There are many ways to become — and remain — an ally to support someone with schizophrenia.
Family and friends of those living with schizophrenia often do their best to support their loved one initially — but for some people it can become increasingly difficult, especially if you’re unfamiliar with the condition or how to handle a crisis.
Symptoms of schizophrenia, such as delusions or hallucinations, may put a strain on relationships. And at times, you may even feel ill-equipped to handle the effects of the condition on your loved one.
You might find yourself feeling frustrated by a lack of progress in their treatment, or feel anxious if their treatment plan doesn’t work out.
While friends and family want the best for their loved one, the most common challenge is not really knowing how to help or offer sustained support.
That’s why we’ve compiled this list of tips, to help you become — and remain — an ally to your loved one living with schizophrenia.
Many misconceptions and stigma surround schizophrenia.
For example, due to sensationalist media stories, people with schizophrenia are often portrayed as being violent, when in reality people with this condition are more likely to be the victim of violence.
Similarly, some people think that schizophrenia causes a “split personality.” However, dissociative identity disorder, the proper term for what used to be called “split personality” or “multiple personality,” is a separate condition.
Due to these and other misconceptions, your initial reaction when you hear that someone you know and care about has schizophrenia may be worry and fear.
By educating yourself about schizophrenia — including its symptoms, causes, treatment options, and common myths — you can get a clearer understanding of what your loved one is experiencing.
It also allows you to be an ally. For instance, you can do this by using scientific evidence to speak out against discrimination that people with schizophrenia face.
For someone with schizophrenia, having people they trust who will stick by them no matter the circumstances is important.
Speak up against discrimination and stigma. Some people with schizophrenia experience internalized stigma, which may affect the person’s self-esteem and self-efficacy.
In turn, this may affect various aspects of their life, including personal relationships, overall quality of life, or the effectiveness of treatment plans.
Internalized stigma may even increase risk of suicidal thoughts or intent.
Therefore, researchers have highlighted the importance of preventing internalized stigma and promoting positive beliefs about oneself.
By advocating for someone with schizophrenia, you may help them overcome internalized stigma and improve self-esteem, which may improve treatment outcomes overall.
Talk with your loved one about how to best support them to reduce their risk of relapse.
You can offer to check in on how their treatment is going — like whether they’re taking their medications or continuing to go to follow-up appointments.
Staying connected and checking in on how their treatment is going can be particularly helpful following release from in-patient care or if they’re making changes to their treatment plan.
Ask whether you or another trusted ally can come along to a doctor’s appointment or therapy session.
This can be helpful, not only to help your loved one advocate for themselves, but because many people with schizophrenia don’t always recognize all their symptoms.
Because of this, their treatment team can find it useful to talk to their friends and family. You can inform their medical provider of any schizophrenia-related symptoms or behaviors you’ve noticed.
You may also want to encourage your friend or family member to prepare legal documents, such as a healthcare power of attorney (HCPA) or psychiatric advance directive (PAD). These would allow a designated personal representative to receive information about their health information or to make decisions on their behalf when they’re unable to.
Encouraging your loved one to continue treatment and supporting them throughout treatment can help them stay on track, with greater success in managing their symptoms.
Delusions and hallucinations are two well-known symptoms of schizophrenia. Someone with schizophrenia truly believes these perceptions are real — they appear real to them, not imagined. Therefore, trying to change their mind in the moment is generally futile.
But it can be challenging to navigate a conversation with a loved one who’s making statements that seem strange or false.
Rather than agreeing with or challenging their delusions or hallucinations, convey that even though you don’t agree with what they’re seeing and saying, you still acknowledge their point of view and feelings.
Gently direct the conversation to areas or topics that you can both agree on.
For example, rather than talking about your loved one’s delusions, focus on their feelings instead. You may say “This must be frightening,” rather than “You shouldn’t be frightened, because nobody wants to hurt you.”
Helping keep a record of your loved one’s symptoms, as well as their medication use (including dosage), and the effects that various treatments have had, can be very beneficial.
This can help them maintain their treatment plan, communicate with their treatment team, and aid you to better understand their condition.
By logging symptoms, you can also understand what their symptoms look like in your loved one to better figure out what to look for in the future.
You may even be able to identify early warning signs of a potential relapse, which can allow your loved one and their medical team to come up with a new treatment plan to prevent a full-blown relapse.
Also, by logging which medications helped and which didn’t, the most suitable treatment options may be discovered more quickly.
Schizophrenia can affect many aspects of a person’s quality of life, including relationships, self-esteem, and the ability to find or keep work.
When it comes to setting goals — and that generally goes for everyone independent of whether they have a mental health condition or not — it’s important to keep things attainable.
For example, you and your loved one may want to follow the SMART guidelines for setting goals, which outline that goals should be:
- specific
- measurable
- achievable
- realistic
- timed
Well-defined goals allow people to focus their desires and intentions. Plus, they create a standard by which success can be measured.
With your loved one, you can help them write down specific, attainable goals — ideally in collaboration with their medical team. Together, you can come up with an action plan on how to achieve these goals.
Goal setting in action
So let’s say your loved one is interested in exercising more as an add-on to their treatment plan. To start:
- Think of a SMART goal: This could be to do 30 minutes of aerobic exercises 3 days a week for the next 4 weeks.
- Create an action plan: This may entail figuring out what specific type of physical activity your loved one wants to do.
- Maintain motivation: To keep them motivated, encourage them to stick with their goal. For instance, you could offer to set the same goal for yourself and tag along.
- Keep things positive: Emphasize your loved one’s strengths and things that are going well, rather than focusing on their limitations, setbacks, or perceived weaknesses. A positive approach can be more effective in the long run over criticism.
Family and friends aren’t the only sources of support for someone with schizophrenia.
Others can offer different types of support for your loved one. This can be anyone from an organization to an individual, such as:
- support groups
- case managers
- shelter operators
- roommates
- residential or day program providers
- church or religious communities
Their healthcare team may be deeply involved in managing their condition and can also help get them into programs as necessary, such as Coordinated Specialty Care (CSC) or Assertive Community Treatment (ACT).
CSC
CSC is a recovery-oriented treatment program for people with first-episode schizophrenia that involves:
- psychotherapy
- medication
- employment and education support
- family education and support
ACT
ACT is intended to help people with schizophrenia who are at risk for repeated hospitalizations or homelessness.
It’s characterized by a multidisciplinary team approach, crisis support, individualized care, and regular contact. Healthcare providers partaking in ACT often have a smaller caseload, allowing for more focused care and contact.
Participating in ACT may reduce the rate of hospitalizations and help people with schizophrenia stick with their treatment plan.
Further support
Don’t hesitate to reach out to your loved one’s treatment team if you feel like you can’t offer your friend or family member the help they need.
In the case of an emergency — like if your loved one is posing a danger to themselves or others — you may need to call their treatment team, a local hospital, crisis hotline, or psychiatric care center.
In some situations, staff from a local community mental health center can evaluate an individual’s condition at home if your loved one won’t willingly go in for treatment.
While schizophrenia and its symptoms can be managed, moments of crisis can happen.
To be prepared for both you and your loved one, you can make an action plan for emergencies so you can react calmly and appropriately when your loved one may need your support most.
If possible, don’t try to handle the situation alone. Having someone else with you — even if it’s just on the phone — can help you help them.
When not in a moment of crisis, make a list of emergency contacts that includes your loved one’s primary care doctor and therapist, as well as crisis hotlines or emergency service numbers.
You may also want to write down reminders of how best to react in an emergency situation. Having a list on hand may help you stay calm in a crisis.
Reminders you may want to include are:
- Speak in a calm, quiet voice, not only with the person in crisis but also with others who may be present.
- Keep instructions or explanations clear and simple.
- Don’t challenge or criticize your loved one’s delusions or hallucinations. Focus on their feelings instead.
- Don’t touch your friend or family member unless absolutely necessary. Before you do, ask for permission.
- Don’t hover over the person. Bring yourself down to their eye level.
Suicide prevention
If someone you know is considering suicide or self-harm, help is available:
- Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
- Text “HOME” to the Crisis Textline at 741741.
- Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.
- If it’s an emergency, call or visit your local emergency room or psychiatric care center to speak with a mental health professional.
While you wait for help to arrive, stay with your friend or family member and remove any weapons or substances that can cause harm. Listen, but don’t judge, argue, threaten, or yell. You’re not alone.
Helping a loved one with schizophrenia can be challenging at times, and to offer continued support to your friend or family member, you must find time to take care of yourself.
You can only help others if you yourself are taken care of.
Carve out time for yourself, whether it’s to meditate, exercise, read, paint, or watch a movie. Anything that allows you to relax and recharge.
Get others involved. If your friend or family member can rely on a support network rather than just one person, the load for everyone involved gets lowered.
You may also wish to find a support group for friends and family members of people with schizophrenia.
For example, the National Alliance on Mental Illness offers regular peer-led support groups for friends and family members of people with mental health conditions. You can also ask your loved one’s healthcare provider for recommendations near you.
Lastly, if you find that supporting your loved one is taking a toll on your own mental health, consider reaching out to a mental health professional for your own needs.