For some, it may mean accepting a considerable amount of help from loved ones to finish school and find work. Others may need support in maintaining relationships and setting goals for themselves. And how each caregiver supports their loved one may differ from person to person. “Supporting an individual’s autonomy is very important when it comes to engaging in care. Each person is different, and respecting their boundaries and unique needs is crucial,” says Aubrey Moe, PhD, a psychologist in the department of psychiatry and behavioral health at the Ohio State University Wexner Medical Center in Columbus. Here are eight ways you can support a loved one with schizophrenia. RELATED: Schizophrenia: Popular Myths, Real Facts
1. Encourage Them to Schedule Regular Doctor’s Appointments
There are several reasons someone with schizophrenia may not attend doctor’s appointments. Some may not believe that they have an illness or need medical help, while others may realize the need for help but can’t get themselves to make the appointments. And others may be busy and have a hard time attending regular appointments. Keeping doctor’s appointments is critical, because the sooner the person is treated, the better the outcome, says Krista Baker, a licensed clinical professional counselor and director of operations of the community psychiatry program at the Johns Hopkins Bayview Medical Center in Baltimore. Arguing with your loved one or attempting to convince them to view their symptoms a certain way won’t be effective. Instead, remind your loved one how treatment can help them reach whatever goals they may have for their lives, says Baker. “There needs to be a sense of motivation on the person’s part,” Baker says. Dr. Moe adds that some people with schizophrenia may find direct, repeated reminders about doctor’s appointments or medications from family members to be helpful. But others may find this type of reminder to be intrusive or unwanted. Other ways to support a loved one with schizophrenia include suggesting they use calendar reminders in their smartphones or online healthcare portals to keep track of doctor’s appointments and prescriptions, Moe says. This may allow them to feel more empowered and in control of their healthcare, she says. Some people may not want their loved one involved in their care, Moe advises. “Individuals with schizophrenia may also prefer more privacy when it comes to sharing their healthcare-related information with family or friends, and may find it preferable to plan reminders or care with their therapists or other members of their healthcare teams,” says Moe.
2. Remind Them to Keep Taking Their Medications and Talk to Their Doctors About Any Concerns
People with schizophrenia may not always notice that their medication is improving their mental health or thought processes, but they often notice the side effects, says Baker. These can include tiredness, dizziness, muscle cramps, and weight gain, and may cause people to stop taking their medications. Finances, stigma, cooccurring substance use disorders, and cultural influences can also play a role in whether a person takes their medication consistently, according to a review article first published in April 2016 in The International Journal of Psychiatry in Medicine. When your loved one has been using medication consistently, it can be helpful to point out positive changes that align with your loved one’s goals — for example, showing up to work more often or having a better social life. Being understanding of your loved one’s concerns about medication side effects is also essential. It’s helpful to show understanding that although the medication may have benefits, there may be unwanted side effects, too, and to encourage your loved one to discuss these concerns with their doctor. Working with a doctor to find a medication and dose that keeps schizophrenia symptoms under control with the fewest side effects can help your loved one stick to their treatment plan, Baker says. Medication calendars and weekly pillboxes may also help a person with schizophrenia remember to take medications regularly. RELATED: A Therapist Speaks: Are Lower Doses of Antipsychotic Meds Better in the Long Run?
3. Help Them Avoid Alcohol and Illicit Drugs
When people with schizophrenia experience symptoms, such as hearing voices, some may seek relief by using alcohol and drugs, which work quickly to help them feel different. Caregivers can help prevent substance abuse by clearing the house of drugs and alcohol and by talking to their loved one about how abstaining from drugs and alcohol can help them maintain their overall health and achieve their goals.The best approach may be to help your loved one consider the negative impact of substance use on their symptoms and quality of life, with the goal of facilitating a shift toward healthier behaviors, suggests Moe. When possible, it’s helpful to work with your loved one to make a plan for coping with negative symptoms when they’re feeling well and not experiencing a crisis, adds Moe. Therapy can also be helpful for learning new coping skills and strategies, and empowering people with schizophrenia become less reliant on substance use to cope, Moe says.
4. Help Them Reduce Their Stress
Stress can make it hard for a person with schizophrenia to function and may trigger a relapse. For someone living with schizophrenia, a loud, chaotic household and other sources of stress might intensify delusions, hallucinations, and other symptoms. “Everyone wants to be treated respectfully,” says Baker, “and we all do better in calm, inviting environments.” However, keeping quiet to avoid upsetting the person can add to the stress of other family members. Use quiet but firm voices and create a calm and safe home environment, Baker advises. And don’t forget to include your loved one with schizophrenia in planning a supportive and safe environment for them, as each person experiences their symptoms and deals with their stressors differently, says Moe.
5. Help Them Maintain a Healthy Weight
Medications to treat schizophrenia can cause weight gain, which can increase the risk of obesity-related health conditions. People living with schizophrenia and other psychotic disorders have high rates of physical health problems and cardiometabolic risk factors like high blood pressure and high cholesterol, says Moe. Eating a nutritious diet is the best way to maintain a healthy weight, but not everyone can plan their meals in advance. Baker says that caregivers can help by accompanying the person with schizophrenia to the grocery store and talking to them about healthy foods. A registered dietitian nutritionist can also help teach your loved one about making nutritious choices and educate them about meal planning. Regular exercise is another way to promote weight maintenance and general well-being. Engaging in aerobic exercises like walking or other activities like stretching or yoga can be beneficial for weight management among people with schizophrenia, says Moe. And while not a replacement for appropriate psychiatric care, exercise is a noninvasive and low-cost approach to improving both mental and physical health, Moe says. Your loved one with schizophrenia should consult with their healthcare providers to determine the best approach for integrating exercise into their wellness plan, Moe adds. RELATED: Newly Approved Antipsychotic for Schizophrenia and Bipolar I Disorder Lessens Weight Gain, Studies Show
6. Try to Limit Power Struggles
Schizophrenia usually sets in during late adolescence, a time when young people tend to want independence and freedom. But whatever the age of your loved one, people with schizophrenia don’t want to be micromanaged and hounded about everything from taking medications to cleaning their rooms, Baker says. Rather than using phrases like, “You need to go out and get a job,” Baker advises caregivers to focus on the person’s own goals and what needs to be done to achieve them. “We want to think about individuals moving down the same path they would have chosen if they had never been diagnosed,” she says. Family therapists can often help families avoid power struggles and work on dialogue that benefits a person with schizophrenia, Baker adds.
7. Help Them Maintain Their Social Skills
People with schizophrenia tend to have a reversed sleep cycle, staying awake late into the night and then waking up in the afternoon, Baker says. Sleeping late can disrupt routines and encourage isolation. Other symptoms of schizophrenia, such as social withdrawal and poor interpersonal skills, can also contribute to this isolation. Caregivers can help their loved one maintain social skills by adhering to routines, including planned social activities and outings. One could also take an active role by getting the person into a community program, planning an outing with them once a week, or helping them keep in contact with friends, Baker suggests. Whatever activity you choose, it should preferably be something your loved one is interested in doing and possibly helped plan. RELATED: Keeping Your Relationship Strong After a Schizophrenia Diagnosis
8. Know That You May Have to Intervene, if Necessary
People with schizophrenia who refuse treatment or help of any sort may need to be hospitalized. In some cases, families may need to call the police for help if their loved one becomes a danger to themselves or others. Once treatment starts and symptoms subside, families can redirect their loved one back toward their life goals. “Treatment works, but it doesn’t work overnight,” says Baker. “It’s a process.” If you have specific concerns for your loved one’s safety, working with their healthcare providers to create coping and safety plans is an important way to prepare for difficult symptoms when they arise, says Moe. Additional reporting by Michelle Pugle.
