I personally do not have any negative symptoms. (Which played a large part in me being diagnosed as having a nonspecific psychotic disorder instead of sz). I’m thinking of writing a paper for my class on the modification of CBT to better suit the treatment of schizophrenics/those w psychotic disorders or even finding an entirely new method of talk therapy not related to CBT. This of course requires understanding of not only positive symptoms but negative symptoms as well and since I haven’t experienced those I’m not sure what they’re like.
What thought processes/emotions go with your negative behaviors? For example, lack of hygiene. I know for myself it can take hours to work myself up to get in the shower but it’s because of my anxiety, and knowing showering is a time commitment. Why do you choose not to do it? Do you just not care enough? Does it bother you? What other kinds of negative symptoms do you experience and could you explain how you feel about them, or what your thought process is behind them?
Also I’m deeply sorry in advance if anyone found any of my questions offensive. It’s my sole intent to better understand the aspects of the illness that I do not experience, and I feel the only way I can do that is by asking people who have dealt with it.
When I don’t shower I just don’t care because I know that im not going anywhere anyways.
I dont know if its a negative symptom but I don’t interact with society because I believe in its current state it is evil.sorry I dont think thats negative I didn’t realize until I typed it.
I don’t have facial expression in any case even when I think something is hilarious I barely smirk and this has effected my life negatively because people think im stuck up.
Which leads to my other negative symptom of not caring about anything and I think that stems from my of view the world which is negative. …I don’t like it.
How do I feel about these symptoms and there effect on my life? I dont care, im basically just waiting to die.
Hey, don’t feel that way, never! Why die? You just need love, like all of us!!! Try to find it, that’s what I do!! Perhaps in the future there will be better medicines, don’t give up hope!! I try to do the same!!
My negative symptoms take the form of a lack of desire to accomplish anything. When I wake up in the morning the only thing I want to do is go back to bed. I do that until sleeping some more becomes impossible. I rarely go out - except for the usual shopping - it’s usually every couple of months with my parents for a restaurant or the movies. I have no desire to make friends. I haven’t tried to have any sort of activity for some years, I tried to take steps to study or volunteer, even go to the gym but the motivation didn’t last…
Oh im not suicidal and when I sayed im waiting to die I meant that in the most positive way I just meant that as a Christian im looking forward to Heaven.
I haven’t had trouble showering lately. When I first got to my assisted living center over ten years ago I drank a lot and I didn’t shower. I was always sweating out alcohol, and I looked greasy. I spend hours and hours and hours doing nothing, when there are a lot of constructive things I could do. I’ve wasted large amounts of time since I was fifteen. That’s four decades ago. Occasionally I do a little something constructive - read literature and write, but I don’t do nearly enough of it to get as good as I’d like to get. I’ve been writing a little bit more lately, and I take a shower almost daily. Sometimes on the weekend I skip a night. I have big problems with a flat affect. When I talk to people I go rigid and start talking in a monotone, and they start yawning. In my case, being so anxious about basically nothing is a great big bore.
I go in phases, sometimes I see a glimpse of hope and other times I keep asking God how I ended up in this mess.
I have registered for courses full-time in September, I just need to pay the fees. I’m debating going because I might be removed from the waiting list of Section 8 Housing if I study full-time. I want to ask you a question, since you take classes, where do you find the motivation to wake up in the mornings and how to do you handle being forced to socialize with other classmates AKA do you have issues with some of them?
I ask because I’m wondering if the lack of motivation symptoms that can come with sz are caused by depression related to the illness rather than a legitimate sz symptom…I know it’s possible for mental illnesses to be comorbid and it makes a lot of sense that people with sz would also be prone to depression because, well it sucks and makes life an absolute pain a lot of the time. Just my thoughts though.
I’ll make sure to add something about stress management/depression management to my paper I think.
I would say both. It’s strongly associated with anxiety, but it is something I do without thinking. I think part of it is wanting to drive people away.
As I wrote earlier, there is a theory that says that when you take antidepressants and you have psychosis, the psychosis gets worse, so that means that psychosis and depression are connected somehow. But all I believed so far, is that the depression comes from the fact that we have the illness, both for the positive symptoms and the stigma also. But now I see only one of these two theories is true, so, that doesn’t make any sense, hard to decide the right one!
This is one of the reasons why I have significant Schiz symptoms infused into my bipolar diagnosis -
I wake up, have enough energy to make a pot of coffee for the family, I will quickly after I make my coffee, go into vegetative mode. I have a beautiful guitar in front of me, but I rarely play, I dont feel like doing much of anything.
I dont like to go out to stores etc… I may walk the dog once or twice lately, I will go online, but I dont really have the motivation to do much of anything. I dont think its depression, it is inertia - I do believe that they are negative symptoms of SZ.
My last psychiatrist believes that bipolar disorder rarely presents itself as pure. It is almost always comorbid with another disorder. She told me that although I present myself as being bipolar, I have comorbid anxiety, panic disorder, OCD and enough Schiz symptoms as she puts it. Negative symptoms, except for depression are not usually present in bipolar disorder - but I have them separate from my depression - some psychiatrists will diagnose my with schizoaffective, others bipolar - but negative symptoms are a real issue for me
So for a little preview of things I was thinking (in a very basic outline)
Positive Symptom Treatment
-Delusions: person must learn what kind of delusion they are prone to and why by going through their history of odd beliefs and breaking them down w help of therapist, must learn how to identify delusional thoughts, must learn how to retrain brain to break pattern finding that can lead to delusion development
-Hallucinations: person must learn how to remain calm when hallucinating and identify when they are hallucinating and when they are not, person will discuss hallucinations and attempt to understand why they are hallucinating what they are, possible triggers etc
-Issues w Organization/hygiene/sleep: person must set up a routine for themselves (w help of therapist), so that cleaning happens on same days every week, grooming happens at the same time every day, same bed time every night, also therapist can help person plan any important events month by month and keep track of them
Also stress management skills and depression coping tactics are of course important too, feelings that come with dealing the disease can be just as important as the disease itself.
I’m still thinking of ways to help with flat effect and inappropriate expression. Maybe keeping a mirror in the room during the session so the person can watch their facial expression during the talk and practice corrections? That one is still really rough because I’m trying to learn more about it, heh.
Anyways this is still developing so I’m open to criticism! I have plenty more research to do
I think many negative symptoms are adaptive behaviors in the face of the positive and cognitive symptoms, and traumas of psychosis and treatment. I’ll go through these, so you see what I mean.
Flat affect- withdrawal in the prodrome means that various communication social skills weren’t learned. Coexisting depression adds to this, and people on typical APs have rigidity which gives them some of the loss of affect that Parkinsonism sufferers display.
Lack of social interaction/speech- learned or heightened introversion in the prodrome leads to lack of social skills and learned shyness. The reality of social stigma adds fear of discovery and being ostracized. It’s safer not to interact. Senses are overstimulated and positive symptoms like delusions and hallucinations are triggered by social interaction. Again it’s safer not to interact.
Avolition / lack of ability to plan activities- Thought disorders and cognitive difficulties make it a struggle to sustain the executive function planning these activities require. Positive symptoms provide distractions that make it difficult to follow-through and keep a train of thought. Prodrome stunts opportunities for learning experiences to master executive planning skills.
Lack of pleasure in everyday life- learned depression from the realization that positive symptoms and cognitive symptoms coupled with stigma and side effects from medication may lead to a less comfortable and satisfying life.
Lack hygiene, personal care- learned hopelessness and social phobia coupled with fear of doctors and dentists contribute to this.
Here are my negative symptoms. Some of them come and go as they so please.
Flat Effect or Restricted Emotional Expression :
I have a high level of difficulty conveying emotion when i experience this aspect of negative symptoms. I feel emotions but my face does not show it . my voice also becomes very inexpressive and no matter how hard I try, it comes out completley monotone.
Tired/Fatigue : I’m not sure if this is a negative symptom or a sign of another health issue but I feel physically tired to the point of not wanting to move. Sleeping excessively for 12+hrs.
Lack of motivation/ Avolition : I want to get stuff accomplished but I have 0 energy to follow through. very frustrating. when it is real heavy. its difficult to even turn the television on , or brush my teeth , or make anything to eat. everything seems like way too much effort. i just sit on the couch and stare at the wall and im ok with that. although discouraging.
Depression: I still get a depression ocassionaly (rarely) but it is very distinct from negative symptoms as I get feelings of sadness and pain for no apparent reason. then it will lift. my depression might last for a few hours to a day or 2 at most. in the past year its maybe happened 5 times? but a couple of those times i got depressed because my negative symptoms were so bad.
Physical depression? when i have a depression or no motivation my body feels physically painful at times.
Within myself, I still experience emotion in every way, and also when I end up following through and doing an activity I still experience pleasure and enjoyment.
Its just getting myself to do the activity that is so difficult!!
That sums up my negative symptoms.
Those are the symptoms I experience as someone who is not on any medication
I tried using a mirror. I tried recording myself and practicing acting monologues infront of a camera, i tried expression courses. singing lessons. voice exercises.
The help from that was pretty minimal. but i tell you when the flat expressive symptoms lift it is a night and day difference. when i get a break from it everyone notices it. its such a huge difference as I am able to use my personality the way im meant to.
one thing I have noticed is that if I eat small meals throughout the day to maintain a good blood sugar level I am able to be more expressive. im not sure why but its just what ive noticed over the last year.
