[Victoria'smom]

I feel empty, like in my chest, I'm isolating, I really wanted to sleep through the weekend but I'm not sleepy. T is going to do an assessment as always Tuesday and I have no idea what to say. I don't feel unsafe or a threat to myself. but they ask about sleeping through things and I would if I could not forever just until I feel better he doesn't know me well yet so I don't have his trust. It's not like it's bad yet if it is depression. I have 10 days to fix this until I'm without support for a week in a highly triggering situation

[MuddyBoots]

Which do you think it is? From what I gather (mostly just online stuff, we hardly talk about negative symptoms explicitly because I don’t really have those), negative symptoms are more of the person’s traits at baseline regardless of mood. They could be super happy or completely despondent and others would have a hard time gathering that from body language and tone and stuff whereas depression is more mood-focused and will involve experiencing primarily negative feelings and thoughts and is a shift from baseline.

I’ve been kind of all over the place but you seem to have that mood aspect in there to me. Not just appearing empty but feeling the emptiness, wanting to sleep “until things are better.” You can ask your T how they would differentiate between the two and maybe they could say “well I noticed x, y, and z,” (though I know you have relatively new people so it’ll be hard to trust their judgement but it’s worth seeing what they have to say anyway).

[Victoria'smom]

I can't tell if it's mood or situational or just negative symptoms and I don't trust him yet. I'm worried about checking the box on the suicide check list but not being suicidal.

[HALLIEBETH87]

it sounds like situational depression

[Scooter9]

You've gone through a lot, not just recently, but overall.

Being a parent is hard, add to that your own struggles, and adult child's struggles, and it's perfectly understandable that you're feeling bad. You're managing your mind, but your body is having a hard time keeping up, despite its best efforts.

Sometimes this is how we feel because our bodies need some kind of outlet, or relief. Personally, I would try to not ignore this, but I wouldn't actively do anything about it and let this pass on its own and in its own time. I'd acknowledge that it's happening, sleep when I need to, and as the cliche says, listen to and follow my body.

I think you're adding pressure to the situation by putting a timeframe around it.

Based on what you said, your situation will change on 10 days, but this might pass by then.

[Victoria'smom]

I have a 10 days to get better enough to mask because I'm going to my parents which is highly triggering. They're not triggering it's the place is and it's out of state so I won't be able to reach out to my team that week. I just don't know. V's getting better, slowly but she has to switch her team. My T doesn't really know me yet. So I'm worried I'll unintentionally worry him if I'm honest. Just a couple weeks ago my old T had me email my pdoc.

[Scooter9]

Yeah, perfectly understandable to be worried with a new T. They unfortunately tend to pathologize things that aren't really a big deal for you.

So, yeah, being careful is prudent. I think you can still be honest and selectively share until he gets to know you better.

You might feel different within the 10 days.

[Tart Cherry Jam]

Originally Posted by MuddyBoots

Which do you think it is? From what I gather (mostly just online stuff, we hardly talk about negative symptoms explicitly because I don’t really have those), negative symptoms are more of the person’s traits at baseline regardless of mood. They could be super happy or completely despondent and others would have a hard time gathering that from body language and tone and stuff whereas depression is more mood-focused and will involve experiencing primarily negative feelings and thoughts and is a shift from baseline.

I’ve been kind of all over the place but you seem to have that mood aspect in there to me. Not just appearing empty but feeling the emptiness, wanting to sleep “until things are better.” You can ask your T how they would differentiate between the two and maybe they could say “well I noticed x, y, and z,” (though I know you have relatively new people so it’ll be hard to trust their judgement but it’s worth seeing what they have to say anyway).

Gemini AI, when asked to play the role of an experienced psychiatrist, pretty much concurs with the above. Here goes:

Prompt: "For a change, play the role of an experienced psychiatrist. Tell me the difference between depression and negative symptoms in a schizoaffective disorder.

Gemini's generation:

It's an important question, and the distinction between depressive symptoms and negative symptoms in schizoaffective disorder is indeed one that can be subtle and challenging, even for experienced clinicians. They often look similar on the surface, but their underlying mechanisms and implications for treatment can differ.

Let's break down the differences from a psychiatric perspective:

Depression (as a Mood Episode)
When we talk about a major depressive episode in the context of schizoaffective disorder, we're referring to the mood symptoms that are also seen in Major Depressive Disorder (MDD). These symptoms reflect a disturbance in affect and cognition.

Key features of a depressive episode (DSM-5 criteria):

Depressed mood: Feeling sad, empty, hopeless, or irritable for most of the day, nearly every day.

Anhedonia: Markedly diminished interest or pleasure in all, or almost all, activities. This is a core symptom.

Weight/Appetite changes: Significant weight loss or gain, or decrease/increase in appetite.

Sleep disturbances: Insomnia (difficulty sleeping) or hypersomnia (sleeping too much).

Psychomotor agitation or retardation: Observable restlessness or slowed movements/speech.

Fatigue/Loss of energy: Feeling tired nearly every day.

Feelings of worthlessness or excessive/inappropriate guilt: Often pervasive and not easily dismissed.

Diminished ability to think or concentrate: Difficulty focusing, indecisiveness.

Recurrent thoughts of death or suicide: Ranging from ideation to plans or attempts.

Crucially, with depression, these symptoms are often accompanied by subjective distress. The person usually feels bad, knows they are depressed, and often seeks help or expresses a desire for things to change. There's often a sense of sadness, despair, or profound emotional pain.

Negative Symptoms (of Schizoaffective Disorder/Schizophrenia Spectrum)
Negative symptoms represent a diminution or absence of normal mental functions or behaviors that should be present. They are considered core features of psychotic disorders and can be particularly debilitating.

Key features of negative symptoms:

Diminished emotional expression (formerly "flat affect"): Reduced intensity in the expression of emotions through facial expressions, eye contact, intonation of speech (monotone voice), and gestures. The person might feel emotions but not show them outwardly.

Avolition: A decrease in motivated, self-initiated purposeful activities. This is more than just feeling tired or unmotivated (as in depression); it's a profound lack of drive to engage in even basic daily tasks (e.g., hygiene, work, school).

Alogia (poverty of speech): A decrease in the amount or fluency of speech. The person might give brief, empty replies, or appear to have difficulty thinking of what to say.

Anhedonia: (This one is tricky, as it overlaps with depression.) A diminished ability to experience pleasure from positive stimuli. However, in negative symptoms, it might be a more pervasive, baseline inability to anticipate or experience pleasure, rather than primarily a loss of interest due to low mood.

Asociality: Apparent lack of interest in social interactions, leading to social withdrawal. This is often due to a lack of motivation to seek social contact, rather than social anxiety or sadness (though those can also be present).

Crucially, people experiencing prominent negative symptoms often have less insight or subjective distress about these symptoms compared to depressive symptoms. They might not realize their affect is flat, or that they lack motivation. Family members often notice these symptoms more than the individual themselves. They can often appear apathetic or indifferent, even if they're not necessarily sad."

[Victoria'smom]

I'm pretty sure it's depression.