Battling with negative symptoms of schizophrenia

Steel Maiden · 10-07-2011, 06:12 AM

A lot of people with schizophrenia experience positive symptoms - delusions, hallucinations, thought disorder. When I'm very ill in hospital I get delusions and hallucinations, sometimes even thought disorder. Even when I'm at home and on a medication regime (like now), I hallucinate quite a lot, and I do admit I go through delusional moments.

But right now my negative symptoms (lack of motivation, inability to experience pleasure, depressed mood, not looking after myself etc) are more difficult to deal with.

Can anyone suggest ways I could help myself?

A friendly poster on my thread in Serious suggested that I play puzzles, that helps.

But I don't shower much, I don't brush my teeth as much as I should, and I am completely unable to study. Cooking a stir-fry last night felt like an exhausting task. And I didn't even enjoy the result like I normally would.

Everything seems like a huge effort.

Help?

spiders*web · 10-07-2011, 10:04 AM

Hi Steel Maiden. It sounds like the negative symptoms of schizophrenia are very similar to symptoms of clinical depression. I don't suffer from the former but I do suffer from the latter and I find a gradual building up of a routine is the only way to get me through those periods. It might not happen all at once but I write down what I eventually want to be doing each day. I wrote a similar list of things in another thread so I've pasted them in here.

Start off really small, and be proud of yourself when you achieve anything. To others it might seem tiny but all sufferers of depression will know what a big achievement it is to just get out of bed and wash.

Having a set getting up and going to bed time really helps. I put my alarm across from my room. It makes me get out of bed just to get rid of the annoying noise! Although in severe times you may be tempted to put up with it for fear of moving.

Have everything you would like to achieve that day written down. I know this isn't the whole answer, but having it written down will help when your concentration is poor. Thinking you've forgotten something will only increase anxiety. When you do achieve it tick it off with a smiley face! (I know that's sad but it always cheers me up a little!)

You note showering as something that is significantly missing in your life now. Try to make that a goal for one day. It only has to be the one goal of the day. And if and when you are able to achieve that think about adding brushing your teeth to the routine for the next day, building it up gradually. If you don't achieve everything, and you probably won't as we all seem to expect far more from ourselves than is realistically possible, concentrate on what you have done and remember that there is always tomorrow.

When you go to bed make sure everything is how you would like it to be when you wake up. For me it's a tidy room, clean bedsheets, me in jim jams and not my day clothes, clean face and stuff sorted that I need tomorrow ie clothes, books, etc.

Studying when feeling like this I often feel is nigh on impossible. I'm fortunate as I'm doing independent research so to a certain extent there is a flexibility of when I have to work. So it often helps to take a few days out to concentrate on building up those others things, the foundational things I tend to think of them, like washing, getting up, eating, keeping tidy surroundings. And when you return to study return slow. Try reading an article you know isn't going to cause you much trouble. And listen to yourself, you'll know if it's productive or not. If your head cannot take in the information then it is not worth studying at that moment in time. The important thing is to tell yourself that you tried, you're not well, and you need to look after yourself in other ways. Carry on with your routine and try again the next day.

Not being able to experience pleasure is a hard one to beat. So I tend to try my best to ignore it and do things that I know used to give me pleasure, perhaps not quite so often but I'll put it in my routine, like watching a film. The fact you made that stir fry is great. Don't concentrate too much on how you felt about doing it because it won't always be like that. The fact that you are doing it will help get you through these periods.

If you don't do as well as you wanted to do today, remember that tomorrow you can try again. Be kind to yourself, don't shout at yourself in your head or berate yourself. Tell yourself when you lie down to go to sleep that you did good today and tomorrow you can do it again.

I hope this helps in any way and I'm sorry for the length. I don't know how to do that thing where you hide the contents for space reasons?

Like I say I don't know what negative symptoms of schizophrenia are like to experience, unless they are very similar to depression, so I hope you get a reply from someone who has the same/similar diagnosis as you. Much love and hugs xxxxx

Ami · 10-07-2011, 12:45 PM

Hi steel,

I tend to get quite unsocial, keep in my room all day and hate talking to anyone. I do things over and over but ends up being pointless. I am forever 'tidying my room' but it never actually gets tidied. Sometimes I just sit and do absolutely nothing for days, i just dont care.

Do you find the aripiprazole helps with this type of stuff? I did when I first started it. But that effect seems to have gone now.

Things that help are just forcing self to do things and keep talking to people. Its really hard but thats the only thing I cn think of. After a shower I usualy feel a bit better anyways. Maybe antidepressants would help? To be fair, all 3 Ive been on (albeit all ssri's) were rubish.

Sorry not much help. I know what you mean though. xx

not_so_insig · 10-07-2011, 08:05 PM

I dont know what the solution is, but I suffer badly with lack of motivation, so I just wanted to say you are not alone. Negative symptoms suck.

Steel Maiden · 11-07-2011, 07:48 AM

Thank you everyone for the posts. Spider's Web, the advice you gave me was very good. I'm going to take points from your post and type them up and print them out so that I can remember to do those things.

The negative symptoms of schizophrenia are not far from depression, I agree.

I've tried two SSRIs (fluoxetine and citalopram) and they really disturbed me with the gastrointestinal effects (I have IBS which means that I'm susceptible to these things), and fluoxetine increased my anxiety and stopped me from sleeping properly.

The aripiprazole did help me a bit initially, but I feel a psychological exhaustion from my illness, which is probably preventing the meds from helping with the negative symptoms.

A good thing is that my friend C lent me a Microsoft Visual Basic .NET programming textbook, which has been keeping me quite busy as its something I used to do (with the old Visual Basic) four hours a day when I was 11 years old. So its bringing back a good hobby. But I find it hard to do it for more than 15-20 minutes at a time.

I'm really worried about my concentration span; I cannot concentrate for more than 15-20 minutes at a time. I have a 2hr 30min exam coming up next month! How am I supposed to focus? (the 30min is the 25% extra time)

makedamnsure · 11-07-2011, 09:03 AM

Hi Oly, I agree with Spiders web about the importance of routine.
I'd suggest writing down a kind of timetable including a shower and meal times and hanging on your wall or somewhere and trying to stick to it, even if you don't feel like you want to.

It sounds difficult about your concentration span. You have a month to try and work on it, so perhaps try and increase your activities by 5 mins at a time and see if you can concentrate? In the exam itself take water and some mints/sweets if you are allowed and you can have a little break every 20 minutes or so if you need one to just have a drink of water and a sweet before trying to concentrate again.

Steel Maiden · 11-07-2011, 09:13 AM

Quote:

Originally Posted by makedamnsure

Hi Oly, I agree with Spiders web about the importance of routine.
I'd suggest writing down a kind of timetable including a shower and meal times and hanging on your wall or somewhere and trying to stick to it, even if you don't feel like you want to.

It sounds difficult about your concentration span. You have a month to try and work on it, so perhaps try and increase your activities by 5 mins at a time and see if you can concentrate? In the exam itself take water and some mints/sweets if you are allowed and you can have a little break every 20 minutes or so if you need one to just have a drink of water and a sweet before trying to concentrate again.

Thank you, that is a good idea. I will try the timetable method. I really need to have a shower so I'll try really hard to do it this morning.

Increasing by 5 mins at a time sounds good, I will build up slowly. I am allowed to take mints or sweets in (as some of my exams are 3hrs 45mins), and I get 5 minutes rest break per hour. I will do that in the exam, take some squash (tasty and gives me energy) in a a bottle and some of my favourite boiled sweets.

Ami · 11-07-2011, 09:20 AM

If you get extra time, consider it as time to use to give yourself 'breaks' of 5 minutes after every 20. Sometimes juat having a few little breaks in exams can help, i find. I bet you do very well anyways. Do u get a seperate room?

At least you're doing something, like the .net stuff. (what is that by the way?) and i think structure is good even if only very loosely, or just 'aims for the day'.

Yea ssri's are nortorious for their gastro affects but there is lots of other antidepressants. Im not really sure what is 'second line' though. Maybe mention youre struggling at the minute to your cpn/psych/social worker/whoever and see what they suggest. I agree - It is mentally exhausting having voices all day and spies and imposters and everyone reading brain etc so i do empathize. Like already said, antipsychs seem only to focus on posirive symptoms, but maybe if they get better, the negative symptoms may ease too? Xxx

Ami · 11-07-2011, 09:22 AM

Sorry took me ages to post then someone said what i was going to say!

rara avis · 11-07-2011, 10:19 AM

I can really empathize with you Oly. The negative symptoms make the simplest things a huge task, or you forget them entirely. I used to be scrupulous with my hygiene, but I have (literally as someone mentioned) put up post it notes reminding me to shower etc. That only combats the memory, not the action though.

Concentration is a big one, I used to be a fanatical reader, I'd go through 3-5 books a week, but now, like you 10-20 minutes is the max I can manage.

I know absolutely none of that was helpful but I can indeed empathize.

Steel Maiden · 11-07-2011, 11:00 AM

Quote:

Originally Posted by Ami

If you get extra time, consider it as time to use to give yourself 'breaks' of 5 minutes after every 20. Sometimes juat having a few little breaks in exams can help, i find. I bet you do very well anyways. Do u get a seperate room?

At least you're doing something, like the .net stuff. (what is that by the way?) and i think structure is good even if only very loosely, or just 'aims for the day'.

Yea ssri's are nortorious for their gastro affects but there is lots of other antidepressants. Im not really sure what is 'second line' though. Maybe mention youre struggling at the minute to your cpn/psych/social worker/whoever and see what they suggest. I agree - It is mentally exhausting having voices all day and spies and imposters and everyone reading brain etc so i do empathize. Like already said, antipsychs seem only to focus on posirive symptoms, but maybe if they get better, the negative symptoms may ease too? Xxx

Five minute breaks every so often are a good idea. I do get a separate room, and a computer as I have significant handwriting problems. Thank you.

The .NET stuff is a programming language on the computer. I had to stop as I couldn't focus.

I am thinking that changing what topic I read or what activity I do every 20 minutes so that I don't feel I have to spend hours on one thing, which pressurises me.

Aims for the day - that's a good one.

Thank you for your kind words. I agree with what you said. I am having a medication review next week (I am seeing my psych with dad and C today about my overall treatment as my dad wants me to have CBT and I agree with him). I will ask about how to treat the negative symptoms. However they said they would taper me off the aripiprazole slowly and leave me on the olanzapine as polypharmacy is apparently not good. To be honest I want to come off the aripiprazole due to side-effects.

I will try and tell my psych about my negative symptoms today.

Quote:

Originally Posted by rara avis

I can really empathize with you Oly. The negative symptoms make the simplest things a huge task, or you forget them entirely. I used to be scrupulous with my hygiene, but I have (literally as someone mentioned) put up post it notes reminding me to shower etc. That only combats the memory, not the action though.

Concentration is a big one, I used to be a fanatical reader, I'd go through 3-5 books a week, but now, like you 10-20 minutes is the max I can manage.

I know absolutely none of that was helpful but I can indeed empathize.

Thanks Rara. Hugs to you, it is so hard I agree. When I was 11, having a shower or bath and then brushing my teeth was routine, I didn't think twice about it. Now I haven't had a shower for four days.

It was helpful to hear your experiences.

I used to be able to read a textbook in 2-3 days, so I know what you mean. But now all I can do is read Wikipedia articles, and even that I cannot focus on.

Steel Maiden · 11-07-2011, 12:31 PM

Bah. I was going to have a shower this morning and it never happened. Now I have about 15 minutes before I have to leave to go to an appointment. I will brush my hair and use a flannel. I really need a way to stop myself from being so forgetful and absent-minded.

Ami · 11-07-2011, 01:21 PM

how did your appointment go? I am on the same meds as you, but I'm very surprised at the lack of side effects on 30mg aripip and 5mg olanz. what side effects are you getting?

have you tried dry shampoo spray? I used to use it and its only about 2 pound a bottle. baby wipes are pretty useful for a quick freshen up. and mouthwash for when I see people hanging in the bathroom and scared to go in. or when I've forgot to brush teeth.

hope your ok x

Steel Maiden · 11-07-2011, 06:19 PM

My appointment was quite good but I am worried they will take me out of this accommodation and put me somewhere else.

I get dizziness, tachycardia, severe heat intolerance and nausea. But the olanzapine barely affects me. I am glad that you're not having side-effects.

Shampoo spray and mouthwash sound good, thanks.

I'm worried about the mum situation. But I am going to try and do some statistics revision tonight.