What to do when a loved one has schizophrenia

A psychotic episode is frightening. For loved ones, caretakers, and especially for the person experiencing the episode.

Patients who have been diagnosed with schizophrenia can at times experience psychotic episodes where they are unable to distinguish between reality and hallucinations[1].

It's important for loved ones and caretakers to take note of the symptoms during a psychotic episode. And to be there to support and care for those living with schizophrenia.

A psychotic episode doesn't happen in one go, it's a gradual process. The most common symptoms include,[2]

  • bizarre behaviour
  • mood swings
  • outbursts
  • and, isolating themselves from family and friends.

When these symptoms present, it's important to seek professional medical help for the person.[3]

There is no right thing to say or do during these episodes, but there are a few things to be mindful of.[1]

  • It's important not to isolate the person. Don't tell them what they believe to be real, isn't so.
  • Listen and sympathise with what they're going through.
  • Minimise stress in their environment.
  • Be supportive and use encouraging words, so they know you are there for them. Try not to criticise or judge.
  • Don't make light of their issues by telling them about your own problems. This will isolate them.
  • When they decide to re-engage with the world, do not place them in overwhelming situations, like noisy places, or with too many people around.
  • Don't ask invasive questions, keep the conversation neutral. They will share with you when they're ready and comfortable.

In the most severe cases, when you think the person is a physical threat to themselves or others, call emergency services.[2] It's vital to make the medical team assisting the person aware of their potential harmful thoughts and actions.[1] This would help the medical team to be extra vigilant of the person in their care.

This isn't a situation you can solve on your own, and it's important not to let the person out of your sight. If you need to step away to call emergency services, do so knowing that you've asked someone else to keep an eye on the person.[2]

You may even need to consider committing the person involuntarily to a hospital or a mental institution.[3] The complexity in this course of action is that an examination by a medical professional and the authorisation by a law official is needed to ensure the person is admitted, or alternatively, that the person be treated as an outpatient.[3]

Remember, schizophrenia is treatable. By using the right medication as prescribed by a medical practitioner, the illness can be managed and the person can live a meaningful life.

EM 90891

References

National Institute for Clinical Excellence. Psychosis and schizophrenia in adults: prevention and management. 2014. CG178.
APA Clinical Guidelines. American Psychiatric Association. Practice Guidelines for the treatment of patients with schizophrenia. 2004.
Hasan et al. World J Biol Psychiatry 2012; 13: 318─378.
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