September 12th, 2023
Schizophrenia is a chronic mental illness that causes people to have episodes of psychosis, which means people lose touch with reality.
Symptoms are divided into positive and negative symptoms.
Positive symptoms (This does not mean “good.” It refers to symptoms that should not be ordinary):
Negative symptoms (Where people withdraw from the world around them and appear emotionless and flat):
In the US, there are 3.7 million adults living with schizophrenia spectrum disorders. Unlike the misconception of it being debilitating, people with schizophrenia can lead successful, productive, and fulfilling lives with loving relationships.
Schizophrenia is not curable; it is chronic and requires lifelong treatment. Schizophrenia can be managed by medications and psychotherapy.
Treatment of schizophrenia is usually lifelong and often involves a combination of medications, psychotherapy, coordinated specialty care services, and support and understanding could be very helpful. Antipsychotic medications, also known as neuroleptic medications, are usually prescribed to treat schizophrenia. They block certain brain chemicals to help control symptoms, prevent relapsing, and increase adaptive functioning.
The choice of medications and psychotherapy depends on the type of schizophrenia, the intensity of symptoms, and the level of care needed.
Cognitive behavioral therapy (CBT) has proven to be effective in the treatment of schizophrenia. There are many other options and different levels of care to help with different symptoms. For example, art therapy was found to be a good fit for some people with schizophrenia; others might benefit from rehabilitation programs. Compliance therapy, social skills, and personal therapies help provide psychoeducation about the importance of compliance to prevent relapse and possible hospitalization. Family therapy is encouraged alongside individual therapy to decrease rehospitalization and increase social functioning. Family members can learn about the symptoms and how to support their loved ones.
The first and most crucial step is to unlearn any assumptions you have about schizophrenia. People are not defined by their diagnosis, and chronic mental illnesses come with a huge stigma and misconceptions. To support our loved ones, we need to come from a place of understanding of what they’re going through. So, let’s delete all those assumptions to make space for some learning.
There are so many myths and misconceptions about schizophrenia that contribute to the “judgment” and bias people have when dealing with someone who is diagnosed with schizophrenia. A good place to start is maybe having a conversation with the therapist, the social worker, the psychiatrist, or the primary doctor if you struggle with finding reliable resources.
You can learn more about the types of schizophrenia and how they present differently and ask about the available treatment options. If your loved one agrees, you can schedule to attend one of the therapy sessions together. For example, in a couple’s or family therapy session, you can both have conversations about how to navigate this together and listen to how they want to be supported.
It's also helpful to listen to the person with schizophrenia, their concerns, and the difficulties they had to go through trying to manage their diagnosis. Listen to their experience so you can understand and see things from their point of view. It is important to listen with empathy and understanding as they share the stress they have been going through with you and be OK with the fact that they might not share anything.
Sometimes, we want to help and support so much that we cross some personal boundaries. Always remember to respect their wish, not to share if they choose to, and be patient. Give them time and space; they may need to process things independently. Once they are ready to talk, listen with patience and empathy.
As you may already know (or when you learn more about symptoms), the hallucinations (hearing voices) and delusions (beliefs that are not true) of schizophrenia can be intense. They feel very real to your loved one. Research using brain-scanning equipment shows changes in the speech area in the brains of people with schizophrenia when they hear voices. These studies show the experience of hearing voices as a real one as if the brain mistakes thoughts for real voices. It will not help if you say things like “It’s just in your head,” or “Stop making things up,” or make fun of it. This makes it very difficult and frustrating for your loved one to come to talk to you or reach out for help. They might avoid you to avoid their feelings getting hurt.
Empathize with your loved one when they go through this, be supportive and patient, and offer help by asking them, “What can I do for you?” or “How can I support you through this?”. You can also be supportive during the hallucination by saying, “This must be a very scary experience for you.” It is very helpful, too, if you plan ahead! This means you can ask how you can support them during the symptoms before the symptoms start. Ask them what symptoms you should watch for. Sit with them to write a crisis plan and try to find out with them what the triggers are to be able to plan how to cope with them. Keep in mind the episodes are not usually long. Good planning and support can ease those episodes and reduce the fear and stress that accompany them.
And don’t be upset if they ask for space. Sometimes, it’s what helps; you provide help and support by doing this. Schizophrenia can be very difficult, and some of its symptoms affect how people communicate with others. Keep in mind that these are symptoms of a mental illness and not them trying to push you away; people are not their diagnosis. So don’t take it personally.
You are helping them through what they’re going through but not taking over the things they can do. Support them while encouraging their independence as much as possible.
This situation was found to be usual and common with people suffering from mental illnesses. According to the Mental Health Million Project, “In the United States, 45% of individuals with a clinical-level mental problem do not seek professional help.”
People with schizophrenia might refuse treatment for different reasons, one of which is the stigma around mental illness in general and the stigma and misconceptions around schizophrenia. Some people with schizophrenia do not seek help because of a lack of knowledge of the treatment available and what kind of help to seek. Some people with schizophrenia do not believe the treatment works, and others mistrust the health system. Overall, the primary reason was found to be the belief they can manage their symptoms on their own without seeking help or treatment.
No matter how much you care for your loved one, their autonomy and decisions must be respected. You cannot force people into treatment against their will. A good conversation and active listening might help determine why they refuse to seek help. Have the conversation away from distractions, listen with understanding and not judgment, and ask open-ended questions like “What makes you afraid of taking medications?” or “What is it that you do not find helpful about treatment?” rather than saying “Why don’t you take your medications?” or “Did you take your medications?”. Understanding their reason will help to understand what kind of help and support they need. Remember to stay emotionally calm so you do not trigger feelings of being unsafe. Hearing from them and creating a plan with them will help support their independence.
You can’t pour from an empty cup! Taking care of someone else can take a lot of time and energy and might lead to emotional and physical burnout. To avoid burnout, it's essential to have a self-care routine. Here are some helpful tips to get you started:
Written by: Sara Fakhri, MA
At Clarity Clinic, we have highly trained staff specializing in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.
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