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Positive Symptoms of Schizophrenia: Hallucinations & Delusions

Schizophrenia is a devastating mental illness that affects approximately 1% of the adult population in the United States. There are many symptoms of the illness, but a split dichotomy of what are called “positive” symptoms and “negative” symptoms. Positive symptoms are like adding something to the person’s experience such as hallucinations, delusions, paranoia, etc.

In contrast, negative symptoms are like taking something away from the person such as blunting emotion, social withdrawal, or inability to experience pleasure (anhedonia). This particular article will break down the major positive symptoms associated with schizophrenia.

Positive Symptoms of Schizophrenia

The PANSS or Positive and Negative Syndrome Scale is used to diagnose the severity of symptoms among individuals with schizophrenia. Below are some of the positive symptoms that individuals are evaluated upon with this scale as well as a few others.  Most of the positive symptoms can cause people with this illness to act oddly.  However, it is the negative symptoms of schizophrenia that take the greatest toll on the person’s ability to function in society.

  • Agitation: A person with schizophrenia will likely experience psychomotor agitation. This can result in them engaging in hyperactive behavior. They may fidget, rock back and forth, sway side to side, and have a difficult time staying still. This is the exact opposite of a catatonic state which is a negative symptom. In fact, on the PANSS, one of the positive symptoms that is looked at is that for “hyperactivity.” Think of agitation as repetitive body movements.
  • Conceptual disorganization: This involved disorganized, unusual, or dysfunctional ways of thinking. This is usually classified as a “thought disorder” – it doesn’t allow the person with schizophrenia to logically connect or organize thoughts in their head. This can result in them speaking in a way that is very difficult to understand or “jumbled.” The person may also experience what is called “thought blocking” which involves stopping speech in the middle of a thought because it is “blocked.” If you ask the person why they stopped talking, they may tell you that they thought was taken out of their head. The individual may also make up words with no meaning called “neologisms.”
  • Delusions: A delusion is a false belief that has no roots in logic or reality. A person with schizophrenia may experience many delusions along with other positive symptoms. Delusions differ for everyone. One person with schizophrenia may believe that his parents are really an alien species plotting to take over the world. Another individual with this illness may believe that the government is using mind control to read their thoughts. Others may think that TV and radio stations are using special symbols to warn just them of imminent danger. Beliefs that individuals are trying to poison, harm, harass, or spy on them are subcategorized as “delusions of persecution.”
  • Grandiosity: Delusions of grandeur or grandiose delusions (GD) is a subtype of delusional way of thinking that occurs in schizophrenia in which a person thinks he or she is famous, wealthy, powerful, or omnipotent. They may hold the false belief that they are actually Jesus Christ or another powerful religious figure. Most delusions are related to supernatural, religion, or science-fiction themes. It should also be noted that about 10% of the general population experiences grandiose thoughts, but they do not meet criteria for delusions of grandeur.
  • Hallucinations: A person with schizophrenia will commonly experience hallucinations. Hallucinations are things that a person hears, sees, smells, or feels that have no basis in reality. In other words, they are unique sensory experiences that the individual with schizophrenia thinks are real, but they are caused by chemical reactions in the brain. It is most common for someone with schizophrenia to report hearing voices in their head (auditory hallucinations). In some cases, people see things (visual hallucinations) and even smell things (olfactory hallucinations) that no one else can. Others may report getting touched by invisible fingers when no one is around (tactile hallucinations). Hearing voices is the most common type of hallucination that is experienced.
  • Hostility: This involves the person with schizophrenia acting out with irritability, aggressiveness, and engaging in arguments. They may act very unfriendly to other people and in some cases, may lash out with violence. Although most people with this illness are not inherently violent, there are still about 20% that will lash out violently towards other individuals – especially if they are prone to experiencing hostility.
  • Paranoia: This is influenced by high amounts of fear and anxiety. The person may develop persecutory beliefs, conspiracy theories, etc. For example, the person may become paranoid and think that the government is listening in on their phone conversations. This is different from basic anxiety and phobias because it involves placing blame on an external figure. In other words, the individual experiencing paranoia thinks that someone else is out to get them with no logical evidence to back up the thought.
  • Suspicion: The person with schizophrenia may become increasingly suspicious of other people – including family and friends. They may believe that everyone is plotting against them or trying to do them harm. This may result in the schizophrenic to believe that people are talking behind their back, trying to harm them, trying to poison them, etc. All of these beliefs are falsely based, but to the person with schizophrenia, they believe with full conviction that they shouldn’t trust other people.

Causes of Positive Symptoms in Schizophrenia: Too Much Dopamine

There is no telling what causes schizophrenia in the first place, let alone the positive symptoms. Most researchers hypothesize that the positive symptoms are closely linked to increases in dopamine activity. In other words, the brain gets flooded with abnormally high amounts of dopamine and it causes the person to experience hallucinations, paranoia, and delusions.

Some researchers believe that dopamine systems in the mesolimbic pathway are what leads to “positive symptoms.”  The main support for the theory that too much dopamine causes positive symptoms is antipsychotic medications. These medications used to treat positive symptoms work by blocking dopamine receptors – and people experience a reduction in hallucinations, delusions, and other positive symptoms.

Additionally, the antipsychotic medications do not really help with “negative symptoms” of the illness, which establishes a link between dopamine and the positive symptoms.  Other evidence supporting the dopamine hypothesis is in regards to the fact that amphetamines and drugs that increase dopamine production yield schizophrenia-like symptoms and can lead to temporary psychosis.

Treatment for Positive Symptoms in Schizophrenia

Atypical antipsychotics typically do a good job at reducing the rate at which an individual experiences positive symptoms of schizophrenia. This is because they block dopamine receptors from being flooded with dopamine in the brain. There really aren’t any other current ways to treat these positive symptoms in schizophrenia other than utilize the pharmaceutical technology that is available.

As science advances and we get a better understanding of the specifics of schizophrenia, we should be able to develop better treatment options. Until then, you may want to check out some natural remedies for schizophrenia that may be used as an effective augmentation strategy to reduce symptoms.

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{ 2 comments… add one }
  • Kyle May 23, 2015, 4:09 pm

    I have been dealing with some of the symptoms of this for a long time & when I am making art it often channels my thoughts and emotions in a positive light. I never understood that I was falling into positive symptoms of one of the five with Neologisms. Now I’m looking to find a natural remedy to block out the over active Dopamine in my system. I’m just glad I have stayed away from heavy Drugs my whole life. Thank you very much.

    • Hunter February 24, 2016, 9:04 am

      Wow I never even would have thought to look for answers here myself either. I just Googled what can be a cause of irritability and thought hallucinations. I’m a writer myself so it’s a bit odd. Email me if you find any help.

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