Negative Symptoms – A Look Inside
What are negative symptoms? Well, they can be difficult to explain.
Two days ago, I sat in the passenger seat of the car, sorting through my thoughts. I was irritated, but consciously forced urges to say mean things out of my head. There was nothing worth fighting over.
At a certain point, the mean thoughts slowed and stopped appearing. Instead, they were replaced by ordinary things to say like comments on the songs playing and random thoughts. As they unfolded in my mind, I looked them over. But with each one, I ultimately decided they weren’t worth sharing, though there was no anger behind it. So we drove in silence.
My lips and teeth felt heavy, drawn together as if by magnets. Talking felt as though it would take great physical effort. It’s difficult to describe the intent. I didn’t feel as though I was actively choosing silence, but I also didn’t feel like there was some kind of force or being preventing me from speaking. In fact, I was fully aware that I was still capable of speech and did respond to conversation occasionally, but with only a few words. At the same time, my thoughts had become less frequent and I found comfort in my silence. It was a safe place, even if I wasn’t sure why it was happening.
This isn’t the first time I’ve experienced a symptom of schizoaffective disorder and schizophrenia called alogia, or poverty of speech.
The first time I remember it happening, it lasted three days. I spoke in very short sentences on the rare occasions that I spoke at all. Ultimately, I ended up carrying a notepad and pen with me. Thankfully, my friends weren’t bothered by it and school was not in session. Once again, the loss of speech was not driven by pettiness. It was an emotional time, and I receded into the quiet without conscious effort or force on the part of another being. And in both this situation and the one above, it’s just as hard for me to describe what it was that pulled me out of the silence as it is to pinpoint what started it.
This is not the only symptom I experience that is difficult to explain.
I’m trapped in my head, trying to sort this out. Something sad happened. But I’m not sad. Only I am – I just don’t feel it. I could experience the sadness in a logical way, but I couldn’t physically or emotionally experience it. I couldn’t feel my feelings.
It was easy to identify it in my head – you’re sad. No feelings behind it, just a matter-of-fact acknowledgment. Where were the tears? Where were the memories and emotions? Frustration overwhelmed me. I was uncomfortable. And what would others think when I appeared completely unfazed by a sad situation?
This symptom, called flat or blunted affect, has been one of my most frustrating symptoms.
In flat affect, the emotion is there, I just don’t experience the physical and emotional responses that go along with it. When it happens, I’m actually less concerned with what others will think than I am about my own inability to access my feelings. Thankfully, I experience flat affect very rarely.
Both flat affect and alogia fall into a class of symptoms of schizophrenia and schizoaffective disorders referred to as negative symptoms.
Hallucinations and delusions are considered positive symptoms, not because they’re fun, but because they are things that should not be there, but are. In contrast, negative symptoms are when things are missing. In the case of alogia, that’s speech, and for flat or blunted affect it’s emotional expression. Other negative symptoms involve deficiencies in motivation, experiencing pleasure, and social functioning. You may recognize some of these symptoms from other mental health disorders like depression.
How do you cope with something you can’t explain?
In actuality, very little is known about the exact causes of the symptoms of schizophrenia, though we are beginning to understand them more now. Personally, dealing with all of my schizoaffective symptoms is difficult. I have little control over them, and there’s very little that I can do to stop them in the moment.
What’s frustrating about my negative symptoms, is that I feel as if I should be able to control them. I know that I can’t reason my way through every bit of a delusion and hallucinations won’t always go away if I shut my eyes or cover my ears. But when I’m physically capable of speech, I feel that I should be able to talk. And when I know what emotion I’m feeling, I want to feel it, and I don’t understand why I can’t.
These symptoms don’t frighten me as much as my positive symptoms, but I want to feel in control and I want to understand. I may be perfectly happy to sit in the safety of silence, but I’m aware of the disconnect. And I’m aware that others might notice or take offense and there’s little I can do. So for now, I process these symptoms as much as I can and try to remind myself that they will end. But I have to admit, it’s a little humorous that it’s easier for me to explain the cat that no one else can see than the reason I don’t speak. That’s the other way I cope.
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