Illustration © Mireia Azorin

I think that talking about the negative symptoms of schizophrenia means talking about the time since you are diagnosed it and you start the treatment until your death. So, it’s the same as talking about the rest of your life that you can enjoy once you have been given a diagnosis of schizophrenia. In my case, I would almost confirm that everything that is not an acute psychotic break is part of the negative effects. Because of the laxity of this definition, one can perceive how different and diverse the negative symptoms are. Of course, the life of people who have been diagnosed schizophrenia is large, as it tends to happen between 15 and 25 years for men and between 25 and 35 years for women. Just once you become an adult, the mental disorder interrupts and modifies the life project that you have, and a new interpretation and conception of your life starts.

For me, the negative symptoms are all these that make the ill people be less functional, the ones that make us lose some cognitive capacities (memory, attention and concentration), emotional capacities (anhedonia, apathy, lower motivation, among others), social capacities, such as the one to relate with people within our community, and also the fact of having sleep disorders and lack of organizational and planning capacities. These symptoms may lead us to lose, progressively, capacities, until the end of our days.

The negative symptoms are these that make of the mental disorder of the schizophrenia a chronic disorder, without the possibility of avoiding or controlling them. Furthermore, people who suffer it we might end up in a process in which we cannot even recognize that we have this scarcities. When the disorder becomes chronic, they are telling you that you are suffering the negative effects of schizophrenia and so you are never going to leave them behind, no matter how you reject them and opposed you are to them. It’s difficult to accept that things are like that.

Nonetheless, for people who suffer schizophrenia as I do, I will mention Albert Solà and Anna Cohí. I will particularly quote a fragment of his book: “Do you know what schizophrenia is?”. Then, it says: “It’s true that sometimes a person who suffers from schizophrenia might act in a non-common way, infrequent, but almost always is behaving in an appropriate way”. The extravagant, irrational, infrequent or unusual way in which people who suffer from schizophrenia behave is perfectly explained by the disorder. It has its explanation and we are congruent with our thought and mental state, but we are still ill and we can have important shortages.

Antipsychotic or neuroleptic medication tend to help with the negative symptoms or this is what prospects tell us. However, the certainty that this symptoms are battled in an efficient way is just a utopia. There are many secondary effects, and I would dare to stay that, in the long run, the weight of the extrapyramidal effects might be more revealed than the benefits. It’s been said that they are addictive (Joanna Moncrieff) and that, for instance, they cause a high cardiovascular risk in people of advanced age. Medication is not the panacea. In my opinion, it’s not worse the remedy than the illness, but it leaves a great deal to be desired.

In my case, fighting against the negative symptoms means assuming and understanding that I suffer them and I can voluntarily focus my efforts to understand them better. It often happens to me that I care more about the idea that I am limited by a sickness behavior such as the one of suffering the disorder and the negative symptoms and that I take part of it, than the willingness to overcome them.

I advice to develop the capacity to improve these abilities through training, to learn in introspection to know yourself in a spiritual way. Exercises like yoga, meditation and alternative therapies like music therapy or Bach flowers could be of big help, as well as physical activities and sports, to keep fit and think more clearly. If it’s not possible, I would at least suggest to keep on doing the daily cleaning tasks at home: washing clothes, do the shopping, cook, personal care, etc. It’s important to take into account the routines, as the adaptation to the environment will depend on them. I prefer to be valuated because of having an organized and harmonic home than for being a successful person.

We always think on improving, if there is a range of improvement. It’s the logic of anyone who has a bit of self-esteem. The negative symptoms have the key to establish whether people will evolve more or less favorably in a context that, a priori, is difficult to forecast.

To achieve this goal it’s important the monitoring of a psychiatrist, the medic team and the psychologist, who will follow our evolution in all its fields and complexity during the rest of our days.

Dani Ferrer