What Is Alogia (Poverty of Speech)?

Medically Reviewed by Smitha Bhandari, MD on March 11, 2024
3 min read

Some people are naturally quiet and don’t say much. But if you have a serious mental illness, brain injury, or dementia, talking might be hard. This lack of conversation is called alogia, or “poverty of speech.”

Alogia can affect your quality of life. If you can’t carry on a conversation, you may withdraw from friends and family. Or you may not be able to work. But with a doctor’s help, there are ways to manage this condition.

Alogia is often linked to schizophrenia. It’s considered a negative (and sometimes early) symptom of schizophrenia. It’s negative because it takes away your ability to do something.

If you have alogia, you might:

  • Pause for a long time between words
  • Give short or one-word responses
  • Answer only what someone asks you
  • Have a flat tone in your voice
  • Have dull facial expressions
  • Use limited sign language (if you can’t hear)

Negative symptoms often come before a more serious psychotic break. Quick treatment may help you manage the condition better. If your child or loved one has alogia, they might not know. You may need to help them talk to a doctor.

Anywhere from 15%-30% of people with schizophrenia have negative symptoms. They may show up 1-3 years before behaviors like delusions.

Experts don’t know how many of those people will experience alogia. But it happens less often than some of the other symptoms.

You may get alogia if you have a serious mental illness like bipolar disorder or major depression. Neurological problems caused by a traumatic brain injury, dementia, or Alzheimer’s disease can also lead to alogia.

Experts aren’t sure, but they think it has something to do with how your brain gets information from long-term memories. That’s where words and their meaning are stored. Parts of your brain may have problems “talking” to each together. But more research is needed to find out exactly what’s going on.

Your speech problems may be caused by other things, like psychosis or anxiety. That’s called secondary alogia. For example, you may not talk because you hear voices that tell you not to speak. Or you might not talk because you feel nervous or paranoid around other people. In general, social situations can make alogia worse. That’s because it can be hard to think when there’s a lot going on. You may talk less when you’re stressed and your brain gets overwhelmed.

Researchers are working on medications specifically for alogia. Right now, the most effective treatments involve a mix of medication and psychosocial therapy. That may include:

Medication. Your doctor will likely give you a drug known as a second-generation antipsychotic. They might want you to try an antidepressant. Experts don’t know if these drugs treat alogia directly. But your speech may improve if primary symptoms, such as depression or delusions, go away.

Psychosocial treatment. Your alogia may get better if you get help in other parts of your life. Talk therapy or other types of therapy, social skills training, and family education might help.

Speech therapy. Dementia can cause problems in your brain that make it hard to find words. That’s called anomia. It can also make it hard to process full sentences. A speech-language pathologist can help.