The Invisible Symptoms of Schizophrenia!
by Pam Maroney & Chris Lawton
When you hear the word ‘Schizophrenia’ what comes to mind?
You might automatically think of the words, ‘hallucinations’ or ‘delusions’. You might imagine a person looking anxious, and looking unkempt and dishevelled. You might imagine someone walking around the streets yelling out to no one that is there. You might even feel scared by their presentation or behaviours.
Not many of you would have imagined a person fully clothed, laying on top of their bed in the middle of the day, with the curtains drawn, perhaps staring into space, unable to get up and do anything. Would we be right?
Well this is because this type of presentation is due to symptoms of schizophrenia that are largely unknown amongst the general public. They are known as ‘negative symptoms’. In fact, up to 60% of people[1] with schizophrenia experience negative symptoms, which is why that image of a person laying on their bed, in a dark room, in the middle of the day, staring into space can be a reality for many.
Well, what are negative symptoms, you might ask. Negative symptoms are essentially an absence of something (instead of a presence — like hallucinations and delusions). They are the absence of a person’s motivation, or their drive, or their ability to concentrate, or to generate clear thoughts, or their ability to enjoy activities that they once used to. Now a person may not experience all of these negative symptoms, but can you imagine if some of these things were happening to you and how that would impact your everyday life!?
Often these types of symptoms are known by their psychiatric terms, such as, avolition, alogia, apathy, anhedonia, and attentional deficits. And just like these terms are likely to be incomprehensible to those untrained in psychiatry, it is incomprehensible to imagine the impact they can have on your life if you are not experiencing them yourself.
In fact, they have such a devastating impact on a person’s ability to function — that just doing day-to-day activities, like cleaning, cooking and shopping can become difficult. Therefore can you imagine how hard it would be to be able to study or work if you were experiencing negative symptoms? It seems impossible, and this is why employment and education rates are low amongst people with schizophrenia compared to the general population. Also, think about the age of when schizophrenia is commonly diagnosed. For almost two thirds of people it is before the age of 25. This is when they are excited to be starting out in new jobs or careers, not to mention socialising with friends, developing relationships, and generally having a good time. Not being able to do these things at that age would be heartbreaking, I know not many would choose to be laying on their beds, all alone in a darkened room, if they had a choice!
So you can see how people who experience negative symptoms may be perceived as being lazy to those around them. In fact, it is not uncommon to hear close family members saying “why can’t they just get a job?” with some even saying “they just need a good kick up the arse”. Friendships are often lost and intimate relationships break down, all due to this lack of understanding of negative symptoms. Not being understood, especially by those whom you deeply love and would ordinarily be your main source of support, despite best efforts to explain these negative symptoms to them, must be utterly heart wrenching. But it is not just friends and family that do not understand, the list of people who also have this same mentality and attitude is endless.
And unfortunately, this stigma continues on today.
If a person has a broken leg, it would be obvious as to why they couldn’t do certain tasks, such as, cleaning, shopping, or going to work, however a broken mind cannot be seen — which is why there is this misunderstanding of people with schizophrenia, especially those who experience negative symptoms, and even to those closest to them. Negative symptoms certainly are the invisible symptoms of schizophrenia!
It is very easy to feel scared or think that someone with schizophrenia is lazy, but it is important to try to have some empathy. It is also important to consider what life might be like in their shoes (or their mind!) and try to have some compassion. Just because you can’t see the symptoms doesn’t mean they are not real. For further information about negative symptoms go to https://livingwithschizophreniauk.org/information-sheets/negative-symptoms-understanding/