Negative and Positve Symptons of Mental Illness by Guest Writer, John Hoezel

What are Positive and Negative Symptoms of mental illness? Positive symptoms are behaviors and beliefs that the person with mental illness has that should not be there. Negative symptoms are capabilities and skills that the person with mental illness should have, but they are missing or considered deficits.

For example, Positive symptoms of schizophrenia can include: feelings of being controlled by outside forces, hearing, seeing, smelling or feeling things which are not there, (hallucinations) and unusual beliefs, (delusions).
Negative symptoms of schizophrenia can include: Loss of normal behaviors such as tiredness, loss of concentration and lack of energy and motivation; inability to hold a job, and reduced expression and emotions.
More Positive symptoms can include: Disorganized thinking, apparent in patients' speech patterns as schizophrenia progresses. Affected people lose their train of thought during conversations, make loose associations of topics (tangentially jumping from one topic to another apparently at random, or on the barest of associations), and give answers to unrelated questions. Disorganized behavior may range from simple problems sustaining goal-directed self-care behaviors such as personal hygiene to unpredictable and bizarre socially inappropriate outbursts. For example, people may not dress according to the weather.

Examples of Negative symptoms are detailed below. "Affect" refers to emotional expression. Affective flattening, distinguished by a restricted range of expressed emotions, is a fairly common negative symptom among some schizophrenia patients. Patients with affective flattening show relatively immobile and unresponsive facial expressions, often accompanied by poor eye contact and little body language or movement. "Avolition" describes a loss of motivation; the will or desire to participate in activities or to do things. Some patients with schizophrenia show avolition in that they will sit still for long periods of time, seemingly indifferent to their surroundings, and without displaying any interest in work or social activities. In extreme cases, this behavior becomes catatonia.

Disorganized symptoms include thought disorder, confusion, disorientation, and memory problems. Fortunately "New Generation Medicines" (NGM-future topic) can help greatly with positive, negative, and disorganized symptoms. Many times NGMs take away all the positive symptoms. If not they are typically markedly diminished. Geodon and Clozapine are two medicines that we have seen take away delusions and hallucinations, and also restore negative symptom deficits to the extent that productive work was restored. And we were pleasantly surprised at our son's new found awareness. For example he often said, "How could I have done that?" as he looked back on past behavior and thinking. Treatment today offers much hope, even in the face of both Positive and Negative symptoms.