Family and Caregiver Schizophrenia Discussion Forum

Schz and motivation


#1

My 25 yr old daughter is doing very well on her meds and living in a board and care. Every time I visit and or speak to her she has ideas of getting in shape (gained a lot of weight on meds), looking for work and or taking a college class. However, she never gets past the ideas and move into action mode. I ask her did you do this today, or that today? The answer is always no. I ask her how her day is on a scale of 1 - 10 and it is always a 5. I ask her if she is depressed and she says no just bored. Any feedback on if this lack of motivation is common, or any suggestions on how I can get her motivated. I have offered to by her a computer, cell phone and or iPad and her response is always no I don’t need those things.

Thanks,

Susan


#2

I’m the same, lots of good intentions, then I jam up when I try to do anything.


#3

My former therapist said schizophrenics always just talk about doing things but never do them. Time just passed them by. People move on. That’s how it is with me. I used to be extremely motivated, but the illness and medications have reduced my drive to zero. Instead of bettering myself, I just smoke all day. I think our motivation will change when new medications come out.


#4

Just wondering how did you find a room & board?


#5

We live in CA and my daughter was put on a conservatorship by the county she lives in. After months in a locked input facility they found her A board and care.


#6

I vega injection once a month, zyprexa, and lithium.


#7

Lack of motivation is a big problem with me. The only way I managed to get a ged, drivers license and a college plan was my father pushing me to do it. Other than that there’s medication that helps with motivation, Wellbutrin, adhd medication, etc. I would suggest she finds someone in her life that can help propel her to where she wants to go.


#8

I have an issue with time. Time keeps going and I’m not. Maybe if you could show this forum to your daughter, maybe she will get out of her apathy and write something.

I suffer from anhedonia and now and then from apathy. Everything is boring. Dn if it is the meds or the illness.


#9

She only has me to be the person to motivate her and unfortunately she either loves or hates me so my influence is limited.


#10

From what I’ve read (even here) lack of motivation is a common problem. It’s definitely a problem with me. I don’t know what advice to offer since this is a problem for me as well.

Maybe you can make an to-do chart and manage it until she gets the hang of it on her own?

It might help me if someone managed a to-do chart for me. It would also frustrate me that someone was managing, but I’d most likely comply.


#11

It is not the meds that do it; it is known to be one of the very first symptoms in unmedicated people with sz or in the prodrome. That was my son’s first and primary symptom. It persisted for ten years. When he was a teenager he was really high-achieving, but in his prodrome he dropped out of med school, then spent ten years never finishing anything - almost never finishing anything. He is slowly getting better. He has support from an Early Intervention Team. But CBT has helped. He tends to say he has done nothing in ten years and he is a failure. So I point out the things he has done and finished (usually short courses, things to do with art, his religion, etc). He has learned to cook very well, for example. He also lives independently and has done various very nice bits of work on his flat. In the last two years he has been on risperdone - which was disastrous because it knocked him out too much. Then he was on Ability for a while, which did help, and he did more. Then he came off it and had a huge long depression. Now, he is on serotonin re-uptake inhibitors and he seems to be getting more active again. He is doing more work on his flat, doing some weight training (so I guess eating better) and has enrolled on another course. When he was very depressed I went to stay with him for a month and cooked etc for him and kept him company (social withdrawals probably his biggest problem). the we went together to visit family, or they came to visit us. We went out together and bought furniture etc. Went to parks and so on.

So doing stuff together can be a start. Start with really tiny tasks. People with sz talk themselves down a lot. Plus, apparently they find it hard to anticipate enjoyment. I believe that people can probably “retrain” themselves. I actually made my son stand and look at some of the work he has done on his flat, and told him, “Look at it every day and think ‘I did that. That’s good.’” I hope it will reinforce his “pleasure circuits” and his confidence to do more stuff.

I admit here that my son doesn’t have a full sz diagnosis. He has had psychosis a couple of times, but always with insight so he’s still on the borderline of having a “psychotic depression” diagnosis. Anyway, his positive symptoms are not very strong or frequent. His struggle has been ore with the negative ones. But for me, yes, the most significant one is the motivation one. Because it is a vicious circle. The less he achieves, the more he berates and hates himself and then he destroys his own self-esteem and confidence. But he is getting better (I pray).


#12

Lack of motivation & sz are common. I was an ambitious engineering student pre-sz & loved doing yard work. I don’t do those things anymore.


#13

Get a copy of this book and read it. Have your family read it, too.


#14

Lack of motivation is one of the characteristics of the “negative symptoms of schizophrenia”. There are a number of characteristics of these symptoms. Maybe you could read up on these negative symptoms. Unfortunately, anti-psychotic medication only seems to increase the negative symptoms. There is a new nutritional supplement called “Sarcosine” which we hope will decrease some of the negative symptoms. It is advertised at the top of this page. I take it myself. I don’t know if it has helped me because my activity patterns have always been so erratic. I take everything in binges. Sarcosine is relatively cheap - $31.00 counting shipping for 180 grams if you buy it from the people advertising at the top of this page. I take three grams a day.


#15

i was also taking invega and i can tell you: the lack of motivation one has when taking it is great. i barely forced myself to do any bodily exercise once a week because of the lack of ambition, motivation & enjoyment. prior to taking this med i was doing exercise every day, reading books, researching complicated topics etc. and was enjoying anything i was doing. the difference is so big that on the worst and most lazy day i had without the meds wasnt comparing in the least to the best and most motivated day when i was taking invega.


#16

Unfortunately she has been on different med combos and nothing had worked. What she is on now Invega, zyprex, and lithium seems to be doing the trick.


#17

Thanks to everyone for your feedback and book recommendation. You helped me a lot.


#18

The lack of motivation is a very common negative symptom of schizophrenia - and difficult to treat too. There are no medications that target the negative symptoms yet - though some are in development.

Here is some good reading about negative symptoms:

Negative Symptoms in Schizophrenia: An Update on Identification and Treatment - See more at: http://www.psychiatrictimes.com/schizophrenia/negative-symptoms-schizophrenia-update-identification-and-treatment#sthash.KOsBMhmG.dpuf

and

http://www.psychcongress.com/article/treatment-negative-and-cognitive-symptoms-schizophrenia-13473

The most helpful approaches so far available seem to be some supplements and therapy - including cognitive remediation therapy and also some computer-based memory training.

Here are some links to these:


#19

Recent news you should be aware of:


#20
  1. The lack of motivation may be the result of negative symptom sz, but it is far more commonly the result of over-medication. Invega paliperidone + Zyprexa olanzepine + lithium carbonate is a VERY potent polypharmacy for this era. I am guessing that she must have been extremely manic to have been put on that combo… which would be extremely de-motivating and lethargy-inducing for most sz pts.

  2. I would look into motivational interviewing at https://en.wikipedia.org/wiki/Motivational_interviewing to see what your options may be. I’d recommend Miller & Rollnick’s book, but it’s rather opaque (even for a professional).

  3. Some combination of the following psychotherapies may produce the result you’re hoping for. (They can for a lot of people.)

DBT – http://behavioraltech.org/resources/whatisdbt.cfm
MBSR – http://www.mindfullivingprograms.com/whatMBSR.php
ACT – https://contextualscience.org/act
MBBT – https://www.newharbinger.com/blog/introduction-mind-body-bridging-i-system
10 StEP – http://pairadocks.blogspot.com/2015/04/the-10-steps-of-emotion-processing.html
SEPT – https://en.wikipedia.org/wiki/Somatic_Experiencing
SMPT – https://en.wikipedia.org/wiki/Sensorimotor_psychotherapy