Schizophrenia is a chronic mental illness that causes people to have episodes of psychosis, which means people lose touch with reality.
What are the Symptoms of Schizophrenia?
Symptoms are divided into positive and negative symptoms.
Positive symptoms (This does not mean “good.” It refers to symptoms that should not be ordinary):
- Hallucinations: Hallucinations are where someone sees, hears, smells, tastes, or even feels things that don’t exist outside of their mind. The most common hallucination is hearing voices.
- Hallucinations are very real to the person experiencing them, even though the people around them cannot hear the voices. Those voices can be different from one person to another. For some, they are nice and friendly, and for others, they are annoying, critical, mean, and abusive.
- Delusion: Delusions are unrealistic beliefs held with complete conviction. They seem very real to the person affected, and they can change the way they behave. Delusion can be presented as:
- Paranoia: Belief that others can read your thoughts, plot against you, or secretly monitor your activities.
- Grandiosity: Belief that you can control other people’s minds or that you are a well-known historical or media figure or an important and influential person.
- Anosognosia: Lack of insight or ability to perceive one’s illness. It is not the same as denial of illness.
Negative symptoms (Where people withdraw from the world around them and appear emotionless and flat):
- Not taking care of themselves, like their personal hygiene.
- Feeling disconnected from their feelings and emotions.
- Wanting to avoid people like family and friends.
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.
4 Ways to Support a Love One with Schizophrenia
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.
- Do your Research and Learn About Schizophrenia
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.
- Do Not Judge
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.
- Empower Your Loved One
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.
When a Loved One with Schizophrenia Refuses Treatment
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.
Helping Your Loved One Get Schizophrenia Treatment
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:
- Talk to someone and share how you feel. You can talk to a trusted friend who you can talk to without being judged, or you can talk to a therapist. Find out about support groups where you can join others who go through the same thing.
- Understand the limits of how much you can do and be more realistic. Discussing coping strategies with a professional or keeping a journal to track your limits and when to take breaks can be helpful. Emotional burnout can manifest in various ways, so it’s crucial to identify the signs and ask for help when necessary. Additionally, it’s essential to make time for activities that you enjoy
- Focusing too much on the diagnosis can create feelings of anger, not just towards the diagnosis itself but also towards the person you’re caring for. Instead, focus on the positive aspects of your relationship – the things you have in common and enjoy doing together. Remember that this person is not just someone you’re caring for; they are also your friend, partner, or family member. Take time to talk about your relationship and explore ways to make it stronger.
- Planning your day, staying organized, and taking breaks can help reduce overwhelm and stress. Daily planners are a helpful tool to plan ahead for breaks.
- Know what support services are available for your loved ones. Ask their therapist or your own about resources and services in your area. You can also contact mental health facilities or hospitals for more information.
Helplines and support
- In the U.S.
- Call 1-800-950-6264 or visit NAMI.org
- Call 0300 5000 927 or visit Rethink: Schizophrenia
- Call 1800 18 7263 or visit Sane Australia
- Visit Canadian Mental Health Association for links to helplines and services
- Call the Vandrevala Foundation Helpline at 1860 2662 345 or 1800 2333 330