negative symptoms vs depression

[dancesintherain]

Sorry if I missed a thread on this.  a link would work fine.  I just don't have the mental bandwidth right now.  

Can someone talk to me about distinguishing between depression and negative symptoms?  I had what I thought was a very mild depression, but the more I read about things, the more it seems like it could have bee negative symptoms rearing their evil head.  Just because of hte symptoms I didn't have (my mood was really just low).  That said, I had it for two weeks without psychosis (and then the AH started), so maybe it was a mild depression.  I'm unsure about the overlap of the two. 

[DogMan]

Flat affect can be tough to distinguish. But for me it is more something that others notice, not that I feel myself. As opposed to depression that I am more aware of. 

 

A coworker years ago told me that her two sons both died in tragic accidents, and that her husband had a brain aneurysm and died the week prior. I giggled like a school girl. That is inappropriate affect.

 

What others specifically are you interested in?

[DogMan]

Depression is more cyclic too. NS are just ever present. 

 

Pdoc says if risperdal ever craps out, which was rxed by previous doc, then amisulpride/solian is good for that. Which he thinks I suffer from more than I realise myself 

[dancesintherain]

Thanks!  From the online SZA list - slightly low mood, irritability, difficulty concentrating, social isolation, anhedonia, lack of motivation

But a lot of those fall into depression as well.  I wasn't having any other psychotic symptoms at the time, so perhaps it was just a very mild depression followed by the AHs.  It's hard for me to tell.  Are there any characteristic giveaways. 

 

 

Edited October 20, 2019 by dancesintherain

[DogMan]

3 minutes ago, dancesintherain said:

Thanks!  From the online SZA list - slightly low mood, irritability, difficulty concentrating, social isolation, anhedonia, lack of motivation

But a lot of those fall into depression as well.  I wasn't having any other psychotic symptoms at the time, so perhaps it was just a very mild depression followed by the AHs.  It's hard for me to tell.  Are there any characteristic giveaways. 

 

 

not that i am aware of

 

it is probably more a case of observation by p/tdoc 

 

what do you consider baseline mood on the 1-10 scale? for me my default is 3

 

people tend to think i am an arsehole, get sick of me never smiling, not talking much. Not in cycles like mood, just all day every day

[dancesintherain]

baseline is pretty neutral--not depressed, not manic or hypomanic.  Outside the weeks like that described above, it's pretty decent.  Not right now because I'm in the adjusting to a new diagnosis period.  But in usual times, I don't really have any positive or negative mood symptoms. 

 

(I have to go to bed, but appreciate the conversation and would love to finish it when it's not my bedtime 😉 )

[DogMan]

night

 

just on social isolation: do you feel like you would like to, but something is holding you back (anxiety, fatigue, whatever) or is it more that you just hav no interest? or even that the idea of interacting with people rarely even occurs to you unless you have to?

[dancesintherain]

2 minutes ago, DogMan said:

night

 

just on social isolation: do you feel like you would like to, but something is holding you back (anxiety, fatigue, whatever) or is it more that you just hav no interest? or even that the idea of interacting with people rarely even occurs to you unless you have to?

it's probably more social anxiety disorder than anything else, now that I think about it.  I'd say it's more that I'm being held back from anxiety but would like to interact with friendly people.  I have an interest, just not the strength or ability for it.  I struggle to make friends (and don't in many settings).

[DogMan]

i guess that sorta encapsulates it?

 

presence of anxiety vs absence of that brain function/interest?

[DogMan]

Quote

Assessment for negative symptoms

The four major clinical subgroups of negative symptoms are affective, communicative, conational, and relational.

Affective. Blunted affect—including deficits in facial expression, eye contact, gestures, and voice pattern—is perhaps the most conspicuous negative symptom. In mild form, gestures may seem artificial or mechanical, and the voice is stilted or lacks normal inflection. Patients with severe blunted affect may appear devoid of facial expression or communicative gestures. They may sit impassively with little spontaneous movement, speak in a monotone, and gaze blankly in no particular direction.

Even when conversation becomes emotional, the patient’s affect does not adjust appropriately to reflect his or her feelings. Nor does the patient display even a basic level of understanding or responsiveness that typically characterize casual human interactions. The ability to experience pleasure (anhedonia) and sense of caring (apathy) are also reduced.

Communicative. The patient’s speech may be reduced in quantity (poverty of speech) and information (poverty of content of speech). In mild forms of impoverished speech (alogia), the patient makes brief, unelaborated statements; in the more severe form, the patient can be virtually mute. Whatever speech is present tends to be vague and overly generalized. Periods of silence may occur, either before the patient answers a question (increased latency) or in the midst of a response (blocking).

Conational. The patient may show a lack of drive or goal-directed behavior (avolition). Personal grooming may be poor. Physical activity may be limited. Patients typically have great difficulty following a work schedule or hospital ward routine. They fail to initiate activities, participate grudgingly, and require frequent direction and encouragement.

https://www.mdedge.com/psychiatry/article/66140/schizophrenia-other-psychotic-disorders/negative-symptoms-schizophrenia-how

 

that is pretty good IMO, and i relate to far too much of it

[aura]

I wondered about negative symptoms when I first got my SZA diagnosis too. Either I don't get them or the clozapine is treating them, because I don't really have issues with affect anymore. 

[dancesintherain]

thanks @dogman and @aura (I couldn't fall asleep)

Dogman, most of what you mention/cite does not feel similar to me.  I'm thinking it actually was a mini-depressive episode (really mild).  I did score in the mild depression range on the Beck's Depression inventory. 

not saying they won't ever develop,, but fortunately it seems like I'm free from them right now. 

[DogMan]

that is good

 

mine tend to really mess up interacting with hoomans. Particularly with regular contact when they realise you weren't just sleep deprived or having one isolated bad hair day

[saintalto]

I was told by my pdoc when I had symptoms that I thought could be negative that negative symptoms are rare in people with Schizoaffective. It’s not unheard of, just rare. Negative symptoms are much harder to treat than depression even though the two can be similar. What I had did turn out just to be depression and I responded to a higher dose of Wellbutrin. 

 

[dancesintherain]

thanks @DogMan and @saintalto.  I'm going with depression because it was responsive to a lamictal change and wasn't a persistent thing--it was about 2-3 weeks.