How My Negative Symptoms From Schizoaffective Disorder Affect My Frame of Mind
It’s common for me to say that the first sign that something was seriously wrong was when my long-standing symptoms of depression changed. They felt new and different despite the general similarities to the depression I had always known. I wasn’t sad or hopeless. It was more like being stuck in my head, sitting cross-legged and watching life happen around me. After several experiences with two distinct symptoms of psychosis from the class referred to as negative symptoms, I began to recognize the differences I felt back in the beginning and at times since then.
Living with depressive-type schizoaffective disorder, I experience both symptoms of depression and negative symptoms, and it’s easy to get them confused.
Negative symptoms can be incredibly difficult to distinguish from symptoms of depression for individuals, supporters, and doctors alike. And it’s understandable given that there is some crossover between symptoms of depression and negative symptoms of schizophrenia spectrum disorders. Things like a lack of taking pleasure in things, difficulty finding motivation, and withdrawing socially are shared by both. However, other negative symptoms like blunted affect (displaying little emotion), and alogia (speaking very little) are not found in depression. The first time I clearly recognized a negative symptom was with an experience with blunted affect well after my diagnosis.
Blunted affect can be frustrating for me.
In one of my college classes, we learned that during blunted affect, while the emotion may not be shown, that doesn’t mean it isn’t there. But that did not prepare me for how it felt to experience it. For me, it’s like the emotion is there as a logical statement in my head – for example, I am sad. On the outside, I look indifferent. But on the inside, I’m shuffling through my thoughts searching for the feelings that go along with the sadness. Shouldn’t I feel something? Where are the tears? Where is that tidal wave of sorrow that should go along with this? All I get is, I am sad.
My psychiatrist put it best when she said, “you can’t feel your feelings.” It’s uncomfortable, disjointed, and sterile. Sometimes it frustrates me to no end. Occasionally, I try to force it – force the welling of eyes and the heaviness of heart, but it doesn’t work. No matter how badly I want to experience this sadness, my brain remains quietly steadfast. I am sad.
Alogia was comfortable.
Sitting in the car with my boyfriend one evening, the conversation grew more one sided. It wasn’t because I was angry or upset in any way. I simply settled into a place in my head where words didn’t seem necessary and I felt content in my silence. My mouth felt heavy, like my upper jaw was weighed down, but it didn’t feel like there was any kind of real or supernatural force keeping my lips sealed. I was aware that I was still completely capable of speech. But this poverty of speech was not a conscious decision either. I felt compelled to lean into the embrace of quiet as I listened to my boyfriend try to carry on the conversation while clearly worried about why words seemed to escape me.
That instance lasted less than an hour. During my most severe experience with alogia, which I did not recognize until years later, I hardly spoke for three days. I took to carrying a pad of paper and a pen with me, though I still didn’t use it to communicate as frequently as I normally do. My friends’ attempts to jostle words out of me all fell flat. In those moments, I was lucky to have very little pushback, though I wouldn’t be surprised if they found my behavior overdramatic. But I don’t know if any level of frustration or force on the part of others would have moved me out from under the blanket of quiet anyway. It was hard enough for me to do that myself.
Now back to the beginning.
Just prior to the onset of my hallucinations, the depression I had lived with for so long shape shifted. There was no sadness or hopelessness. It had nothing to do with feeling like nothing mattered. I just existed. It was difficult to get up off the couch and motivate myself to do things, but when I did, I was not dismayed. Having a work schedule to adhere to helped, and I enjoyed my job at a small fair trade store and the social interaction it involved. But I did not seek out much social interaction beyond what was scheduled or suggested by others. I didn’t see the purpose because I couldn’t imagine the emotions of tomorrow – positive or negative.
I’ve described the feeling as being blank as opposed to empty. My emotions, expressions, and energy were there, just muted. And not in a heartless way – my humanity was very much alive and well. I still loved and cared for my friends and family. I just couldn’t seem to show it. And as the hours I slept and amount I ate decreased, it became even easier to simply sit in my head and exist.
Looking back, it is that muting of feelings that suggests to me that what I felt in that first instance and several others since then was not depression after all.
I still grapple with depression at times, and, at least for me, it’s never without strong emotion. The feelings I get when I experience alogia or blunted affect are not devoid of emotion. Instead, emotion feels quieted. Another difference is in the impact others have upon my symptoms. In the depths of depression, a hand reaching out may not resolve everything, but it can help. Floating beneath the waters of negative symptoms, an outstretched hand, while not always refused, doesn’t really trigger anything in me. Sometimes my distress over these symptoms is there, but hushed. At others, I am content to sit in my head and observe.
One thing that is shared is some level of impairment. In school, assignments would pile up. At home it was chores. In some cases self-care like brushing my teeth felt like an immense feat. Socially, I would stand on the outside. While depressed, these things tore me up and only worsened my depression. Under the influence of my negative symptoms, I was aware, but they had a much smaller impact on my mindset, though I can’t say the same about the impact on my life. But I am not always successful at pulling myself out of theses symptoms with or without help and there are few methods to treat negative symptoms. Sometimes all I can do is ride them out.
It’s important to look past the way negative symptoms appear on the outside.
Negative symptoms do not erase my emotion, compassion, or humanity. All three continue to exist, they are just tucked away, sometimes reachable and at other times less so. In my experience, negative symptoms do not produce malice or ill will of any kind. Nor are they punishment or pushback for anything that anyone may have done to me. Honestly, I rarely know what triggers mine. And any effort on the part of another to resolve them may have very little impact, but that doesn’t mean you are doing anything wrong. If you are confused, you are not alone. After all these years, negative symptoms still leave me with questions too.
For further information on negative symptoms, check out this article by Marder, S.R. and Galderisi, S. and this article by Velligan, D. I., & Alphs, L. D.
Please note that these are just my experiences. Others may experience their symptoms differently. This should not be used as a diagnostic tool.
Looking for more descriptions of what symptoms of psychosis feel like? Click here for an in depth look at my hallucinations
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