Schizophrenia is a debilitating mental disorder that typically first hits adults in their 20s and early 30s. When someone is diagnosed with schizophrenia, they must remain on antipsychotic medications for the rest of their lives to control symptoms. One of the reasons why schizophrenia does not “go away” is the fact that genetics and physical abnormalities of the brain play key roles in its development.
Before learning how to live with someone with schizophrenia, it helps to understand how this mental illness develops and why people with schizophrenia think and behave the way they do. No one “chooses” to live with schizophrenia, just like nobody chooses to have personality disorders, PTSD, or major depression. Loving someone with schizophrenia means recognizing they have no control over what they believe, what they say or how they treat you. It is up to caregivers to provide the stability and unconditional love that people with schizophrenia want and need.
Schizophrenia Is a Chronic Disease
The American Psychiatric Organization defines schizophrenia as a “chronic brain disorder” characterized by:
- Dopamine overactivity
- Increased concentrations of pro-inflammatory chemicals in the bloodstream
- Abnormal enlargement of brain ventricles
- Slight reductions in overall gray matter (neural tissue) within the brain
Evidence exists that environmental factors also correlate with the risk of suffering schizophrenia as a young adult. These factors include oxygen deprivation at birth, maternal stress, infection, and maternal obesity. Childhood viral infections affecting the brain may also increase a person’s risk for developing schizophrenia later in life.
Just like other chronic diseases that require taking medication regularly (diabetes, high cholesterol, hypertension), schizophrenia demands taking medication as prescribed. People with the disorder need to also adhere to healthy lifestyles and maintain social relationships as much as possible to enjoy a good quality of life.
5 Tips for Living with Someone with Schizophrenia
1. Dealing with Hallucinations
Schizophrenia causes people to have visual and auditory hallucinations that are vividly real to them. They often create complex delusions to support beliefs that others deny are true. For example, if someone with schizophrenia tells you that creatures from another planet are living in the walls of their home, you might counter that belief with questions like “how do they survive without food?” or “how come they never make any noise”? The answers you receive will likely be convoluted to reinforce their beliefs to themselves. Your loved one may reply that “they have the power to make food appear whenever they want” or “they are invisible, and that’s why we don’t hear them.”
People with catatonic schizophrenia may adopt odd expressions or body poses according to what they are hearing, seeing, or thinking at the time. They may stand with their arms extended in front of them for a few minutes, then switch to only one arm extended and one arm pressed tightly against their side.
Other symptoms of catatonic schizophrenia include repeating everything another person says or mimicking other people’s movements. If you are a caregiver for someone diagnosed with catatonic schizophrenia and they begin exhibiting these symptoms, it’s likely they have not been taking their medication or need their medication changed.
2. Keep Track of Their Medications
Although antipsychotic medications are essential for reducing symptoms of schizophrenia, they do cause unwanted side effects such as weight gain, fatigue heart palpitations, nervousness and apathy. Once an antipsychotic medication starts making a person feel better, they stop taking it because of the side effects and because they don’t think they need it anymore.
If you are caring for someone with schizophrenia and notice unusual changes to speech or behavior, it is likely they stopped taking their medication. To prevent a relapse that could put a loved one back in the hospital for re-evaluation, ask the person if they have taken their medication every day and remind them if they don’t, it could mean returning to the hospital.
Signs of relapse include:
- Disrupted sleep patterns
- Rise in paranoia
- Hostility/irritability
- Nonsensical speech
- Actively hallucinating (visual and/or auditory)
- Any behavior that deviates from prior behavior while taking medication
Use calendars or pillboxes marked with the days of the week to help keep them on their medication. Also, keep alcohol, OTC medications, or your own prescription medications inaccessible to prevent harmful drug interactions. Combining antipsychotic medication with other substances can cause dangerous side effects or inhibit the ability of the medication to help your loved one.
3. Don’t Expect Perfection
Antipsychotic medications like clozapine, risperidone and aripiprazile can help someone with schizophrenia lead a fairly normal life by reducing dopamine in the brain and preventing hallucinations. However, sometimes a person may retain some delusional thoughts that don’t interfere with their ability to remain employed and develop friendships. For example, Mary has been taking clozapine for several years and works part-time as a secretary for a small jewelry store in town. Although she no longer hears voices talking to her, she still suspects the government is trying to bug her room. To offset this delusion, Mary performs a thorough search of her bedroom for signs of bugging devices before going to work. She also does this when she comes home. Other than this one, persistent delusion, Mary has no other odd beliefs.
4. Keep the Number of Visitors to a Minimum
People with schizophrenia and schizoaffective disorders are extremely sensitive to excessive sensory input. Too many voices, loud noises, and general discord can trigger feelings of confusion and anxiety in a person with schizophrenia. Sometimes, it may remind them of when they were actively hallucinating, hearing a jumble of voices or seeing disturbing visual patterns in the air. In addition, those with schizophrenia do not really know how to connect to people and find it energy-draining and depressing to try to “pretend.” Never throw “surprise” parties or suddenly invite them to a dinner party with 20 people. If the person you are living with wants to socialize, they will let you know.
5. Encourage Creative Expression
It is often difficult for people with schizophrenia to verbalize their thoughts and feelings, because they understand that what they think and feel is completely different from what “normal” people think and feel. Art therapy is routinely used to help hospitalized, mentally ill individuals express and explore their inner selves. It also allows them to creatively articulate strong emotions they are hesitant to reveal verbally to others. Find a creative endeavor your roommate or loved one is interested in—painting, drawing, sculpting or even video-making—and encourage them to keep an art diary. Art therapy is also a great way to build coping skills and gain insight into their mental illness.
If you or someone you know is experiencing signs of schizophrenia, FHE provides immediate help with on-site, psychiatric assistance. Call today for more information about counseling and medication services.
