Schizophrenia and thought disorder are different mental health conditions, but they share some overlap.

Formal thought disorders (FTDs) are a form of disordered thinking that can make it challenging to communicate effectively. Doctors diagnose FTD when symptoms cause a significant negative impact on your everyday interactions and the ability to communicate.

While FTDs are a specific diagnosis, you can also have a thought disorder if you live with a different mental health condition like depression or schizophrenia.

FTD and schizophrenia are separate mental health disorders. But, people with schizophrenia can have some form of formal thought disorder (FTD). Both affect the brain and how it processes thoughts and information, affecting how you interact with the world.

Formal thought disorder is the difficulty or inability to express yourself coherently, either verbally or in writing. Thought disorders may affect parts of the brain related to language and speech.

When you have a thought disorder, you can experience:

  • disrupted thoughts
  • vague connections between ideas
  • little to no verbal expression

But a thought disorder involves more than losing your train of thought, forgetting details, or getting distracted while talking.

You may jump between ideas making it hard for people to follow your train of thought. For example, you might start by talking about a shoe, then meatloaf, followed by cars. With a thought disorder, there would be no logical connection between the three thoughts. You might even stop mid-sentence, pause, and continue talking about something completely unrelated.

But, it can be difficult to diagnose a thought disorder. Some people may not always have symptoms. Consistent, severe symptoms and behaviors usually lead to a thought disorder diagnosis.

There are several types of thought disorders, each with a unique combination of thought-disrupting symptoms. Some are more common in people with schizophrenia than others.

Alogia

Alogia is also called poverty of speech. If you have this type of thought disorder, you may give short, brief answers to questions. You might also show little to no interest in communicating with others.

Blocking or thought blocking

If you experience thought blocking, you probably frequently stop talking mid-sentence. You might change topics once you start talking again with no clear connection between sentences.

Someone with thought blocking disorder may have a conversation that goes like this: “I saw a dog on the beach with a . . .You should pick up milk on your way home.”

Circumstantial thinking

If you have this symptom, you may speak or writes with excessive, unnecessary fluff. You often come back to your main point, but your communication contains irrelevant details.

A person with circumstantial thinking may hear the question, “What would you like to eat?”

And answer: “Sometimes people ask me what I want to eat, but I’m not that hungry because I ate eggs for breakfast, and then all I did was watch TV. Whales migrate, but sometimes they die on the way. Whales eat squid, which kind of makes my stomach upset because it looks rubbery. Once I ate calamari and didn’t like it. I think I’ll have soup.”

Derailment

Derailment happens when the association between your thoughts breaks down. Your thinking process flows from one subtopic to another, but each new topic seems unrelated to the last.

Distractible speech

Distractible speech disorder involves jumping between topics. You might be easily distracted by internal thoughts and what’s happening around you.

This type of thought disorder is more common in people with mania and schizophrenia.

Tangentiality

Tangentiality is speaking about one subject after another without a clear conclusion to the main topic.

According to a 2020 analysis of studies, about 50% of people with schizophrenia also have FTD. Alogia and thought blocking are the most common FTDs in people with schizophrenia. Both disorders affect the brain and how it makes connections, feels emotions, and interacts with the world.

But, each disorder affects the brain a bit differently. For example, FTD affects thought processes, like how you organize sentences, make word choices, and make logical arguments.

Schizophrenia tends to affect thought content, which might involve auditory hallucinations and delusions.

The symptoms of thought disorders vary so widely and range from mild to severe that it’s difficult to pinpoint a single underlying cause.

Like other mental health conditions, FTDs are likely the result of a combination of biology, environment, and genetics.

One 2018 study suggests that the chemical eotaxin may be involved in FTD. Additionally, environmental factors like family interaction may play a role in the development of schizophrenia, according to a 2016 study involving 221 people with the mental health condition.

Other mental health conditions, like mania, depression, and anxiety, may also involve thought disorders.

In people with mania, and sometimes depression, thought disorders usually involve a lack of connection between ideas. The systems in which those thoughts exist stay intact.

This is different from schizophrenia, which involves a breakdown in both how you communicate and how you think.

A few common treatments for thought disorder include:

  • Medication. Antipsychotic medications are a common first-line treatment for thought disorders. They also reduce hallucinations and delusions in people with schizophrenia.
  • Cognitive behavioral therapy (CBT). CBT can help you recognize negative thoughts and patterns of behavior. Once you begin to recognize those thoughts and patterns, the therapist can help you learn to change them.
  • Cognitive enhancement therapy. This type of therapy, also called cognitive remediation, helps people with schizophrenia appropriately recognize and act upon social cues and triggers. It uses group sessions and computer-based training to improve thought organization, memory, and attention.

Formal thought disorders are separate disorders but may occur in people with other mental health conditions, like schizophrenia.

There are many thought disorders, and each one manifests differently. If you have schizophrenia and a formal thought disorder, you may interrupt yourself mid-thought, include too many details when communicating, or only offer one or two-word answers to questions.

A combination of medication and psychotherapy can help manage FTD and schizophrenia. It’s a good idea to talk to a doctor about your treatment options to find out which might be best for your unique needs.

Consider the following resources if you’re looking to learn more about your FTD or schizophrenia diagnosis: