Schizophrenia and related illnesses can be broken into different categories of symptoms, one or more of which might be absent or weak.

Classically, practitioners break the illness into two groups of symptoms

  • Positive
  • Negative

Image result for positive negative symptoms of schizophrenia

Others still divide symptoms into three categories

  • Positive
  • Negative
  • Cognitive

Image result for positive negative and cognitive symptoms of schizophrenia

Finally, more recently, the illness has been divided into five kinds of symptoms by accredited professionals

  • Positive
  • Negative
  • Cognitive
  • Affective
  • Aggressive

Image result for positive negative and cognitive symptoms of schizophrenia

A reason for the two categories of symptoms (as opposed to five) is that the other three proposed types could be traits of the most established two

We will go ahead and curse over these symptoms in words.

Before we proceed, know this: just because someone deals with a mental illness with psychotic components, that does not mean that they pose a threat to others. Psychosis does not denote “violent maniac”.

The positive symptoms, what most ignorant people seem to worry about, are discussed first. They can broadly be thought of as an extreme sensitivity to the world, which leans people to retreating into themselves, into their rooms.

Positive symptoms are perceptions that healthy people don’t have, things that ought not to be sensed, which are. They are well-linked to an unhealthy mesolimbic system.

  • Hallucinations: sensing things that other people don’t sense
    • Such as hearing voices
  • Delusions: false beliefs
    • Example: being telepathic
  • Irrational paranoia
    • Perhaps the belief of being persecuted (trying to be captured by) the CIA
  • Grandiosity: the belief that one is very important, somehow
    • Maybe that one is a billionaire
  • A lot of hostility and irritability
  • Disordered thoughts
    • Talking in a way that other people can’t understand

Negative symptoms, overlapping with affective and cognitive symptoms, are a lack of something healthy that most people have. These symptoms are largely the result of inadequate functioning in the prefrontal cortex and mesocortical pathways.

  • Depression
  • The inability to speak abstractly
  • Having a hard time relaxing into conversation
  • Being very passive
  • Apathy and blunted affect
    •  Apathy
      • Not caring
    • Blunted affect
      • Not being animated
    • Having few types of emotions
    • Feeling empty or numb
    • Difficulty recalling emotional experiences
  • Emotional withdrawal
    • Lack of interest in sexual behavior
    • Not wanting to spend much time with friends
    • Few friends
  •  Alogia
    • Difficult thinking and speaking well
    • Using few words
  • Anhedonia
    • Lack of pleasure
    • Difficulty finding pleasure in past hobbies
  • Avolition
    • Difficulty starting tasks
    • Lack of drive to complete tasks
    • Sometimes, poor hygiene (cleanliness)

Cognitive symptoms may be difficult to recognize. They mimic symptoms of many other illnesses. The function of the dorsolateral prefrontal cortex seems to largely cause them.

  • Little ability to understand things
  • Having a hard time solving problems
  • Difficulty prioritizing (working through the most important tasks first)
  • Impaired attention
    • Focusing attention
    • Sustaining attention
  • Anosagnosia
    • Not being aware that one has an illness
  • Impaired ability to speak fluidly
  • Problems with serial learning
    • Such as learning and remembering a grocery store list
  • Difficulty in short-term memory
  • Having a hard to picking up on social cues to moderate behavior

Affective symptoms include a range of stressful emotions, which appear to be caused by problems in the ventromedial prefrontal cortex. Affective symptoms can be pretty severe. Again, these appear in several other mental diseases.

  • Anxiety
  • Irritability
  • Guilt
  • Depression
  • Tension

Aggressive symptoms, a product of being unable to control impulses, are well-linked to both problems processing information in the orbitofrontal cortex, and in the amygdala, a lack of being able to step back and think in a realistic, objective manner. Such effects are also found in bipolar disorder.

  • Verbal abuse
  • Physical violence

And yet…

How true it is, that each person is their own main enemy…

In schizophrenia, suicide is the major cause of death. Such thoughts need to be directly addressed. Counter-intuitively, a systematic review determined that level of insight into one’s illness, does not lead to significantly less suicidality.

One experiment determined, and ranked, the various risk factors that lead to suicide in this population:

  1. Hopelessness
  2. Self-devaluation
  3. Past suicide attempt
  4. Insomnia
  5. Decreased thinking capacities
  6. Agitation/restlessness

A 15-year study involving over 10,000 hospital admissions for symptoms found significant associations between several variables and suicide attempts

  1. Being of a younger age
  2. Being female
  3. Having a physical illness, too (mostly of the heart, or, diabetes)
  4. Greater drug and alcohol use

What can we conclude from this information? That much more often, those whom carry the burden of this hardship category, are a danger to themselves much more to others.

Here’s an attractive depiction, relating some statistics.

The population of the United States is over 325,000,000. If the above depiction is valid, that means well over 3,000 people in the United States live with schizophrenia.

Here are cogent explanations of schizophrenia and similar illnesses, many of which are classed as types of schizophrenia.

Schizophrenia is a mental illness that interferes with realistic thinking, feeling, behaving, and ways of connecting to others socially. Roughly one in one hundred people have the disease, over 3,000,000 people in the United States. To be diagnosed with schizophrenia, one must have been in a psychotic mind-state for over six months prior to treatment.

For schizophreniform disorder, psychosis must have persisted for one to six months, and without disorder in mood. A minimum of two symptoms that also occur in schizophrenics, must be present in a one-month period.

Schizotypal personality disorder involves strange behavior, appearance, and thought processes that significantly compromise social relationships. Unlike people with schizophrenia, those with schizotypal personality disorder are not disconnected from reality. They don’t have delusions.

Delusional disorder is simply the presence of a delusion, usually strongly-held.

Drug-induced psychotic disorder must include the presence of hallucinations, delusions, or both. Of course, these symptoms must have started while, or shortly after, using a drug.

A brief psychotic disorder lasts for at least a day, and resolves in less than a month. There is no abnormal mood aspect, nor any of the negative symptoms listed below.

Schizoaffective Disorder is a disease that has aspects of schizophrenia, but also symptoms of a disorder in mood. These mood symptoms include depression (being too sad) and mania (being too happy). About .3% of the population is afflicted with schizoaffective disorder, more than 950,000 Americans. Essentially, this disorder consists of bipolar disorder and schizophrenia in one. Though the brains of those with bipolar disorder, and the brains of schizophrenics, ares structurally similar in fMRI studies, a reasonable hypothesis might be that greater physical similarity exists between bipolar and schizoaffective brains.

Psychosis can also occur as a secondary effect, as a result of another medical illness, or lack of a bodily necessity, such as sleep or food.

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Psychotic disorders usually develop earlier in males than in females.

As is it, the prognosis (future outcome) of schizophrenia follows one of three paths. A third of the afflicted will live very normal lives in the future, gaining great control over their symptoms. Another third will have decent lives, but will still be battling symptoms to a significant extent. The last third will be very symptomatic, and live have difficult lives.

Things may feel very similar to what’s depicted below

As stated at the top, psychotic disorders such as schizophrenia and schizoaffective disorder are officially broken up into positive and negative symptoms, but some professionals further recognize, cognitive, affective, and aggressive symptoms. Here we have a general timeline of when the various categories of symptoms tend to appear.

It’s important to recognize that a lot of symptoms of schizophrenia overlap with symptoms of many other mental health disorders.

As with any other mental illness, people with schizophrenia oftentimes self-medicate with drugs if they’re not supported with the resources they need to actually improve their quality of life, and recover.

Depression and mania, of which one or both characterize a significant part of schizoaffective disorder, are briefly discussed on this page. For a more comprehensive explanation, please visit the links below.

What is Bipolar Disorder?

What is Clinical Depression?

Depression can take the form of chronic (regular) sadness, feelings of worthlessness, not finding joy in life, eating and/or sleeping too much or too little, and having thoughts of suicide.

Mania may appear as pressured speech (talking for a long time very fast), agitation (sensitivity and excitement), grandiosity (feeling extremely important for no reason), buying a lot of unneeded things, switching moods fast, acting too sexually, and paranoia (unfounded fear).

sources: the National Alliance on Mental Illness (NAMI), the National Insitute of Mental Ehatlh (NIMH), Mental Health America (MHA), Condensed Psychopharmacology 2013: A Pocket Reference for Psychiatry and Psychotropic Medications, Abnormal Psychology: An Integrative Approach, Stahl’s Essential Psychopharmacology, Schizophrenia.com, https://stahlonline.cambridge.org/essential_4th_chapter.jsfpage=chapter4_summary.htm&name=Chapter%204&title=Summary, https://www.canadianpharmacyking.com/KingsBlog/index.php/2015/07/What-Are-Negative-and-Positive-Symptoms-in-Schizophrenia/, https://www.bmj.com/content/357/bmj.j4578