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https://psychcentral.com/schizophrenia/negative-symptoms-schizophrenia#next-steps

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Gregory Carr

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Aug 3, 2021, 5:28:43 PM8/3/21
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What Are the ‘Negative’ Symptoms of Schizophrenia?
Types
Avolition
Anhedonia
Asociality
Blunted affect
Alogia
Treatment
Next steps
Schizophrenia has three types of symptoms: negative, positive, and cognitive. Negative symptoms indicate an “absence.”

A. Martin UW Photography/Getty Images
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. (Greg: I frequently have this. While at a park out east I was gazing at the really neat waterfalls and the voices in my head kept going boring, boring.)

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. (Greg: I have short and long term memory problems, concentration is difficult. Yesterday I finished shaving then had a shower but had left the tap on. That has never happened before. )

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.

Negative symptoms
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. (Greg : As long as I have a private shower hygiene is not a problem. I frequently hand wash because of the Wuhan pandemic. I have trouble eating because of the voices screaming away even though the food is good and my stomach is rumbling also it is hard to concentrate on eating. Getting out of bed isn't a problem insomnia is.).

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 (Greg: Long before the onset of schizophrenia procrastination sometimes happened although at other times I made sure to get things done in advance.)
Anhedonia: inability to feel pleasure
Asociality: lack of interest in social interactions (Greg: No. However just because someone wants to have a social interaction with me doesn't mean I will accept.)
Blunted affect: diminished expression of emotion
Alogia: reduction in speech (Greg: Speaking can be a problem but I have been told I am articulate I have been told I talk too much and talk too little.)
Avolition
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. (Greg: Bills are paid as a matter of routine with a few clicks on my computer. I am now retired and my last employer told me recently I am welcome to come back as did another old employer. Sometimes when I try to be productive at home the tourette's starts up which ruins my motivation then stops the second I stop doing whatever. Buying groceries is easy.)

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
Anhedonia involves a lack of pleasure or ability to feel good.

Research in 2018Trusted Source compiled from clinical interviews suggests the majority of people with schizophrenia experience anhedonia.

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. (Greg: Still like my old hobbies.) You might also notice a complete lack of sexual desire. (Greg: Lots of medication make ppl impotent.)

Asociality
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.

Blunted affect
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
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. (Greg: Word salad also sucks.)

Treatment
Research suggests that about 60%Trusted Source of individuals with schizophrenia have negative symptoms that require treatment.

There are several treatment options for individuals who experience negative symptoms:

Medication
According to 2016 researchTrusted Source, antidepressants are effective for treating negative symptoms in some people when used with antipsychotic medications.

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.

Therapy
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. (Greg: Had that a few years before I became schizophrenic still have the booklet.)

CBT focuses on examining difficult thoughts, feelings, and behaviors, and learning new methods of coping and improving overall quality of life.

Cognitive remediation
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. (Greg: Who pays for all that?)

Coordinated speciality care
Coordinated speciality care (CSC) is for people in the early stages of schizophrenia or those who’ve just had their first episode of psychosis.

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
Next steps
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.
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