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“The universe I live in
It is different than yours.
I will show you someday
And you will believe
Where death stalks all
Where trickery takes place
Where deception is king
Where demons rule
Where everything is cruel”
Dan Howler quoted these lines, describing the world from the eyes of someone with schizophrenia. Living with schizophrenia can be difficult not only for the patient but also for their loved ones too.
Before delving into the question of “How to help someone with schizophrenia,” it is important to understand the disorder.
Schizophrenia is a serious mental illness characterized by hallucinations, delusions, and disturbances in thoughts, perceptions, and behavior. It is a severe mental illness caused due to several reasons, including genes, trauma, and substance abuse.
Types of Schizophrenia :
According to research, there are 5 classical subtypes of schizophrenia. These are-
This was the most common type of schizophrenia until 2013 when the American psychiatric association determined that paranoia was a positive symptom of the disorder.
Hence, it was not considered a separate condition, but the subtype description is still used. Symptoms include echolalia, flat affect, and behavioral impairment.
Also regarded as disorganized schizophrenia, this variation is, removed from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). However, it is still recognized by the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
This condition signifies a display of behaviors applicable to more than one type of schizophrenia.
This subtype is used when a person has a history of schizophrenia but no longer shows any prominent symptoms. Residual schizophrenia usually includes more “negative” characteristics such as psychomotor difficulties, slowed speech, or poor hygiene.
Although catatonic schizophrenia was a subtype in the past editions of DSM, it is an argument that catatonia should now be more of a specifier. This is due to its prevalent occurrence in a variety of mental illnesses. This can look like autism or a stupor-like condition in someone with schizophrenia.
Early onset of schizophrenia usually occurs between the age of 13 to 18 years, and signs in these young people are generally difficult to diagnose. Early identification could often be confused with diagnosing other psychotic disorders like autism or attention-deficit hyperactivity disorder (ADHD).
Common Schizophrenia Symptoms :
A person with schizophrenia depicts a range of unnatural changes, commonly classified into 3 major categories.
- Cognitive symptoms – These refer to mental health and behavioral abnormalities that are difficult to detect early. Disorganized thoughts, disorientation, and memory problems are some common symptoms depicted by a person with schizophrenia.
- Negative symptoms – Disrupted behavioral and emotional patterns characterize these. Some common warning signs are social withdrawal, lack of interest, lowered self-esteem, frequent anxiety outbursts, disturbed coping skills, and inability to plan and execute tasks.
- Positive symptoms – These are characterized as behaviors not commonly associated with healthy individuals. A psychotic episode involves movement disorders and disorganized behavioral problems like inappropriate dressing, incoherent speech, unprovoked outbursts, hallucinations, or delusions. Such symptoms vary according to time. Treatment options are also available as per the intensity and nature of symptoms.
Characteristic Symptoms :
Some expected changes to be noticed in people with schizophrenia are as follows
- Delusions – Holding on to false beliefs or imagining conspiracies without evidence or even after proven otherwise.
- Hallucinations include seeing or feeling things that do not exist and hearing voices other people cannot hear, among several different symptoms.
- Incoherent speaking- This involves excessive muttering or unnatural usage of absurd speech.
Detection of schizophrenia involves negating other mental issues and determining the cause of illness. The process of diagnosis includes:
- Physical exam – This is usually done to help rule out other possible problems that might result in probable complications.
- Tests and screenings – These are done to separate conditions with similar signs and screening for traces of alcohol and drugs.
- Psychiatric evaluation – Here, the mental health team checks the status and well-being of the mind by observing demeanor and questioning thoughts, moods, and sleep cycle.
Treatment Plan :
Very often, mental disorders are considered stigmatizing. However, seeking proper treatment and ensuring medication regularly accompanied by self-care and support from family members can help the patients deal with specific symptoms.
Several support services ranging from support groups to residential treatment facilities, can provide assistance and support to your loved one with schizophrenia symptoms and help them lead a normal family life.
Medications are the cornerstone of schizophrenia treatment. Antipsychotic medications are the most commonly prescribed drugs. They affect the brain neurotransmitter dopamine and hence control the health from worsening.
Using antidepressants or anti-anxiety drugs might also help. It takes several weeks to notice a significant improvement. Using second-generation antipsychotics like Abilify, Vraylar or Latuda is a preferred method because it poses a relatively lower risk of serious side effects.
Psychosocial Interventions :
Along with continued medication, psychological and social (psychosocial) interventions are also equally important. These may include
- Social skill training helps improve communication and social interaction and the ability to participate in and perform daily activities.
- Family therapy offers support and sensitization to the families of someone with schizophrenia.
- Vocational rehabilitation and supported employment – This helps people with schizophrenia to seek employment and sustain themselves. This also enhances a sense of self-reliance and dignity.
How Can You Help Someone With Schizophrenia?
While dealing with a loved one’s illness can be challenging, the following tips can help you get an appropriate treatment to lead to your loved one’s recovery.
- Family support- Several myths and stereotypes are associated with mental health disorders. Schizophrenia treatment, like most mental health treatments, works best when medical care is accompanied by support from every family member. Resources like the schizophrenia bulletin or being a member of a support group helps you gather a lot of first-hand information on how to deal with someone with schizophrenia.
- Encourage treatment and keep track of their medications. It is important to stay calm and create an orderly wellness plan. This creates a structured living environment for people dealing with mental health problems.
- Develop a crisis plan – It is always better to plan the adversities. Write down the names and other required details of all the people you could reach out to in case of a schizophrenia crisis.
- Hear them out and avoid arguments – It might seem tempting to correct a person dealing with a psychotic disorder. However, you must prevent addressing delusions directly. Instead, listen to what they say and make them feel safe.
- Validate their fears – Be kind, supportive, and respectful towards people with psychotic disorders. Use phrases that offer comfort.
- Help them maintain their social interaction – Peer support significantly improves the quality of life for someone with schizophrenia.
- Digital interventions – Wellness apps like Moodfit or BetterHelp help you monitor and better analyze the patient’s health and emotions. These apps can track moods and symptoms, regulate the sleep cycle, understand and check schizophrenia medication, and seek treatment through therapies.
- Keep your calm – Do not use sarcasm or mockery to address the person; converse calmly and politely. Avoid direct, continuous eye contact or physical interaction. Do not shout or scold the person.
Encouraging Treatment :
There may be various reasons your loved one with schizophrenia might refuse treatment, the most common being anosognosia. Anosognosia is the state of denial or unacceptance of common signs or warning flags.
Intensive programs and evidence-based therapies are critical but convincing your loved ones to undergo treatment can be challenging. Practice patience instead of arguing with them or showing signs of intolerance or agitation. Consider offering them rewards to convince them.
The UNC Health Talk Column offers professional advice to help you cope with people with schizophrenia.
Family Member’s Symptoms:
Dealing with mental illness not just requires extensive support for the patient but also for other family members. It can cause you emotional distress and affect your health. Approaching a mental health professional to discuss and seek your treatment can prove helpful for your mental health and well-being.
Experiencing a schizophrenia crisis or finding emergency help to cater to your loved one’s medical conditions during a psychotic episode can be traumatic. Speaking with your counselor or mental health professional can help you structurize a treatment plan that works to cope and plan for the future.
The impact of expressed emotion on schizophrenia :
Expressed emotion (EE) can be regarded as a complex communication pattern and family relations between patients and their family members.
Hooley and Hiller found that caregivers of schizophrenia patients with highly expressed emotion reported dull or no satisfaction with their activities, declining optimism, and reduced self-efficacy compared with low EE caregivers.
Low levels of EE can be achieved by individual and group work with patients and families and educating the members about mental illness.
Impact of behavioral family therapy :
BFT is a family psycho-educative intervention that deals with stress management strategies and goal achievement. These therapies decrease family burden and feelings of resignation and increase patient care optimism.
Multiple family group therapy :
It is a combination of behavioral family therapy and formal psychoeducational which deals with problem-solving.
It aims to instill a sense of hopefulness in family members and positively impact patient outcomes by reducing relapse rates and increasing vocational and social skills.
These groups usually consist of two clinicians and eight families. It is conducted in four phases, beginning from the joining phase, followed by a 1-day PE workshop and a year of fortnightly sessions dealing with relapse prevention. At last, comes a year of monthly sessions focussing on social and vocational rehabilitation.
Ways to take care of yourself :
Having a loved one with schizophrenia can cause immense stress on families and caregivers. However, amidst all the anxiety and apprehension, you also need to focus on your health. Following are the ways through which caregivers can take care of themselves –
- Eat healthily and exercise regularly.
- Make time for self-care. Meditate, go for a walk, or indulge in pleasurable activities to rejuvenate yourself.
- Seek professional help whenever necessary.
- Set your limits, and don’t be the sole caregiver. Doing so often increases the chances of feeling burnt out.
- Be realistic about how much support you can offer. Try venting out to other people in the family. Do not over-exert yourself and become exhausted.
Available Resources :
When dealing with a person with schizophrenia or any other mental illness, it is vital for every family member to research and educate themselves about the available mental health treatment options and how the treatment works.
Therefore, having ample resources to understand people with schizophrenia is very helpful. Some of these globally available, well-researched resources are as follows:
- National alliance on mental illness – NAMI is the United States-based advocacy group founded by families of people diagnosed with mental disorders. They advocate, educate and spread awareness to provide quality living to all individuals suffering from mental health problems.
- People with schizophrenia anonymous – This is a peer support group that helps people understand schizophrenia and related disorders.
- Schizophrenia and Related Disorders Alliance of America – SARDAR works to promote hope and recovery in the lives of people who have schizophrenia and other psychotic disorders through education, support groups, and advocacy.
- National institute for health and Care Excellence – NICE offers care support teams and virtual and personal therapies for patients with schizophrenia and other disorders.
Dealing with schizophrenia or caring for a loved one with schizophrenia can take a toll on your mental and physical well-being. Take time, give yourself a break, and allow your body and mind to rest.
Recharge and refocus outside of schizophrenia too. Family and peer support are essential in improving schizophrenic conditions in an individual. Hence, be patient and supportive towards those suffering from mental health disorders.