If you’ve ever stared at a menu for 15 minutes and still couldn’t decide between tacos and pizza, you’ve experienced ambivalence. Mixed feelings are a completely normal part of being human. But when you Google “ambivalence schizophrenia,” things suddenly sound a lot scarier. Is feeling torn a sign of serious mental illness, or just a sign you need a snack and a nap?
Short answer: ambivalence on its own is not considered a core symptom of schizophrenia in modern psychiatry. Historically, though, it played a starring role. Understanding where that idea came fromand how experts look at it todaycan help you make sense of your own experiences and know when it’s time to get professional support.
What exactly is ambivalence?
In everyday life, ambivalence means having mixed or contradictory feelings about a person, situation, or decision. You might:
- Love your job and also fantasize about quitting on a random Tuesday.
- Want to text someone and simultaneously dread what they might say.
- Feel both excited and afraid about a big life change.
The word itself comes from Latin roots meaning “strength on both sides”in other words, two emotional forces pulling you in opposite directions.
In mental health, clinicians sometimes use “ambivalence” in a more technical way. It can describe moments when someone feels strongly pulled in opposite emotional directions at the same time (for example, intense love and intense resentment toward the same person) or when it’s very hard to commit to a choice even when the stakes are clear.
But here’s the key: ambivalence also shows up in completely healthy people. It’s part of how the brain weighs pros and cons. Only when it becomes extreme, persistent, or tied to other serious symptoms does it raise more questions.
What is schizophrenia?
Schizophrenia is a mental health condition that affects how a person thinks, perceives reality, and relates to others. It’s not a “split personality” (that’s a different condition) but rather a pattern of symptoms that can include:
- Delusions: fixed beliefs that don’t match reality (for example, believing people are constantly watching you when there’s no evidence).
- Hallucinations: seeing, hearing, or sensing things that others don’t (most commonly hearing voices).
- Disorganized speech or thinking: jumping between topics, using words in unusual ways, or being hard to follow.
- Grossly disorganized or catatonic behavior: behavior that seems bizarre, unpredictable, or extremely slowed/stiff.
- Negative symptoms: reduced emotional expression, low motivation, social withdrawal, or difficulty feeling pleasure.
To meet formal diagnostic criteria in systems like the DSM-5, a person needs a combination of these symptoms lasting for a significant period of time and clearly affecting daily functioningwork, relationships, self-care, or school.
So where does ambivalence fit into all this?
How ambivalence became linked with schizophrenia
The connection goes back to the early 1900s. Swiss psychiatrist Eugen Bleuler, who coined the term “schizophrenia,” described a set of “fundamental” features he believed were central to the condition. Among them were his famous “4 A’s”:
- Associations: disruptions in how thoughts connect.
- Affect: changes in emotional expression and responsiveness.
- Ambivalence: intense, simultaneous contradictory feelings or attitudes.
- Autism: withdrawal into an inner world of thoughts and fantasies, not autism as we use the word today.
Bleuler described ambivalence as a tendency for people with schizophrenia to hold opposite emotions or ideas at the same timefor example, feeling strong love and strong hatred toward a family member in rapid succession, or giving conflicting answers about the same belief.
Because of Bleuler’s influence, ambivalence was historically viewed as a hallmark of schizophrenia. For many years, textbooks repeated this idea, and the association stuck in both psychiatry and popular culture.
Modern view: Is ambivalence still considered a symptom of schizophrenia?
Today, the picture is more nuanced. Contemporary diagnostic systems like DSM-5 do not list ambivalence as a core symptom of schizophrenia. Instead, they focus on the five main symptom groups already mentioned (delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, and negative symptoms).
Recent overviews note that while ambivalence can occur in people with schizophrenia, it’s:
- Not specific to schizophrenia (it shows up in several other conditions and in healthy people).
- Not consistently present in everyone with schizophrenia.
- Only weakly linked to the illness when studied in large groups.
One review article put it this way: ambivalence may be more closely tied to emotional state (like chronic negative mood and anxiety) and general distress than to schizophrenia itself.
So if you’re experiencing mixed feelings, that alone does not mean you have schizophrenia. That’s like saying, “I’m tired a lot, therefore I must have a rare disorder”there are many other, much more common explanations.
Ambivalence vs. the negative symptoms of schizophrenia
Negative symptoms are things that are missing or diminished, rather than addedless motivation, less emotion, less social drive. Commonly described negative symptoms include:
- Avolition: reduced motivation to start or continue tasks.
- Anhedonia: difficulty feeling pleasure.
- Asociality: reduced interest in social interactions.
- Diminished emotional expression: voice, face, and gestures show less emotion.
- Alogia: very sparse speech (listed in some classification systems).
You might notice that “ambivalence” isn’t on that list. While some clinicians informally talk about “motivational ambivalence” (wanting to do something and also wanting to avoid it), it’s not an official diagnostic criterion in modern manuals.
However, chronic indecision and conflicted feelings can show up alongside negative symptoms. For example, someone might genuinely want to reconnect with friends but feel overwhelmed, anxious, and stuck. The result might look like ambivalence from the outside“I want to go, but I can’t get myself there”even though underlying factors include low motivation, fear of rejection, or cognitive difficulties.
Conditions (and situations) where ambivalence is common
Even though ambivalence isn’t a core schizophrenia symptom, it can show up in a lot of contexts, including:
- Depression: feeling torn between wanting change and feeling hopeless about whether it’s possible.
- Anxiety disorders: wanting to face fears and simultaneously wanting to avoid anything scary.
- Obsessive-compulsive disorder (OCD): being emotionally stuck between “I know this is irrational” and “I still feel like I have to do it.”
- Borderline personality disorder: rapidly shifting feelings toward people or situations.
- Everyday life stress: big decisions about relationships, careers, moving, or finances naturally stir up mixed feelings.
None of these automatically equal schizophrenia. They just show that our emotional life is rarely cleanly divided into “yes” and “no.” Sometimes it’s “yes, but also…no…maybe…can I get back to you?”
When ambivalence might be a red flag
Still, ambivalence can become part of a bigger pattern that deserves attention. It may be worth talking to a mental health professional if you or someone you love:
- Feels intensely conflicted about basic realities (for example, repeatedly saying, “I know that’s my parent, but I’m not sure they’re really my parent” without joking), especially if it’s distressing.
- Is torn between clearly contradictory beliefs that don’t shift even when presented with evidence.
- Shows strong ambivalence along with possible psychosis symptoms, such as hearing voices, paranoia, or very disorganized thinking.
- Struggles with basic functioning (school, work, self-care, relationships) because decisions feel paralyzing or reality feels uncertain.
Even then, the goal isn’t to self-diagnose (“Do I have schizophrenia?”) but to use these signs as signals to seek professional assessment. Psychiatrists and psychologists look at the whole picture over timenot just one feeling or behavior.
Coping with ambivalence if you live with schizophrenia
For people who do have schizophrenia, ambivalence can show up in unique ways. You might, for example:
- Want to take medication and also fear side effects or stigma.
- Want social connection and also worry people are judging or watching you.
- Believe part of what your mind is telling you and also partially doubt it.
Some strategies that clinicians and people with lived experience often find helpful include:
- Collaborative care: working with a psychiatrist or therapist who invites your questions, doubts, and mixed feelings instead of brushing them off.
- Externalizing the illness: thinking of schizophrenia as something you have, not something you are, can make ambivalence easier to explore (“Part of me is scared of this medication; part of me wants stability”).
- Journaling or note-taking: writing down pros and cons of decisionstreatment options, social plans, goalsso you can look at them on “clearer” days.
- Support networks: peer groups (in-person or online), family education, and community resources can normalize the push–pull feeling and provide real-life examples of how others handle it.
- Skill-building therapies: approaches like cognitive behavioral therapy (CBT), social skills training, and supported employment/education often weave in decision-making and problem-solving tools.
Ambivalence doesn’t mean you’re “failing” at recovery. It means your brain is trying to protect you from risk while also wanting change. Good treatment plans make room for both sides.
Supporting someone who seems ambivalent and possibly unwell
If you’re worried about a friend or family member, you might see them flip between “I need help” and “I’m fine, leave me alone.” That can be understandably frustrating, but it’s also very humanespecially when someone is scared or confused.
A few gentle, practical approaches:
- Stay curious, not confrontational. Instead of “You’re clearly sick,” try “I’ve noticed you seem really torn about what’s real and what isn’twhat’s that been like for you?”
- Validate the mixed feelings. “It makes sense you’d be unsure about seeing a psychiatrist. A lot of people feel that way at first.”
- Offer concrete options. “Would it help if I went with you to the appointment?” or “We can start with just a phone call to a clinic and see how that feels.”
- Know emergency signs. If someone is talking about harming themselves or others, appears completely disconnected from reality, or can’t care for their basic needs, it’s time for urgent help.
If you or someone you know is in immediate danger or thinking about suicide, contact your local emergency number or a crisis hotline right away. If available in your country, mental health crisis lines or text services can offer fast support.
So…is ambivalence a symptom of schizophrenia or not?
Here’s the bottom line:
- Historically, ambivalence was described as a “fundamental” feature of schizophrenia by early psychiatrists like Bleuler.
- Modern diagnostic systems no longer treat ambivalence as a core or required symptom.
- Research suggests that ambivalence is common in many mental health conditions and in people without any diagnosable disorder, with only a weak and inconsistent link to schizophrenia.
- What matters most for diagnosis is the broader pattern: psychotic symptoms, negative symptoms, functional decline, and duration.
So if you’re wrestling with mixed feelings, that’s not automatically a sign of schizophrenia. It may simply mean you’re human, your situation is complicated, and your brain is trying to protect you from making the wrong move. Still, if ambivalence shows up alongside hallucinations, strong paranoia, very disorganized thinking, or serious trouble functioning, talking with a mental health professional is a wise next step.
Illustrative experiences of ambivalence and schizophrenia (approx. )
The stories below are composite examples based on common patterns described in clinical literature and by people with lived experience. They aren’t about any one real person, but they illustrate how ambivalence can show up in schizophreniaand how it can be confused with everyday human indecision.
“Lena”: Wanting help, fearing help
Lena is in her late 20s and has been hearing voices for several months. Some days, the voices are just background noise. On harder days, they’re harsh and critical. Her family gently suggests seeing a psychiatrist. Lena feels a sharp internal tug-of-war.
On the one hand, she’s exhausted. She misses sleeping through the night. She hates feeling afraid in her own apartment. She wants her life back. On the other hand, she worries that a diagnosis will define her forever. She’s read horror stories online about side effects and stigma. In one conversation, she might say, “I really think I need help,” and an hour later insist, “I’m exaggerating, it’s not that bad, I’ll be fine.”
From the outside, this looks like classic ambivalence: Lena is emotionally pulled in opposite directions. But the ambivalence isn’t the diagnosisit’s a predictable response to living with untreated psychosis and facing big, scary choices. Over time, with a therapist who validates her fear and gives her space to explore both sides, Lena starts medication, continues therapy, and gradually finds a more solid sense of what she wants.
“Marcus”: Mixed feelings or just a tough decision?
Marcus is a 21-year-old college student who doesn’t have hallucinations or delusions. He does, however, have a big decision to make: stay in his major, which is safe but boring, or switch to a creative field that excites him but might not lead to stable income.
Marcus thinks about it constantly. One day he drafts an email to change majors. The next day he deletes it and researches internships in his current field. He talks to his friends so much about it that they gently joke, “Here we go again.” He wonders if his indecision is a sign of something serious.
This is ambivalence toobut it’s tied to normal developmental stress, not schizophrenia. Marcus isn’t experiencing psychosis, disorganized thinking, or major functional decline. His mind is doing what minds do when the stakes feel high: running simulations, worrying about consequences, and trying to protect him from regret.
“Sam”: Living with both hope and doubt
Sam has had schizophrenia for several years and is fairly stable on treatment. Some days, he feels hopeful: he texts a friend, works on a class, and thinks about applying for a part-time job. Other days, he’s flooded with doubtsWhat if I can’t handle it? What if people judge me? What if the symptoms come back?
Sam and his therapist actually make room for this ambivalence in their work together. They talk about the “hope voice” and the “fear voice,” and they practice noticing both without letting either voice take complete control. Over time, Sam discovers that he can be scared and still try new things, doubtful and still move toward what matters to him.
These examples show that ambivalence is not a mental health villain. It can be painful, yes, and in the context of schizophrenia it can complicate decision-making around treatment and recovery. But it’s also a normal part of weighing risks, protecting ourselves, and growing. When ambivalence happens alongside symptoms of psychosis or serious changes in functioning, it’s a signal to reach outnot a verdict on who you are.
Important note: This article is for general information and education. It’s not a substitute for professional diagnosis, treatment, or personal medical advice. If you’re concerned about schizophrenia or any other mental health condition, check in with a qualified clinician.