How To Help Someone With Schizophrenia

If you know someone living with schizophrenia, you’ve likely already tried being as helpful and supportive as possible. But staying supportive is easier when you’re aware of what’s going on (even if the person you love isn’t).

This article will offer tips to have a healthier relationship with your loved one with schizophrenia. It also discusses self-care as a caregiver, coworker, or partner.

Living With Schizophrenia
Schizophrenia is a serious mental illness. What makes it more challenging is that people living with schizophrenia may have an impaired ability to recognize their illness.

When living with schizophrenia, the things people see, hear, and think are their reality. Imagine how scary it could be for everyone around you to keep telling you that your version of reality isn’t real or that you’re lying, making things up, or crazy.

According to the World Health Organization, 20 million people have an official diagnosis of schizophrenia.

Symptoms
People living with schizophrenia can experience a range of psychiatric symptoms, including:

* Delusions (false and persistent beliefs): Delusions are often joined by paranoia or suspicions of others. Clinical delusions are beliefs that aren’t shared by others in a certain culture, religion, or club/group.
* Hallucinations: These can be things that people hear, see, or feel that are not actually there. People living with schizophrenia may be convinced these things are real because, for them, they are real.
* Odd behavior: Severe personality changes and abnormal behaviors can include things like not taking care of oneself, mumbling or laughing to self, and wandering aimlessly.
* Disorganized speech: This includes mumbling but also mixing words up, jumbling words together into a “word salad,” or not speaking clearly.
* Emotional distancing: This is feeling like the person is disconnected or disengaged. It seems like they are not fully with it or with you. Body language is noticeably odd.

Caring for Someone With Schizophrenia
Caring for someone with schizophrenia can be extremely difficult without the right types of support systems in place for everyone involved. People with schizophrenia can absolutely find relief from symptoms and get better. However, staying the course of lifelong illness treatment is challenging for most, let alone someone with a mental disorder.

Verywell / Joules Garcia

Effect on You
You may be feeling up to the challenge, or perhaps you’ve already realized it’s too much to take on alone and you’re wondering where to go for help. Whatever your personal situation and relationship to the person or people with schizophrenia, you need to remember to take care of your own health, too. Schizophrenia can cause an incredible amount of stress and pressure on any family.

A Counselor Can Help
Understanding that someone you know is experiencing psychosis can be difficult to handle, especially when you’re very close to the person and/or living together. Watching a psychotic episode or finding emergency help during a psychotic episode can be traumatic. Speaking with your own counselor or mental health professional can help you to cope and plan for the future.

Ways Caregivers Can Take Care of Themselves
* Make a life outside schizophrenia.
* Don’t be the sole caregiver.
* Make your own health a priority.
* Eat healthily more often.
* Engage in enjoyable physical activity.
* Make mindfulness part of the routine.

Types of Support
You really don’t have to do this alone. There are many types of support available. If one doesn’t work, you can try the other. With the move toward online doctor’s appointments (telehealth), it’s now more possible than ever to help your loved one get a diagnosis and seek treatment for schizophrenia.

Family Support
There’s a lot of stigma attached to schizophrenia. Stereotypes can make it seem like your loved one is destined for jail or homelessness. It’s best to set aside any preconceived ideas about schizophrenia and start by looking into the symptoms (especially symptoms of psychosis) and try these strategies instead:

* Listen without correcting: It’s tempting to tell the person experiencing psychosis they’re wrong in hopes they’ll believe you and snap out of it. Unfortunately, it doesn’t work like that. Avoid addressing the delusion directly; instead, listen to what their main concern is before deciding how to help.
* Validate their worries and fears: Validating is different from agreeing with their delusion or enabling their illness. Validating sounds like, “That must be scary, stressful, etc. Would it be helpful if…” and “That sounds upsetting, is there someone you want me to call?”
* Encourage treatment and help them remember medication: You don’t have to do things for the person (and you shouldn’t), but you can connect them to resources and ensure their safety without taking away their independence.
* Help them develop a crisis plan, just in case: You may never need it, but it’s always better to be prepared. Figure out what to do in case of psychosis. This may include writing down who to call and how to get a hold of them, what they can offer for support, and what the person’s wishes are for treatment—e.g., do they want to be taken to the hospital immediately or do they want to contact their mental health team or doctor first? Make the plan as clear and easy to understand as possible in case you’re not the one who needs to use it.

Crisis Helpline Contact Info
* Meet them on their level: Your loved one has schizophrenia even when you can’t see their symptoms. It can be more difficult for them to stay focused and concentrated, finish tasks, or follow through on simple household chores and personal hygiene basics. Be patient, and remember to adjust expectations.
* Assess their housing situation: Considering the examples below can help you determine what is best and if you have enough resources on hand to safely support your loved one.

When to Seek Other Housing Options
In some situations, living with family may be problematic. Examples include:

* The main caregiver is single, ill, or elderly.
* The person with schizophrenia is so ill that there is little chance of leading a normal family life.
* The situation causes stress in the marriage or leaves children in the home feeling afraid and resentful.
* Most family events revolve around the person with schizophrenia.
* Support services are unavailable.

Residential options can help your whole family, and it doesn’t have to be a permanent thing either. A lot of guilt can come with sending a family member to a facility to treat schizophrenia.

Try to remember that these facilities exist because of the challenges you and your household are facing. Using these services doesn’t mean you’re casting away your family member or that you’ve given up.

Housing Support
Options for alternative housing facilities include:

* Residential treatment facilities or 24-hour care homes: A structured living environment for those requiring greater assistance
* Transitional group home: An intensive program that helps individuals transition back into society and avoid relapse after hospitalization or other crises
* Foster or boarding homes: A group living situation offering some independence, but still providing meals and other basic necessities
* Supervised apartments: Housing in which residents live alone or share an apartment. Typically a range of staff members and different professionals are available onsite to provide assistance and support.

Workplace Support
The American Psychiatric Association says people with schizophrenia often benefit from workplace programs that teach life-management skills, guide the person as they complete training, and support them in holding a job.

Ways to offer workplace support:

* Set small goals: Small goals that the person can reach quickly and feel the sense of reward more often can help motivate them and keep them focused.
* Avoid micromanaging: Hovering over and taking over tasks for a person with schizophrenia doesn’t help them develop confidence in their role. Rather, offer support or additional help if necessary.
* Reassure the person they’re a part of the team: Living with schizophrenia can be extremely isolating. Self-stigmatizing is a real thing. Depression symptoms, including feelings of worthlessness and being a burden, can also happen in people with schizophrenia, making them feel even more disconnected.

Peer Support
Peer support goes a long way in helping a person who has schizophrenia. It helps to reduce feelings of isolation and loneliness that often come with mental illness.

A review from 2017 found that people with psychotic disorders benefit from digital interventions that include moderated peer-to-peer interaction (e.g., moderated chat rooms, online support groups). These interactions may increase compliance with other evidence-based therapies by making more acceptable and engaging (online) environments.

How friends can help:

* Don’t judge the person: Schizophrenia is not anyone’s fault. Avoid making judgments, and instead get to know the person first.
* Avoid joking about their illness: Your friend may joke about their illness, but that doesn’t mean it’s okay for you. Joking about schizophrenia could really upset the person and break trust between the two of you.
* Don’t assume you know what they’re feeling: Even if you know the person well and have read all about schizophrenia, it’s best not to make assumptions. Everyone experiences symptoms differently, and everyone copes with chronic illness differently.

Apps
Wellness apps can help a person monitor and better understand their condition. They can be used for:

* Tracking symptoms
* Tracking moods (mood journaling)
* Sleep monitoring
* Fitness and exercise/activity tracking
* Medication tracking and reminders
* Food journaling or keeping a food diary
* Digital therapy
* Guided mindfulness, breathing, or meditation options

A 2020 review found two prescription apps geared toward people with schizophrenia (FOCUS and PRIME) can ease symptoms of depression and boost independence.

A three-year Canadian-based study ending in 2024 will use data collection to further examine how telehealth technologies can help people with schizophrenia improve illness management.

Don’t force the apps on your loved one all at once. Find a few apps that have more than one function (e.g., they can track substance use and daily steps) so it’s less overwhelming. Understand that your loved one may or may not be trusting enough in the apps to listen to your advice. Talking to them about the privacy settings can help reassure them.

Medical Support
Medical support comes in the form of medications, psychosocial rehabilitation, and various methods of talk therapy that can help your loved one with everyday functioning. A healthcare provider will likely prescribe antipsychotics for symptoms of psychosis. You may need to encourage your loved one to continue treatment if they begin feeling better.

You can offer support by:

* Taking side effects seriously: Listen to their concerns. These are commonly what makes a person stop taking their schizophrenia medication.
* Encouraging them to take their medication regularly: You can also help them choose an app for tracking their medications and remind them to reset their medication phone alerts.
* Attending appointments: This includes medication refill appointments, keeping tabs on their current list of medications, and monitoring substance use and any interactions. When in doubt, call the doctor.

If you notice any warning signs of relapse or other indications that your family member’s symptoms of schizophrenia are getting worse, call the doctor right away.

What Not to Say
You may not say the right thing every single time, and that’s okay. Even the most well-intentioned people make mistakes. But knowing what not to say can make a major difference in preventing triggers for someone with schizophrenia.

Avoid statements that sound judgmental, stereotypical, and overly controlling. Remember that every case of schizophrenia is unique, and tone matters.

Examples of what not to say may include:

* Did you take your meds today?
* Are you still seeing a therapist?
* Are you exercising enough?
* People with schizophrenia should… or shouldn’t…
* But you always feel worse when…

Relapse and Crisis
Caring for someone with schizophrenia requires you to prepare for the case of relapse or mental health crisis. While no one really likes to think of these things, having an emergency plan in place will help to keep everyone safe should problems arise.

Handling a Crisis
Here are some tips for handling a schizophrenia crisis:

* Avoid trying to reason with a person experiencing psychosis.
* Understand the person is likely scared, confused, and feeling out of control.
* Take a mindful deep breath and exhale irritation, frustration, or anger (do not express these emotions to the person).
* Avoid joking, sarcasm, or trying to lighten the mood.
* Ask casual visitors to leave (the fewer people, the better).
* Avoid continuous eye contact or entering their space (do not touch them).
* Sit down, ask the person to sit down if they feel comfortable, and begin a conversation to see what’s troubling them.
* Take threats of self-harm or suicide seriously.
* Ask the person what they’d like to do, but be clear you cannot leave them in this distressed state and you want to help. Give them options between resources (this helps reduce suspicions).
* Don’t hesitate to call 911.

Summary
It can be hard to help a loved one with schizophrenia, especially someone you live with or are very close to. There are many ways to support someone with schizophrenia, including educating yourself about the condition, finding useful resources, and approaching them with kindness and empathy. Prioritizing self-care and setting boundaries can help you be a better caregiving partner. Working with a mental health professional can help them find the right care plan and help you feel more balanced.

A Word From Verywell
Schizophrenia can begin to take a toll on caregivers if they don’t prioritize their own wellbeing. Make sure your loved one has a treatment plan in place and that you don’t shoulder all the responsibility.

While you may feel as though taking an afternoon “off” isn’t allowed when you’re a caretaker, it’s actually quite essential to everyone’s health. You need time to rest, recharge, and refocus outside of schizophrenia.

Frequently Asked Questions
What triggers people with schizophrenia?
People with schizophrenia may be triggered by stressful, emotional, or traumatic life events like death, divorce, and abuse.

How should you act around people with schizophrenia?
When someone you know has schizophrenia, you should educate yourself about the illness, listen with empathy, avoid taking it personally, and encourage the person to seek and continue with treatment. Always act when you believe you or your loved one is in danger.

What if someone isn’t taking their medication?
When someone with schizophrenia stops taking their medication, they may relapse and end up in a mental health crisis. Encourage them to take their medications and, if necessary, call their doctor for support.

Do people with schizophrenia recognize their symptoms?
Schizophrenia is a loss of touch with reality, and the person with the disorder may not recognize their symptoms and know they’re experiencing psychosis.

Can you have schizophrenia and depression?
Yes. Schizophrenia is a life-changing illness that is often accompanied by depression as a person deals with isolation, alienation, and a loss of interest in things that once mattered to them.

What treatment options help with schizophrenia?
People with schizophrenia are treated with antipsychotic medications, psychotherapy, psychosocial rehabilitation, and community and family support.