Understanding Thought Disorders
The interplay between genetics (e.g. family history of mental illness) and environment (e.g. infections or drug use) leads some people to develop impaired brain function during late adolescence and adulthood. This can affect the brain circuits responsible for perception, emotional regulation, motivation, memory, attention, language, executive function (problem solving & planning), and social cognition.
For simplicity, these deficits are often broken down into two categories: negative and positive symptoms.
Positive symptoms are the abnormal thoughts, perceptions or behaviors, such as hallucinations or delusions (i.e. things that are there, but shouldn’t be.). Negative symptoms are things that should be but are absent, like motivation, hygiene, or looking forward to activities.
Positive symptoms are what draws the most attention from society and are the most amenable to treatment with medications. Contrary to popular belief, merely improving or eliminating these positive symptoms alone only provides a modest benefit when it come to overall functioning and perceived quality of life. In contrast, improvement in negative symptoms is the best predictor of real recovery and satisfaction in life.
Are there any early warning signs before a thought disorder emerges?
Early signs and symptoms are often subtle and every person’s experience will differ, though some people may notice gradual changes in their thoughts, behaviors, and feelings.
- A drop in grades, job performance, or other activities
- Trouble thinking clearly, feeling distracted, or difficulty concentrating
- Suspiciousness or uneasiness with others
- A decline in self-care or personal hygiene
- Withdrawing from family and friends and spending a lot more time alone than usual
- Stronger emotions (anxiety, sadness) than usual or having no feelings at all
The early signs of a thought disorder seem like they could apply to almost any young person at some point, but the specific changes fall into three categories:
Social & Cognitive Performance
- Trouble reading or understanding complex sentences
- Trouble speaking or understanding others
- Becoming easily confused or lost
- Trouble in sports or other activities that used to be easy
- Attendance problems related to sleep or fearfulness
Emotion & Behavior
- Extreme fear for no apparent reason
- Uncharacteristic and bizarre actions or statements
- Impulsive and reckless behavior
- Extreme social withdrawal
- Decline in appearance and hygiene
- Dramatic changes in sleep or eating
Perception & Interpretation
- Fear that others are trying to hurt them
- Heightened sensitivity to sights, sounds, or touch
- Making statements like “my brain is playing tricks on me.”
- Reporting visual changes (i.e. colors are more intense, faces distorted, etc.)
- Feeling like someone else is putting thoughts into their brain or others are reading their thoughts
- Hearing voices or other sounds that others don’t hear
While many of these symptoms may not represent early psychosis, it is important to reach out if you start to notice any of these changes in. a loved one. Responding to these symptoms early can make a BIG difference on future outcomes.
Does hearing voices mean you have schizophrenia?
The short answer is no. Hearing the voices of people not around you is far more common than you think. Voice hearing is frequent among writers, those with sleep disturbances, following the death of a loved one or after a traumatic experience, but it can also occur in the context of a thought disorder.
What isn’t psychosis?
Psychosis is not being “crazy” or “psycho” or violent. Research has shown that people with psychosis are more likely to be the victims of violence than the perpetrators of violence. It also does not mean that you have multiple personalities. This myth comes from a misunderstanding of the word ‘schizophrenia’ which literally means ‘split mind’. Most importantly, it is not the result of any personal failure. Psychosis is not your fault or the fault of anyone else.
Is recovery possible?
Yes. Psychosis often comes in episodes of heightened symptoms that can last a few days to months. In between these episodes, symptoms can be very manageable. Those who begin treatment soon after the onset of symptoms are the most likely to achieve full recovery. Through a combination of effective treatment and illness self-management techniques, many go on to live the life they want.