Key Takeaways
- Alogia is a symptom of schizophrenia that makes it hard for people to speak or talk much.
- It can cause people to give very short answers or take a long time to respond when talking.
- Alogia might also happen from other illnesses or even stress and fatigue.
Alogia comes from the Greek words meaning “without speech” and refers to a poverty of speech that results from impairment in thinking that affects language abilities. More specifically, it involves using fewer words, answering only what is directly asked, and speaking in a way that may be vague, repetitive, or overly concrete.
Alogia can be a symptom of various conditions, but it is most commonly associated with schizophrenia and is considered a “negative symptom,” meaning that it takes away the ability to do something.
If you are living with alogia, or know somebody who is, you will know that it can impair your ability to hold conversations and may lead to social isolation. For this reason, it is an important symptom to understand, in terms of how to manage and cope as best you can.
Alogia Symptoms
While most symptoms related to alogia are considered “negative” symptoms of schizophrenia (that appear early in the course of the illness before a psychotic break, such as up to 1 to 3 years prior), alogia actually involves both positive and negative symptoms.
The positive symptoms emerge when there is poverty in the content of speech (meaning that it becomes disorganized or incoherent).
The negative symptoms relate to things like thought blocking, response latency, and poverty of speech. About 15 to 30 percent of those with schizophrenia have negative symptoms. These are described in more detail below.
A person experiencing alogia may exhibit any or all of the following negative symptoms:
- giving replies to questions that are overly brief or concrete (giving short, one-word answers)
- not speaking spontaneously (only giving an answer to what was asked of you)
- laconic (blunt) speech or poverty of speech (not using many words)
- normal amount of speech but the speech is nonsensical
- vague, empty, or repetitive ways of speaking
- poverty of content (talking without really saying anything)
- thought blocking (stopping speaking in the middle of a sentence because the thought has been lost)
- taking a long time to respond to questions or taking a long time to speak from one word to the next (long pauses between words)
- failing to answer at all when asked direct questions
- slurring words when speaking
- not pronouncing consonants clearly or ending words at the second syllable
- trailing off into a whisper at the end of sentences
- having trouble finding the right words when speaking
- having trouble formulating thoughts enough to speak
- having a flat tone when speaking
- having a dull facial expression during conversation
To summarize, alogia is one of five types of negative symptoms that are present in schizophrenia (blunted affect, anhedonia, asociality, and avolition are the other four).
Causes
Alogia can be caused by schizophrenia or by other illnesses such as severe depression, bipolar disorder, traumatic brain injury, dementia, Alzheimer’s, or schizotypal disorder.
Alogia can also be a secondary effect, resulting from primary symptoms such as psychosis or anxiety. For example, you might choose not to speak, because there are voices in your head threatening you if you do. Similarly, you might not speak due to feeling paranoid around other people or nervous/anxious.
In order to determine that alogia is caused by schizophrenia, it is necessary to first rule out other organic mental disorders.
In schizophrenia, it is considered a negative symptom related to the illness.
In contrast, in the case of illnesses involving dysfunction of the central nervous system, such as what is found with dementia or other illnesses that involve mental deficiency, alogia has a different cause.
Alogia may even appear in those without a mental illness, as a result of a disruption in thought processes due to extreme stress or fatigue. In this sense, alogia may appear on a continuum from mild to severe depending on the source of the symptoms.
With schizophrenia, alogia involves a disruption in the thought process that leads to a lack of speech and issues with verbal fluency. For this reason, it is thought that alogia that appears as part of schizophrenia may result from disorganized semantic memory.
What’s more, it’s believed that this may be caused by brain dysfunction which causes the semantic store to degrade, which is the part of the brain that helps you to process language and the meaning of words. This explains why those with alogia produce fewer words overall and have trouble with finding the words to say what they want to say.
Research
In a study of 38 people with schizophrenia and 38 controls, those with schizophrenia demonstrated disorganized semantic structure in their language, meaning that they made strange associations between words. This suggests once again that alogia related to schizophrenia is due to semantic memory disorganization.
In summary, alogia seems to be related to how your brain obtains words and meanings from your long-term memory stores. When different parts of the brain have difficulty communicating with each other, this can create the symptoms that manifest as alogia.
Clearly more research is needed to fully understand the cause and effect; however, if you live with alogia, know that this is most likely a primary symptom of schizophrenia and not simply an after-effect. In other words, it’s not that you just need to “try harder” (or that a friend or relative needs to try harder, if you know someone with this illness).
Examples of Alogia
Below is an example of a conversation with someone with alogia. Following that is an example of a conversation with someone without alogia. Notice that there are differences in how much information is spontaneously offered when asked questions.
Alogia: Poverty of Speech
Q: Do you have a job?
A: Yes
Q: What is your job?
A: Janitor
Q: Where do you work?
A: At the school
Non-Alogia Example
Q: Do you have a job?
A: Yes, I work as a janitor. I do the night shift.
Q: Where do you work?
A: I work at Woodside College, it’s a school on the other side of town.
Alogia Example #2 (incoherent speech, vague, little information actually provided)
Q: Why do you work as a janitor?
A: To explain that… it’s the tendency to do it…. some times more than other times…. the thing that happens… you know, the way the world works… that’s what I think about.
Non-Alogia Example
Q: It’s good money and I like working nights. Not too many people around and it’s quiet.
Alogia Treatment
Treatment for alogia follows along with treatment for the underlying condition. In the case of schizophrenia, this typically means a combination of medication and therapy. Below are the main ways that medication and therapy may be used in the treatment of alogia.
Medication
Medications such as second-generation antipsychotics or antidepressants may be used to treat alogia. However, medications can sometimes have adverse effects. If you will be taking medication, it is important to work closely with your doctor and to take the medication exactly as it is prescribed.
Therapy
What forms of therapy are helpful for alogia? It all depends on the underlying cause. For example, in the case of an organic mental disorder such as dementia, speech therapy might be used. In the case of schizophrenia, social skills training or family education might be offered.
Coping With Alogia
Living with alogia can have impacts on your quality of life. You may withdraw socially from family and friends due to an inability to carry on a conversation or organize your thoughts.
Your ability to find work, hold a job, or interact with coworkers or customers could also be affected. This could have long-lasting effects on your quality of life.
Know first of all that social situations will tend to worsen alogia. When there is a lot of external stimulation, it will be harder for you to process your thoughts and produce verbally.
Below is a list of things that you could do to help manage alogia or to help a family member or friend who is living with alogia:
- Make sure those around you know that your lack of speech is a symptom of your illness so that they can learn more about this symptom and understand what you are experiencing.
- Be aware of your limitations and avoid putting yourself into stressful situations that will exacerbate your alogia symptoms when possible.
- Work with your doctor or mental health professional on a plan for coping and what you will do if your symptoms worsen. It’s always better to put a plan in place when you are thinking more clearly than to wait for those times when your symptoms are severe.
- If you have been prescribed medication or are attending therapy, follow the protocol as outlined so that you obtain the full effect.
- Take a video of yourself on your good days, reminding you that there are better days ahead if you can make it through the tough ones. Replay that video for yourself on the days that you are struggling.
- Read books, watch videos, and educate yourself about what you are experiencing so that you have a better understanding yourself. While this won’t mitigate your symptoms, just having a better understanding of what you are experiencing may help to lower your level of stress.
If alogia seems to result from anxiety or from primary symptoms, talk to your doctor or mental health professional about treating those other issues that are contributing to alogia.
You can ask a friend or family member to monitor your symptoms and to make you aware if they seem to be getting worse so that you can follow up with your doctor or mental health professional. It may be hard to recognize this yourself.
Look for community supports or those through a workplace (if you are working) to help you manage tasks of daily living. If you tend to isolate yourself due to alogia, it could also be helpful to join a support group or other situation where you are regularly meeting with others so as to avoid becoming completely isolated.
Be kind and compassionate toward yourself when experiencing alogia. Your symptoms are a result of your illness and not a personal failing. While they will be difficult to manage, the secondary effects of isolation and feeling bad about yourself are within your scope of control.
