Positive Symptoms in Schizophrenia

Voices, Delusions, and Disorganized Thinking

scared woman with mental illness
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The typical positive symptoms of schizophrenia, such as hallucinatory experiences or fixed delusional beliefs, tend to be very upsetting and disruptive--not positive experiences at all for the people who undergo them. 

These types of symptoms are referred to as "positive" because, compared to a normal mental state, certain individuals have more mental experiences (thoughts, feelings, behaviors) than others.

For example, hallucinations are not part of the normal, day-to-day experience for most people. Therefore, they are classified as a surplus, or positive symptom.

The phrase "positive symptoms" refers to symptoms that are in ​excess or added to normal mental functioning.

Positive Symptoms in People With Schizophrenia

Hallucinations

In short, to hallucinate means to perceive things that others don’t.

People with schizophrenia can experience a variety of hallucinations, but, by far, they most commonly experience hearing noises and voices (auditory hallucinations). The voices can be good, but they are often bad, dismissive, and mean. From the outside, a patient who hears voices appears distracted, as if they are listening to something (psychiatrists call this “responding to internal stimuli”). From the inside, they might hear clicks and knocks or even full conversations between multiple people or voices that talk to them directly.

At times, the voices might tell them to do things.

One of the common reasons for patients with schizophrenia to come to the hospital is that the voices are telling them to harm or even kill themselves or others. Please ask for help and talk to a doctor as soon as possible if you feel that you are losing control and might act on the voice's orders.

Delusions

Delusions are ideas that are not true. People with schizophrenia might feel that the secret service is out to get them when there is no evidence for that, that TV anchors transmit them coded messages by the way they move, talk or dress, or that their food is poisoned.

A fairly common type of delusion in schizophrenia is paranoia. A patient with paranoia feels threatened by others. From the outside, a patient with paranoia will be guarded, suspicious of anyone’s intention and closed up, not happy to answer questions or even associate with other people. From the inside, the individual might see evidence for plots and threats all around, or they might feel followed or under close monitoring and surveillance everywhere they go.

Disorganized Thinking

From the outside, disorganized thinking looks like a series of disjointed thoughts. It is hard to follow and make sense of what a patient with disorganized thinking is trying to say. At times the language structure is completely lost; the words are no longer connected in sentences or the patient uses words that do not exist and have no clear meaning (neologisms). It may seem like the process of thinking collapses or comes to a complete, sudden stop (thought blocking).

From the inside, an individual might feel that is hard to keep their thoughts straight or express what they have in mind.

Movement Disorders

Patients with schizophrenia at times present with excessive and agitated body movements. It is hard to say how this feels as most times patients are either unaware of the movements or have a difficult time explaining what is wrong.

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