Could Communication Issues Signal Mental Health Disorders?

Communication can sometimes go awry in any relationship. Perhaps a friend doesn’t respond to our excitement or disappointment in the way we hoped, or a family member misinterprets our feelings during a conversation. Small misunderstandings happen, and most of us brush them off as part of daily life. However, psychiatry suggests that when these miscommunications happen repeatedly with the same person, it may not be a matter of poor listening skills or lack of interest. Instead, it could be a sign of a change in social cognition — a critical cognitive skill that affects how we interact and relate to others.

Social Cognition and Mental Health Disorders

Social cognition is our ability to understand emotions, intentions, and beliefs in the people around us. It allows us to pick up on subtle cues, such as when someone is feeling down or excited, and to respond appropriately. However, research increasingly shows that impaired social cognition may be linked to various psychiatric conditions, including depression, bipolar disorder, and schizophrenia. For those affected, basic social situations may become confusing, leading to misinterpretations and responses that may seem odd or unempathetic.

When someone with impaired social cognition fails to understand or respond to the emotions of others, it can disrupt their relationships and daily life. For instance, they may not recognize when a friend is sad or might react inappropriately to a joyful moment. Such misunderstandings could be due to a decline in social cognitive skills, often resulting from underlying mental health conditions.

A Field of Emerging Research

At McGill University, assistant professor of psychiatry, Dr. Vanessa Jones, is focused on studying cognitive impairments associated with psychiatric disorders. Her work is part of a broader field that examines the link between social cognitive impairments and mental health conditions, and it aims to uncover ways to address these issues effectively. Dr. Jones’ research, as well as that of other teams, has identified varying degrees of social cognitive impairment across conditions like depression, bipolar disorder, and schizophrenia. Each condition may affect social cognition differently, but a common thread is that people with these impairments often struggle to interpret social cues and respond appropriately.

Dr. Jones explains that this is more than just an academic curiosity. The effects of impaired social cognition can significantly impact everyday functioning. Someone might be unable to read between the lines of a colleague’s joke or miss the subtle cues in a favorite TV series, leading them to feel out of sync with others.

The Real-Life Impact of Impaired Social Cognition

Dr. Jones and her colleagues conducted a literature review examining the effects of social cognitive impairment on people living with bipolar disorder. They found that individuals with significant impairments in social cognition struggled more in their daily lives, reinforcing the importance of this cognitive skill in maintaining functional relationships and understanding complex social dynamics.

Other studies also suggest that social cognition impairments mediate the relationship between broader cognitive issues (such as memory loss) and clinical symptoms in disorders like schizophrenia and certain types of bipolar disorder. For example, people with schizophrenia often experience memory issues, which can be compounded by a loss of motivation and emotional withdrawal. Social cognition impairments, such as difficulty recognizing emotions in oneself or others, play a central role in these problems and can lead to further isolation and misunderstanding in relationships.

Programs and Interventions to Improve Social Cognition

Fortunately, research is progressing on ways to support and improve social cognitive skills for those affected. Several programs have been developed that use exercises to help individuals improve their ability to recognize and interpret emotions, beliefs, and intentions. For example, some exercises involve practicing how to read another person’s expressions and respond to the underlying feelings or intentions. This type of intervention was initially developed for schizophrenia but has since been adapted for other psychiatric disorders, showing positive results across a range of conditions.

One exercise, for example, might involve reading a story where a young girl brings chocolates to an elderly woman who accepts them graciously but later discards them. After several months, the girl returns with another box, and participants are asked to consider the girl’s expectations and how she might react to different responses from the elderly woman. Such exercises can gradually help individuals identify areas where they struggle to interpret social situations and build strategies to manage these challenges. A recent meta-analysis on this approach in schizophrenia found that, after participating in these programs, people showed sustained improvement in symptoms, self-esteem, and daily functioning for up to a year.

These programs typically take place in clinical settings with the guidance of a therapist. Through practical exercises, individuals with social cognitive impairments can start to incorporate these strategies into their daily lives. The goal is to provide them with tools to help them respond more appropriately in social situations, which can lead to more meaningful and sustainable improvements in their relationships and quality of life.

Expanding Access to Support

Making these interventions widely accessible remains a challenge. Many people with social cognitive impairments do not receive the support they need, especially in rural or underserved areas. To address this, some researchers are exploring digital solutions. For example, Dr. Jones and her team began offering videoconferencing group sessions during the pandemic, targeting individuals with severe mental health conditions. Participants in these remote programs reported finding the sessions helpful and felt that their sense of well-being improved.

The benefits of these digital programs suggest a promising path forward. As access to mental health resources improves, more people may be able to receive the support they need, even if they cannot attend in-person sessions.

Helping Families Understand Social Cognition

For families and friends of individuals with mental health disorders, understanding social cognition impairments can also be beneficial. When a loved one repeatedly misinterprets others’ emotions or seems disconnected in conversations, it can be easy to misjudge their intentions. Dr. Jones notes that for families of those with schizophrenia, misunderstandings are especially common. Programs like AMI Québec aim to help families improve their communication and relationships with affected loved ones, even if these programs do not specifically target social cognition. By learning about social cognitive impairments, family members can better understand the challenges their loved ones face and respond with empathy.

Moving Forward: Future Research and Hope

The study of social cognition is a growing field with significant implications for mental health treatment. While there is still much to learn, researchers like Dr. Jones are making real progress in understanding the mechanics of social cognition and its role in mental health. Each breakthrough brings us closer to providing effective treatments that can improve the lives of people with psychiatric conditions.

There are still challenges in adapting these programs to meet individual needs, but the advances in digital tools and clinical approaches are making a difference. By addressing social cognitive impairments directly, mental health professionals can help those affected build stronger relationships and lead more fulfilling lives. Ultimately, better support for social cognition can mean a brighter future for those affected by mental health disorders and their loved ones.