges in your daily life and functioning.
Trouble making decisions is common in people who have negative symptoms. For example, people with schizophrenia may have trouble showering, eating, or getting out of bed.
Negative symptoms have primary and secondary characteristics. Primary symptoms are related to the disorder of schizophrenia itself. Secondary symptoms are related to other factors, including side effects from medications, environmental stressors, and other co-occurring mental health conditions or substance use disorders.
The negative symptoms of schizophrenia can include:
- Avolition: lack of motivation
- Anhedonia: inability to feel pleasure
- Asociality: lack of interest in social interactions
- Blunted affect: diminished expression of emotion
- Alogia: reduction in speech
Avolition is another term for a severe lack of motivation. With this symptom, everyday tasks may feel debilitating.
With avolition, you might have trouble eating, showering, paying bills, buying groceries, or socializing with others. It might also be difficult to hold down a job due to the effort required to complete job-related tasks.
When someone is experiencing avolition, they lack goal-directed behavior.
If you experience avolition as part of a mental health condition, it usually doesn’t cause distress because you don’t see the point in completing tasks — or you lack the emotional ability to do so.
Anhedonia involves a lack of pleasure or ability to feel good.
With anhedonia, you may have little interest in leisure activities. Hobbies and enjoyable activities that others might do to take care of themselves are nonexistent. You might also notice a complete lack of sexual desire.
Asociality is a lack of motivation to form social connections. When you’re experiencing asociality, you have a decreased interest in socializing.
This can also result from other symptoms of schizophrenia, such as hallucinations and delusions (positive symptoms). You may become suspicious of other people’s intent, or you may believe that others are out to get you or harm you in some way, impacting your desire to socialize.
If you have a blunted or flat affect, you may appear to have no emotions or diminished emotions. Your tone may appear flat and emotionless. Vocal and facial expressions decrease, along with expressive gestures.
Many people with blunted affect have decreased use of body language, such as facial expressions, nodding, and shrugging shoulders.
Alogia occurs when there’s a reduction in the quantity of speech. This symptom also presents itself as a decreased amount of spontaneous speech.
Alogia refers to trouble speaking due to disorganized thought processes. If you have alogia, you’re unable to form coherent thoughts. Therefore, people with alogia may exhibit illogical speech.
Research suggests that about
There are several treatment options for individuals who experience negative symptoms:
However, in this growing area of research, the effectiveness of antidepressants has been mixed. Antidepressants don’t work for everyone.
Talking with your treatment team about symptoms and potential side effects is essential. Your doctor can help you decide what medications and other treatments are right for you.
Several therapies can help reduce symptoms and improve your daily life.
Cognitive behavioral therapy
Research in 2020 suggests that cognitive behavioral therapy (CBT) can help improve negative symptoms of schizophrenia.
CBT focuses on examining difficult thoughts, feelings, and behaviors, and learning new methods of coping and improving overall quality of life.
Cognitive remediation — aka cognitive rehabilitation intervention — is a type of therapy that uses individual or group sessions to improve cognitive function in individuals with schizophrenia.
This is done through practicing cognitive tasks, sometimes using computers and sometimes using pencil and paper.
Assertive community treatment
Assertive community treatment is an option for people with schizophrenia, especially those with a higher chance of hospitalization or becoming homeless.
It’s also designed to help individuals complete daily tasks and help them with necessities.
This team consists of different support professionals such as case managers, doctors, psychiatrists, and therapists who all work together to assist you with treatment.
Coordinated speciality care
CSC involves a team of care members to:
- provide talk therapy (psychotherapy)
- assist with medication management
- support activities of daily living
- support employment
- provide resources to family members
If you need help coping with negative symptoms of schizophrenia, support is available.
- NAMI Helpline is available Monday through Friday from 10 a.m. to 8 p.m. ET at 800-950-6264. They provide treatment and resources for people with mental health conditions, along with support for families and caregivers.
- National Suicide Prevention Lifeline is available 24/7 to anyone in crisis or having suicidal thoughts. You can call 800-273-8255 for English or 888-628-9454 for Spanish. You can also text the Crisis Text Line at 741741.
- Schizophrenia and Psychosis Action Alliance offers peer support services through a team of individuals who have been diagnosed with schizophrenia and understand what you’re going through.
- SAMSHA has a national helpline to provide treatment referral information that can be reached 24/7 at 800-662-4357. You can also use their treatment locator to find treatments near you.
Remember: There’s not a one-size-fits-all treatment plan for everyone with schizophrenia. But talking with a trusted treatment team of medical and mental health professionals can help you find the right treatments — which makes a world of difference.