Columbia University Medical Center
Ranked #1 in Psychiatry
U.S. News & World Report
Ranked #1 in Research Funding
National Institutes of Health
NewYork-Presbyterian Hospital The University Hospital of Columbia and Cornell

Ask the Experts

Question:

My mother has had schizophrenia for the last 20 years. I am 23 years old and feeling less motivation and sometime get upset about past bad experiences.

Answered by: Cheryl Corcoran

I imagine your question is what to do, and whether you may be at risk for schizophrenia yourself. If you wish to have more motivation and not get so upset, I suggest you see a psychiatrist for evaluation, so you can receive treatment and feel better, and lead the life you want to lead.

Here are some facts which may be of use to you. First, the risk of schizophrenia for anyone who has a parent with schizophrenia is about 13%, which means an 87% probability of not developing schizophrenia.

However, for someone who has a parent with schizophrenia, but who has also had a steep decline in functioning himself, or who has unusual thoughts or suspiciousness or perceptual disturbances, the risk then becomes somewhat higher. I do not know if you have had these problems yourself. If so, there are specialty programs throughout the US that offer treatment and evaluation, such as the Center of Prevention and Evaluation (COPE) at Columbia in New York, and I would recommend that you contact one. The phone number at COPE is 212 543 5874.

Feeling less motivation is an experience which could be related to life context, drug use or even physical illness (i.e. low thyroid). Absent these, feeling less motivation can also be a feature of depression, which is characterized by depressed mood, decreased interest, guilt, low energy, poor concentration, changes in appetite and sleep, and sometimes suicidal thoughts. Depression can be treated very effectively with antidepressants and therapy.

If your past bad experiences were traumatic, the low motivation you feel could also be a feature of post-traumatic stress disorder, which can include flashbacks, nightmares, startle response, irritability.

Finally, sometimes feeling less motivation may just be a symptom by itself. Similar symptoms include less enjoyment of things you used to enjoy, feeling numb or apathetic, and having less facial expression. These are negative symptoms which people with schizophrenia can have, as can their family members (even if they don't have psychosis).

Negative symptoms like "feeling less motivation" are hard to treat, though there are exciting new clinical trials of medications which may be promising for improving motivation, pleasure, and emotional experience and expression, especially in terms of other people.