Alogia, also referred to as poverty of speech, is a speech disturbance common to several mental and neurological conditions including dementia, schizophrenia, and some mood disorders.1 It is the reduction in the quantity and quality of speech, and is usually caused by brain abnormalities. Alogia may be treated with a combination of medication and speech therapy.2,3
What Is Alogia?
The term alogia comes from the Greek word meaning “without speech,” and refers to difficulties with communication, such as identifying words or speaking in coherent ways.1Alogia occurs on a spectrum, ranging from mild to severe speech limitations.
In more mild cases (i.e., dislogia), people with alogia may struggle to find the right word, take long pauses, mispronounce a word, or give shorter responses. A person experiencing severe alogia may slur, mix up, or mispronounce words, and possibly be unable to speak in complete sentences.2,4
Alogia usually reflects problems with the brain’s long-term memory recall, semantic structure of language, or executive functions. The paucity of speech seen in alogia presents differently, depending on the underlying condition or problem causing it.2,5,6
Poverty of Speech Vs. Disorganized Speech
Poverty of speech (alogia) and disorganized speech are often confused, although they both impact people in different ways. Alogia refers to a decrease in the amount of words a person says, while disorganized speech refers to jumbled and nonsensical speech. People with disorganized speech often have disorganized thoughts (e.g., delusions or psychosis), whereas a person with alogia struggles more with memory recall of words.1,7
For example, someone with disorganized speech may repeat words, make up words, use the wrong word, or put words that don’t belong together in a sentence. On the other hand, a person with alogia is often unable to think of or pronounce certain words, and may take long pauses or speak less.4,6,7
Alogia Symptoms
The symptoms of alogia can vary from person to person, and depend on the underlying disorder or injury in the person’s brain. When the symptoms are severe, they can limit a person’s ability to socialize and function normally. Often, alogia occurs in addition to other neurological, cognitive, or emotional symptoms linked to the underlying condition.2,4,6
Alogia is considered a negative symptom of schizophrenia, which refers to the absence of normal functions (e.g., speech or emotions). In some cases, alogia presents along with other negative symptoms like avolition (i.e., lack of motivation) or apathy (i.e., lack of emotions).
Symptoms of alogia may include:1,4,6,7
- Marked decrease in frequency, amount, or quality of speech
- Being unable to remember or recall certain words
- Using fewer words or a restricted vocabulary
- Giving no reply or only brief, one-word responses to questions
- Lack of spontaneous speech (only speaking when asked a question)
- Thought blocking (stopping mid-sentence because of a ‘lost thought’)
- Abnormally long pauses between words
- Not pronouncing certain sounds or syllables clearly
- Slurring or mixing up pronunciations of words
- Struggling to formulate thoughts and responses
- Poverty of speech content (talking but not saying much)
- Not being able to elaborate on a topic when prompted
- Not being able to maintain a normal pace or flow of conversation
- Lack of emphasis on words or fluctuation in tone when speaking
What Causes Alogia?
Alogia isn’t a distinct disorder, but instead is a symptom associated with a number of underlying disorders. When alogia occurs as a result of a traumatic brain injury, it’s usually caused by damage done to specific regions of the brain that control speech, language, executive functioning, and memory.6
These frontal regions of the brain are also believed to be involved in alogia that’s caused by thought disorders like schizophrenia. Alogia often indicates executive dysfunction in the brain, and severe symptoms are associated with invasive forms of these disorders.5,6
Possible causes of alogia symptoms include:1,2,6,7
- Schizoaffective disorder
- Schizophrenia
- Traumatic brain injuries
- Brief psychotic disorder
- Major depressive disorder
- Bipolar disorder
- Alzheimer’s disease
- Parkinson disease
- Dementia
- Acute stress disorder
- Mental fatigue
- Delusional Disorder
- Anxiety disorders
Examples of Alogia
Because alogia may be caused by different conditions, there are also several ways in which it can show up. Having a few different examples of alogia can help people understand what it looks and sounds like.
Here are a few different examples of alogia in the context of a conversation:
- Question: “What have you been up to lately?”
- Long pauses in response: “Uhhhhh… I…. working. Working a lot.”
- Question: “I am so looking forward to the weekend, what about you?”
- Lack of response: The person is trying to find words, may even move their lips in an attempt to respond, but cannot
- Question: “Where have you been? I’ve been trying to call you!”
- Incoherent response: “Sh..orry I did-annndd know” (Trying to say, “Sorry I didn’t know” but unable to pronounce some of the words right)
Treatment Options for Alogia
Treatment for alogia depends on the underlying cause. In cases of sudden and unexplained alogia, a person may need to undergo medical exams, MRI/CT scans, or psychiatric assessments to determine the diagnosis. Identifying the underlying disorder causing alogia is essential, as this will often determine what the correct treatment is. Alogia may be treated with speech therapy, mental health treatment, or medication.3
Therapy for Alogia
The most common type of therapy for alogia is speech therapy, which involves working with a speech therapist to regain or improve the ability to speak clearly. This is often necessary for people who have experienced a brain injury or accident, but may also be recommended for alogia caused by mental or neurological conditions.8
When alogia is caused by a mental health disorder, psychotherapy is considered the first-line approach. Therapy for alogia differs depending on the root cause, but could include communication and social skills training found in interpersonal therapy.3 You can start to find the right therapist by using an online therapist directory, which lets you narrow your search by location, insurance, and specialty.
Popular Choices For Online Therapy
BetterHelp – Best For Those “On A Budget”
Online-Therapy.com – Best For Multiple Sessions Per Week
According to 14 Best Therapy Services (updated on 1/16/2023), Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp and Online-Therapy.
Medications for Alogia
Depending on the cause and severity of symptoms, a treatment plan for alogia may include a combination of therapy and medication. The most commonly prescribed medications for alogia are antidepressants, such as SSRIs* and SNRIs*, and antipsychotics. In some cases, mood stabilizers may be recommended.3
*This medication has a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.
8 Tips for Coping With Alogia
Alogia can be a very debilitating and frustrating problem to deal with, and the recovery process looks a little different for everyone. Alogia often indicates a severe underlying psychological or neurological problem, so it’s important to seek professional help from a licensed professional. In addition, making healthy lifestyle choices can also help facilitate your treatment and recovery.
Below are eight tips for coping with alogia:9,10
- Get enough sleep: Getting eight hours of quality sleep helps your body and brain rest, recover, and primes it to function better the next day. Many people find that their symptoms worsen with poor sleep, so making sleep a priority is a good start.
- Consider meditation: Meditation is proven to lower stress, improve mental and physical health, and promotes optimal cognitive functioning. Adding a few minutes per day into your routine might make a difference in your symptoms, and is easy to do with a meditation app.
- Stay physically active: Exercise is great for your physical and mental health. It can help lower stress and anxiety, improve mood, and boost low energy. Try setting aside 30 minutes each day to get active–whether it be taking a walk, practicing yoga, or going to the gym.
- Avoid drugs and alcohol: Alogia is often caused by problems with the brain’s functioning, so adding drugs and alcohol into the mix can worsen symptoms.
- Have regular conversations: Regular interactions are important to help your brain re-learn how to speak normally. Start off with shorter conversations with people you’re close to, and gradually work up to longer, more involved discussions.
- Write things down: Writing and speaking use different regions of the brain, meaning you may be able to write things down more fluently than say them. Try using written forms of communication (e.g., emails, texts, etc.) to communicate longer or more complicated messages.
- Stick to your treatment plan: It’s important for you to stick to your treatment plan. Skipping out on this can slow or even reverse your progress. It’s important to be consistent with your appointments, medication, and any clinical recommendations provided to you.
- Join a support group: Support groups are excellent ways for people who struggle with similar issues and disorders to connect and support one another. You may not find specific support groups for alogia, but can often find ones for those with schizophrenia, depression, or neurological disorders.
How to Help Someone Exhibiting Alogia
If a loved one is struggling with alogia, providing support can prove beneficial. Because alogia makes it hard for a person to communicate, some of your conversations with them may be difficult or frustrating. Try to be patient and encourage your loved one.
If they’re really struggling, don’t push them and let them know you don’t mind it if they need a break. This could mean you do more of the talking or that you both agree to sit together quietly. Sometimes, it can be comforting for them to spend time with others without feeling pressured to talk.
Final Thoughts
Alogia can be a challenging symptom to experience and make it difficult to maintain communication with others. If you are experiencing severe speech disturbances, such as an inability to recall words, pronounce them, or speak in complete and fluent sentences, consider seeking medical help. Alogia can often be treated with a combination of counseling, speech therapy, and prescribed medications.1,3
For Further Reading
- The Best Speech Therapy Exercises to Regain the Ability to Speak / Flint Rehab
- Living Well with Schizophrenia / SAMHSA
- Taking Care of Yourself / Alzheimer’s Association
- Brain Support Network Support Groups
Alogia Infographics
