Depression vs Negative Symptoms vs Natural Response

DX'd - Other
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I have tried to find materials on how to tell the difference between the two, but instead what I find is just material explaining that they are two different things, well duh lol. I looked at some old posts/threads trying to get a better understanding but it still seems confusing when I try to look at my own experiences.

Does anyone have any links to helpful information on this? Or have a way of explaining it?

I am starting to wonder after doing some more reading if maybe psychotic depression is more apt than schizo/affective for me. I’m really not sure how even professionals tell the difference.

I normally play an online game a lot. It fills the hours of the day that I home alone. Otherwise I will be pacing and talking to myself all day and sometimes that gets me really wound up internally doing that, so it is better that my mind is occupied with something. But sometimes like lately I just have no desire to play it even though I am normally obsessed with it and could play it for hours completely entertained. I tried logging onto the game but I just don’t do anything, my character just sits there and I end up tabbing out, and then eventually getting up to have a smoke and pace around.

Everywhere I look something like this is considered “loss of interest” in some manner or another. But then maybe it’s just a normal thing as my life is so small and empty, hard to really tell anything in that way, I guess. Like if people are alone all the time due to MI and don’t ever get out much, should they really be expected to stay interested in the same thing all the time? Doesn’t make much sense anyway. Do those of you in similar situations (isolated, no social life) have trouble staying “interested” in everyday life?

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Okay for anyone else who wonders the same thing, I just found this:

http://fragminds.com/how-do-i-tell-the-difference-between-depression-and-schizophrenia/

“People with psychotic depression, however, know that their hallucinations are not reality. Most individuals diagnosed with schizophrenia believe that what they see or hear is real.”

If this is accurate then it is psychotic depression.

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Also this man looks just like the General from the Hellsing anime.

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Read this and want to note that schizophrenia is definitely not a “personality disorder” (most of the article seems better researched than that error) per DSM and all other diagnostics.

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Lol yeah I caught that, too, and almost discarded the whole thing, but I’m so desperate to understand what is wrong with me, after a moment of “ugh” I kept reading.

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It would be really good to know, wouldn’t it?

I would say there is nothing wrong with you even though you have a complex illness.

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I don’t think it is accurate.

My first episode I had no idea that the voices I was hearing were not real. And the things I felt and saw that were hallucinations.

Then the next few episodes same thing.

2nd episodes my voices actually said they were my brain after about a week or more of mayhem.

3rd the voices changed there approach so I was tricked again.

Eventually after a ton of research and learning about critical thinking and disregarding magical thinking
I gained insight to know it’s just my brain conjuring up the crazyness.

So now I know it’s not real and I dismiss blips when they come up.

So it took a few years to understand it.

Now I’m mostly dealing with an empty head and flat affect (restricted affect - a lesser degree) lack of motivation/avolition

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Hi, Turnip. I have psychotic depression. I don’t know if my experience will help you much or not.

A lot of the things I experience are very similar to the negative symptoms of sz. I have a couple of friends with sz that have told me that my experiences, particularly avolition but I think also alogia, seem so like negative symptoms that they suspect my diagnosis is incorrect.

But as the first article you linked indicates, I believe it’s the positive symptoms that make the difference.

I’ve had three major delusional episodes, all of them lasting years. The first was when I was a teenager, and I believed that I was a creature of darkness. I believed I was evil and caused pain and harm to everyone around me. I believed that I wasn’t worthy of being around good, decent people. I believed that people, particularly my mother, could read my thoughts, but refused to help me because I was wicked and unworthy of help.

My second period came after a three year remission, and really only ended perhaps three years ago. I believed I was somehow a criminal, that I was being monitored by the NSA, that my citizenship was going to be revoked and I wasn’t going to be allowed back into the country when I left. I thought my mail was being intercepted, my phonecalls tapped, my email monitored. I thought my landlord had put cameras in my home. I thought I was being followed around town. I mainly thought that I must have done something very wrong that I didn’t know about, but that I was going to be punished for.

My third episode came after perhaps an eight month remission. My cat died of kidney failure, but I believed I had killed him. I believed that I had poisoned him. I believed that I had let him get run over by a car. I believed I had let him get mauled by coyotes. If I heard about any action that could result in the death of a pet, I believed I had done that. I also believed that after his death, he was able to see me clearly, and he was angry at me. I believed he could come back but refused to, and so I had to prove to him that I was sorry so he would come back. I had to do this by getting another kitten and doing all the things for it that I should have done for my first cat. Over a year and a half, I probably spent $15,000 on this kitten. If anything went wrong with her, it would send me into despair, because it meant I was failing my test for my first cat. I am still coming out of this episode.

Throughout these, I’ve experienced hallucinations that I’ve never felt were real for more than a second or two. Mainly, I see lights and shadows, cats and people who aren’t there, hear very complex music that isn’t playing. These hallucinations are mainly not disturbing at all.

I’ve also had some minor delusions - that I could heal myself and other people, that I could predict injuries and illnesses in other people, that I am descended from an ancient race that ties me to living beings - animals, plants - in the natural world. None of these delusions are accompanied by any sort of need to do anything, like those with a prophet or savior delusion might experience.

The main thing about my largest delusions is that they all focused on my feelings of guilt, worthlessness and wrongness. Particularly the ones about my cat, I knew they weren’t true, but knowing that meant absolutely nothing. The fact that there is little in the way of meaningful symptoms outside of these feelings is what qualifies it as psychotic depression.

Back to negative symptoms vs depression - like I said, even my sz friends don’t see a lot of difference. I’m not sure if there’s a foolproof way to distinguish them, outside of looking at what symptoms accompany them.

Sorry if this isn’t useful to you, but I hope some of it is.

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@anon31257746 @Rhubot

Thank you both for sharing, both of your posts were helpful, I appreciate it.

I sort of felt/feel like if I am able to figure out that things are not real, then that means I am like John Nash or something (please forgive me it was my honest thoughts), but then immediately after that it sounds really conceited, it’s not like I am super smart or anything, not like that. So it leaves me very confused.

One of the most recent things that really stood out to me was when I was working at that gas station, and the guy that worked in the cooler stopped to talk to me on his way out after clocking out. I looked up at him and his face was really messed up. There was just black energy in his sockets where his eyes should be, and the rest of his face did not look right. I immediately looked away and acted like it didn’t happen. He was offering to take the trash out for me and I just said “no thank you I’ve got it” and kept staring down, wanting him to go away, which he then did. I then dismissed it. I knew that dwelling on it would be bad, and I knew that it wasn’t real, to just ignore it. This makes me really doubt that it’s psychosis when I can know it’s not real, or it makes me feel like I am somehow tricking my own brain into doing these things, rather than my brain doing it on its own.

I also hear music but that is one thing that I love, it is beautiful and doesn’t cause me any problems.

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Yeah, I don’t know. If you had asked me if I really believed my hallucinations - straight down the line, the answer is no. Particularly with the lights and shadows, when they started happening, I thought perhaps I had a detatched retina.

With the delusions, they varied from “100% absolutely true” (the NSA) to “I don’t want this to be true but it’s the only thing that makes sense” (creature of darkness) to “I know logically this isn’t true but at the same time it absolutely is, and there is nothing anyone can say to the contrary that makes any impression on me” (my cat).

With the injury prediction, it was odd, because I thought it was probably not true, but I couldn’t figure out how it could not be true. It was like a math problem I kept getting wrong: 2 + 2 = my presence in 4-dimensional space alerted me to my coworker’s herniated disk before it happened in our 3-dimensional space! @Minnii helped me a lot with this one, mainly by telling me that the why of how it was wrong wasn’t the important part; just the fact that it was obviously wrong was enough. Once I accepted that, I could see where I went wrong.

Are you sza-depressive? Honestly, research is showing that there isn’t much difference as far as brain patterns go. The real treatment difference seems to be that APs are used for acute psychotic episodes only in psychotic depression, then they try to taper you off once you’ve stabilized. Sza-depressive tends to have more psychosis outside of depressive episodes and requires more continuing care to prevent relapse.

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It basically feels like just because I sometimes get mental illness symptoms, doesn’t mean my intelligence is instantly halved or something. And I am still able to understand how normal people are. I know not to talk about certain things because they are “crazy” things. I know that certain things I experience can’t be real because it makes no sense. The only time I have a major issue is when I get a delusion, until it starts to go away. Like I genuinely thought the government was going to round people up and kill them, and I wanted to save my family, and I genuinely freaked the hell out when my family wouldn’t listen to me. But that wasn’t the sort of thing where it was super obvious that I was wrong. There was a lot of conspiracy theory material online that was very manipulative, and the government HAS done some messed up stuff before, and other governments have done some REALLY messed up stuff before. It wasn’t like I was believing that Godzilla lived in our basement. And I don’t mean that in an insensitive way to people who have “bizarre” delusions as opposed to “non-bizarre” but just that even if I get delusions, it’s not totally random, there is at least some thought process to it and at least a little evidence.

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From what I understand given my own episodes of depression and what I face now with negative symptoms, in depression I cry a lot, and now I don’t. In depression the feeling of emptiness is overwhelming, the feeling that nothing will be right again, that I won’t be successful in my endeavours and that the world is is worst shape than it actually is.

One of the negative symptoms of sz can be depression, the most common are avolition and anhedonia.

Hope this helps.

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Thank you for the extra insight, and yes everything helps. TBH I think just being able to read others’ thoughts helps me feel a little less crazy all by itself.

I almost never cry, but I think that might just be me, not sure. The only expressions I give most of the time is that I laugh when I am nervous. So it’s a little backwards because I mostly just feel anxiety, and then I laugh. I have been that way since I was a kid, though.

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Yeah I don’t get depression much. Sometimes I have like a few minutes where I feel weepy or whatever but it goes away.

Most of the time i feel blank and void. Like I could just stare at a wall and do nothing. And lack of interest. Feeling like nothing will be enjoyable. But when I do get around to doing something I do feel a sense of accomplishment.

I also lose expression and become totally monotone. It’s a night and day difference when it goes away.

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@turnip, for what it’s worth, what @Minnii describes here is baseline normal for me. It is so normal for me that I don’t even think of those things as symptoms, just the way life is. Avolition and anhedonia are also part of depression, but @Minnii is right, what she describes is the backdrop for everything.