What mental illness is talking to yourself?

The following list, compiled by one mental health consumer, contains some of the typical early warning signs of schizophrenia. Keep in mind that schizophrenia onset is typically between the ages of 15 and 25 (although it can affect children younger than fourteen, with a subtype known as childhood-onset schizophrenia). The disorder can come on over a period of years (called insidious onset) or be very rapid. It affects 1% of the general population. The list is subdivided into Physical Symptoms, Feelings and Mood, Behavior, Cognitive Problems, Delusions, and Hallucinations.

Please remember that only a qualified psychologist, psychiatrist (or in some areas a social worker) can properly diagnose schizophrenia, or any other brain disorder. A psychologist or psychiatrist will use the clinical history of the person, as well as the symptoms and criteria in the DSM-IV (in the United States) to make a diagnosis.

Examples of Physical Symptoms—-

—A blank, vacant facial expression. An inability to smile or express emotion through the face is so characteristic of the disease that it was given the name of affective flattening or a blunt affect.
—Overly acute senses- lights are too bright, sounds are too loud.
—Staring, while in deep thought, with infrequent blinking.
—Clumsy, inexact motor skills
—Sleep disturbances- insomnia or excessive sleeping
—Involuntary movements of the tongue or mouth (facial dyskinesias). Grimacing at the corners of the mouth with the facial muscles, or odd movements with the tongue.
—Parkinsonian type symptoms- rigidity, tremor, jerking arm movements, or involuntary movements of the limbs
—An awkward gait (how you walk)
—Eye movements- difficulty focusing on slow moving objects
—Unusual gestures or postures
—Movement is speeded up- i.e. constant pacing
—Movement is slowed down- staying in bed (in extreme cases, catatonia)

Examples of Feelings/Emotions—-

—The inability to experience joy or pleasure from activities (called anhedonia)
—Sometimes feeling nothing at all
—Appearing desireless- seeking nothing, wanting nothing
—Feeling indifferent to important events
—Feeling detached from your own body (depersonalization)
—Hypersensitivity to criticism, insults, or hurt feelings

Examples of Mood—-

—Sudden irritability, anger, hostility, suspiciousness, resentment
—Depression- feeling discouraged and hopeless about the future
—Low motivation, energy, and little or no enthusiasm
—Suicidal thoughts or suicidal ideation
—Rapidly changing mood- from happy to sad to angry for no apparent reason (called labile mood)
—Severe Anxiety

Changes in Behavior associated with schizophrenia —-

—Dropping out of activities and life in general
—Inability to form or keep relationships
—Social isolation- few close friends if any. Little interaction outside of immediate family.
—Increased withdrawal, spending most of the days alone.
—Becoming lost in thoughts and not wanting to be disturbed with human contact
—Neglect in self-care- i.e. hygiene, clothing, or appearance
—Replaying or rehearsing conversations out loud- i.e. talking to yourself (very common sign)
—Finding it difficult to deal with stressful situations
—Inability to cope with minor problems
—Lack of goal-directed behavior. Not being able to engage in purposeful activity
—Functional impairment in interpersonal relationships, work, education, or self-care
—Deterioration of academic or job-related performance
—Inappropriate responses- laughing or smiling when talking of a sad event, making irrational statements.
—Catatonia- staying in the same rigid position for hours, as if in a daze.
—Intense and excessive preoccupation with religion or spirituality
—Drug or alcohol abuse
—Smoke or have the desire to want to smoke (70-90% do smoke) — note: this is a very normal behavior for people who do not have schizophrenia also!
—Frequent moves, trips, or walks that lead nowhere

Examples of Cognitive Problems Associated with Schizophrenia —-

—Ruminating thoughts- these are the same thoughts that go around and round your head but get you nowhere. Often about past disappointments, missed opportunities, failed relationships.
—Making up new words (neologisms)
—Becoming incoherent or stringing unrelated words together (word salad)
—Frequent loose association of thoughts or speech- when one thought does not logically relate to the next. For example, «I need to go to the store to buy some band-aids. I read an article about how expensive AIDS drugs are. People take too many street drugs. The streets should be clean from the rain today, etc» The need to go to the store to buy band-aids is forgotten.
—Directionless- lack goals, or the ability to set and achieve goals

—Lack of insight (called anosognosia). Those who are developing schizophrenia are unaware that they are becoming sick. The part of their brain that should recognize that something is wrong is damaged by the disease.
—Racing thoughts
—In conversation you tend to say very little (called poverty of speech or alogia)
—Suddenly halting speech in the middle of a sentence (thought blocking)

—Trouble with social cues- i.e. not being able to interpret body language, eye contact, voice tone, and gestures appropriately. —Often not responding appropriately and thus coming off as cold, distant, or detached.
—Difficulty expressing thoughts verbally. Or not having much to say about anything.
—Speaking in an abstract or tangential way. Odd use of words or language structure
—Difficulty focusing attention and engaging in goal directed behavior
—Poor concentration/ memory. Forgetfulness
—Nonsensical logic
—Difficulty understanding simple things
—Thoughts, behavior, and actions are not integrated
—Obsessive compulsive tendencies- with thoughts or actions
—Thought insertion/ withdrawal- thoughts are put it or taken away without a conscious effort
—Conversations that seem deep, but are not logical or coherent

Examples of Delusions—-

The most common type of delusion or false beliefs are paranoid delusions. These are persecutory in nature and take many forms:

—Overpowering, intense feeling that people are talking about you, looking at you
—Overpowering, intense feeling you are being watched, followed, and spied on (tracking devices, implants, hidden cameras)
—Thinking that someone is trying to poison your food
—Thinking people are working together to harass you
—Thinking that something is controlling you- i.e. an electronic implant
—Thinking that people can read your mind/ or control your thoughts
—Thinking that your thoughts are being broadcast over the radio or tv
—Delusions of reference- thinking that random events convey a special meaning to you. An example is that a newspaper headline or a license plate has a hidden meaning for you to figure out. That they are signs trying to tell you something.
—Religious delusions- that you are Jesus, God, a prophet, or the antichrist.
—Delusions of grandeur- the belief that you have an important mission, special purpose, or are an unrecognized genius, or famous person.
—Delusions that someone, often a famous person, is in love with you when in reality they aren’t. Also called erotomania or de Clerembault syndrome.

Examples of Hallucinations—-

—Hallucinations are as real as any other experience to the person with schizophrenia. As many as 70% hear voices, while a lesser number have visual hallucinations.
—Auditory hallucinations can be either inside the person’s head or externally. When external, they sound as real as an actual voice. Sometimes they come from no apparent source, other times they come from real people who don’t actually say anything, other times a person will hallucinate sounds.
—When people hear voices inside their heads, it is as if their inner thoughts are no longer alone. The new voices can talk to each other, talk to themselves, or comment on the person’s actions. The majority of the time the voices are negative.
—Visual hallucinations operate on a spectrum. They start with the overacuteness of the senses, then in the middle are illusions, and on the far end are actual hallucinations.

Disclaimer: The following symptoms overlap with many other diseases such as bipolar disorder, major depression, the various kinds of personality disorders (specifically paranoid and schizotypal personality disorders), and other problems such as brain tumors and temporal lobe epilepsy. There is no «typical» case of schizophrenia. Everyone has different symptoms. Seek the opinion of your doctor always.

Moreover, it is always important to keep the big picture in mind. Having just a few of these symptoms does not necessarily mean that a person has schizophrenia, or any other sort of psychiatric disorder. Almost all of the signs below can be present to a «normal» degree in people; it is when someone displays them to a significant degree that they can become psychiatric symptoms. Think if all of these behaviors as being on a continuum, in which the middle 99% of people displaying varying degrees of the behavior, but are still within the «normal» range. The 1% of people on the outer edges have the behaviors in extreme proportion, and/or a significant proportion of the time, and that is when they can become debilitating.

A diagnosis of schizophrenia requires that continuous disturbance (i.e. debilitating symptoms) be present for at least six months, including at least one month of certain key symptoms (active symptoms: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms such as severe emotional flatness or apathy)

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Is talking to yourself a sign of mental illness? An expert delivers her verdict

This article by Paloma Mari-Beffa, Senior Lecturer in Neuropsychology and Cognitive Psychology, Bangor University was originally published on The Conversation. Read the original article.

Being caught talking to yourself, especially if using your own name in the conversation, is beyond embarrassing. And it’s no wonder – it makes you look like you are hallucinating. Clearly, this is because the entire purpose of talking aloud is to communicate with others. But given that so many of us do talk to ourselves, could it be normal after all – or perhaps even healthy?

We actually talk to ourselves silently all the time. I don’t just mean the odd “where are my keys?” comment – we actually often engage in deep, transcendental conversations at 3am with nobody else but our own thoughts to answer back. This inner talk is very healthy indeed, having a special role in keeping our minds fit. It helps us organise our thoughts, plan actions, consolidate memory and modulate emotions. In other words, it helps us control ourselves.

Talking out loud can be an extension of this silent inner talk, caused when a certain motor command is triggered involuntarily. The Swiss psychologist Jean Piaget observed that toddlers begin to control their actions as soon as they start developing language. When approaching a hot surface, the toddler will typically say “hot, hot” out loud and move away. This kind of behaviour can continue into adulthood.

Non-human primates obviously don’t talk to themselves but have been found to control their actions by activating goals in a type of memory that is specific to the task. If the task is visual, such as matching bananas, a monkey activates a different area of the prefrontal cortex than when matching voices in an auditory task. But when humans are tested in a similar manner, they seem to activate the same areas regardless of the type of task.

In a fascinating study , researchers found that our brains can operate much like those of monkeys if we just stop talking to ourselves – whether it is silently or out loud. In the experiment, the researchers asked participants to repeat meaningless sounds out loud (“blah-blah-blah”) while performing visual and sound tasks. Because we cannot say two things at the same time, muttering these sounds made participants unable to tell themselves what to do in each task. Under these circumstances, humans behaved like monkeys do, activating separate visual and sound areas of the brain for each task.

This study elegantly showed that talking to ourselves is probably not the only way to control our behaviour, but it is the one that we prefer and use by default. But this doesn’t mean that we can always control what we say. Indeed, there are many situations in which our inner talk can become problematic. When talking to ourselves at 3am, we typically really try to stop thinking so we can go back to sleep. But telling yourself not to think only sends your mind wandering, activating all kinds of thoughts – including inner talk – in an almost random way.

This kind of mental activation is very difficult to control, but seems to be suppressed when we focus on something with a purpose. Reading a book, for example, should be able to suppress inner talk in a quite efficient way, making it a favourite activity to relax our minds before falling asleep.

But researchers have found that patients suffering from anxiety or depression activate these “random” thoughts even when they are trying to perform some unrelated task. Our mental health seems to depend on both our ability to activate thoughts relevant to the current task and to suppress the irrelevant ones – mental noise. Not surprisingly, several clinical techniques, such as mindfulness, aim to declutter the mind and reduce stress . When mind wandering becomes completely out of control, we enter a dreamlike state displaying incoherent and context-inappropriate talk that could be described as mental illness.

Loud vs silent chat

So your inner talk helps to organise your thoughts and flexibly adapt them to changing demands, but is there anything special about talking out loud? Why not just keep it to yourself, if there is nobody else to hear your words?

In a recent experiment in our laboratory at Bangor University, Alexander Kirkham and I demonstrated that talking out loud actually improves control over a task, above and beyond what is achieved by inner speech. We gave 28 participants a set of written instructions, and asked to read them either silently or out loud. We measured participants’ concentration and performance on the tasks, and both were improved when task instructions had been read aloud.

Much of this benefit appears to come from simply hearing oneself, as auditory commands seem to be better controllers of behaviour than written ones. Our results demonstrated that, even if we talk to ourselves to gain control during challenging tasks, performance substantially improves when we do it out loud.

This can probably help explain why so many sports professionals, such as tennis players, frequently talk to themselves during competitions, often at crucial points in a game, saying things like “Come on!” to help them stay focused. Our ability to generate explicit self instructions is actually one of the best tools we have for cognitive control, and it simply works better when said aloud.

So there you have it. Talking out loud, when the mind is not wandering, could actually be a sign of high cognitive functioning. Rather than being mentally ill, it can make you intellectually more competent. The stereotype of the mad scientist talking to themselves, lost in their own inner world, might reflect the reality of a genius who uses all the means at their disposal to increase their brain power.

Publication date: 3 May 2017

Talking to Yourself: Is It Normal?

Self-talk is a healthy way to build motivation, calm nerves or analyze a tricky situation. “It’s a useful way to check in with yourself and organize thoughts and feelings,” says health psychologist Grace Tworek, PsyD.

So, let’s get a conversation started on the topic.

Is self-talk healthy?

The practice of talking to yourself goes by many names. Some call it self-talk. Others refer to it as inner dialogue, inner monologue or inner speech. “There are so many terms for it because it really is just that normal,” notes Dr. Tworek.

So know that it’s OK to sit back and process things through an internal conversation. Taking the time to self-talk can decrease anxiety, boost self-esteem and increase productivity.

“It can be the pep talk you need at the time you need it most,” says Dr. Tworek.

Benefits of talking to yourself

So, what can you get out of a one-on-one chat with yourself? Here are some five potential benefits of self-talk, with sample conversation starters.

Critical thinking

Situational self-talk conversation starter: “How can the day get scheduled to get this to-do list done?”

This type of self-talk can help you break a situation down and organize your thoughts. Dr. Tworek explains it as “internal problem solving,” or a way to make a plan and stay on task moving forward.

Increased focus

Situational self-talk conversation starter: “Keep an eye out for deer on this road.”

An internal conversation engages more areas of your brain, allowing you to better pay attention to what’s happening around you. “Self-talk can be a powerful tool during a situation that requires more concentration,” explains Dr. Tworek.

Stress reduction

Situational self-talk conversation starter: “Take a deep breath. It’s going to be OK.”

An internal monologue can be used to regulate your emotions when a day takes a tough and unexpected turn. Conversations in your head can be calming and help you keep things together. “It’s about telling yourself that everything will be all right.”

Motivation

Situational self-talk conversation starter: “A five-mile run? That’s nothing. Let’s do it!”

Difficult tasks can feel daunting. Giving yourself a little encouragement can build confidence before taking on a challenging task. Studies show that self-talk can help athletes increase performance while in the cauldron of competition.

A personal check-in

Situational self-talk conversation starter: “What are you doing to yourself here?”

Ever lie in bed with your mind racing? Well, you’re the best person to step in and quiet the chatter in your head. “Tell yourself it’s time to take a break or get up and go in the other room for a few minutes,” suggests Dr. Tworek. “Give yourself permission to step away and relax.”

Tips for productive self-talk

To get the most out of your personal chat with yourself, try these tips:

Refer to yourself by name. Using your name instead of a pronoun allows you to self-distance to better process the conversation. “It gives you a little bit of emotional space,” says Dr. Tworek.
Stay positive. “If you’re negatively talking to yourself, it’s not really going to increase or help your performance,” notes Dr. Tworek. “So don’t be hard on yourself. Instead, try to make the conversation uplifting and productive.”
Emphasize your strengths. You know what you do best, right? Focus on your personal superpowers when you talk to yourself to build confidence and courage in whatever job awaits.

Is it OK to talk to yourself out loud?

There’s no rule that says your “inner dialogue” has to stay inside of your head. Talking to yourself out loud is perfectly normal. In some cases — such as when you’re trying to increase focus — it may even be more beneficial.

Be mindful of your setting, however. Talking to yourself might be ideal when you’re alone in your car or out on a hike, but it’s not as fitting if you’re on a crowded elevator.

“Make sure it’s appropriate for the moment,” says Dr. Tworek.

Can self-talk become a concern?

If self-talk is being driven by hallucinations — meaning you think you’re talking to another source — it’s best to seek out mental health services. Hallucinations could be a sign of conditions like schizophrenia.

“Self-talk needs to come with an awareness that you’re engaging with yourself,” explains Dr. Tworek.

Should you try talking to yourself?

If you’re comfortable doing it, absolutely. There’s something to gain by taking a few minutes to conduct an internal assessment. Think of it as a form of meditation where you gather your thoughts.

“In today’s hectic world, we often don’t take the time to literally just engage with ourselves,” says Dr. Tworek. “Don’t be afraid to get into your own head.”

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