Schizophrenia: Helping a Loved One Manage Their Condition

Schizophrenia is a complex and severe mental health condition characterized by distortions in perception, thinking, language, emotions, behaviors and sense of self. The National Institutes of Health estimate that about 1.5 million people in the United States are living with schizophrenia, although the exact prevalence rate is difficult to ascertain due to difficulties in diagnosis and potential overlap with other mental health conditions.(1)

The age of onset – typically in the late teens-early 20s for men and the late 20s-early 30s for women – can present unique challenges for people living with schizophrenia.2 Schizophrenia tends to occur when young people are beginning to establish independence and life skills. Consequently, the condition is associated with measurable disability from educational and occupational performance issues. People with schizophrenia are also 2-3 times more likely to die early from preventable diseases than the general population.(3)

Having a solid support system is of paramount importance for people with schizophrenia. If you have a loved one living with schizophrenia, you will want to learn as much as possible to help them manage their condition. With the right support, people with schizophrenia can lead healthy, productive lives.

Recognize the Symptoms, Causes and Risk Factors Associated with Schizophrenia

Understanding the symptoms, causes and risk factors of schizophrenia can help you get a clearer picture of your loved one’s diagnosis and understand what environmental factors might be at play.

Signs and Symptoms

The specific signs and symptoms of schizophrenia can be grouped into three primary categories – “positive,” “negative” and cognitive symptoms. All symptoms regardless of category can vary in severity over time based on a variety of factors.

Broken down by group, the most common signs and symptoms of schizophrenia include: “Positive” symptoms. Positive symptoms are behaviors considered to be “additional” and not typically seen in healthy people. Specific positive symptoms can include:(1)

• Delusions, or fixed, false beliefs
• Hallucinations, or seeing and hearing things that are not real
• Disordered thoughts or unusual and irrational thinking patterns
• Disordered movement patterns, including moving in a certain motion repeatedly without a clear reason

“Negative” symptoms. Negative symptoms are broadly characterized as disinterest and a generally “flat” emotional affect. Negative symptoms can include:(1)

• Low levels of motivation or trouble with planning, starting or sustaining activities of daily living
• Reduced expression of emotions, including a dull tone of voice or lack of facial expression
• Difficulty enjoying life regardless of circumstance

Cognitive symptoms. Problems with attention, memory and concentration are all considered cognitive symptoms associated with schizophrenia. Specific cognitive symptoms can include:(1)

• Trouble processing information and decision making
• Difficulty focusing or paying attention during conversations or when trying to learn new things
• Missing appointments or other important responsibilities

Causes and Risk Factors

The specific cause of schizophrenia is unknown, but researchers believe that genetics, brain chemistry and environment all play a role in this disease. Studies have found that issues with certain brain chemical and neurotransmitters, including glutamate and dopamine, seem to be associated with schizophrenia.(4)

Despite the unknown cause, there are certain risk factors seemingly associated with development of schizophrenia. These include:

• Family history
• Use of mind-altering drugs during teenage years and young adulthood
• Pregnancy and birth complications, including malnutrition or exposure to certain viruses or toxins that ultimately affect brain development

People with schizophrenia also face an increased risk for drug and alcohol abuse, which can exacerbate symptoms, interfere with treatment and cause downstream problems like homelessness, trauma and increased risk for suicide.(1)

Understanding Medications for Schizophrenia and Associated Challenges

There is no cure for schizophrenia, but treatments are available to help address symptoms. Medications are an important part of any schizophrenia management plan, and managing these medications requires a delicate balance. Learning about the nuances of schizophrenia treatment challenges can help you understand difficulties your loved one may encounter when managing their medications.

What Medications Are Available?

There are several different types of medications available for schizophrenia, and often the process of determining the right course for a given patient is trial and error supervised by the psychiatrist. Anti-psychotics are the most common class of medications used to treat schizophrenia, but antidepressants and anti-anxiety treatments may also be appropriate. These medications can come in a few different forms – including pills and long-acting injectables. They also come in a variety of dosages and schedules.(5)

What Complications Are Associated with Schizophrenia Treatment?

Although a psychiatrist works closely with patients to determine the right regimen, it can sometimes take weeks to see a noticeable improvement in symptoms – even with the right medications. This gap before “feeling it” can sometimes cause people to stop taking their medications because they think they’re “not working.” Another major challenge associated with adherence to schizophrenia medication is the side effects. People taking these medications can experience serious, uncomfortable side effects – which can affect willingness to take them.(5)

The primary goal for you in supporting your loved one through managing their medications is to provide encouragement through the process. Remind them that the outcomes of poorly-managed schizophrenia are often measurably worse than any medication side effect.

Beyond Meds: Focus on Therapy and Skill-building Efforts

Most people with schizophrenia need some form of ongoing support beyond medications to help them optimize their quality of life. Going to therapy and attending life skills training can help your loved one establish a solid base from which they can build themselves up while managing their schizophrenia.(6)

Therapy and skill-building options you can consider encouraging for your loved ones include:(4)

• Individual therapy. Working with a therapist on an individual basis can help people with schizophrenia learn to manage their thought patterns, cope with stress and to identify early signs that they may be headed for a relapse
• Family therapy. Family therapy can help you and your loved one with schizophrenia learn about how to be supportive and understanding of the unique position of all the stakeholders
• Social skills training. Social skills training helps people with schizophrenia focus on improving their communication skills in social situations – which in turn helps them improve their ability to participate in everyday activities
• Vocational training. Life skills training supports people with schizophrenia in their search to find and keep jobs. Being employed can help people with schizophrenia stay accountable to routines and responsibilities

Other Coping Strategies for Loved Ones with Schizophrenia

There are other forms of coping strategies you can employ to help your loved one manage their schizophrenia while simultaneously helping you feel more prepared for the challenges.

Coping strategies for you to keep in mind include:(1)

• Education. Education for you and your loved one can help all parties understand the ins and outs of schizophrenia and the importance of sticking to an established treatment plan. Schizophrenia education can also give you the tools needed to prepare for the inevitable ups and downs that come with schizophrenia – well-managed or not.
• Setting realistic goals. You and your loved one can work together to develop achievable goals in the service of effective disease management. Goals help motivate people, and your participation in these goals can help improve overall accountability and commitment.
• Support groups. Support groups are available for both you and your loved one. Making connections with people facing similar challenges can help foster a sense of community – which in turn helps create solid support systems.

Final Thoughts: Self-preservation and Supporting a Schizophrenic

While the above describes everything you need to know to support a loved one with schizophrenia, the reality is you cannot be of much use if you fail to care for yourself adequately. Make sure to take of yourself by doing the following:

• Get enough sleep at night
• Maintain a healthy diet and exercise to keep energy levels high
• Schedule “me time” – you need a break from time to time. Trying to be available 24 hours each day can cause burn out

Reaching out for help when you need it will pay major dividends for both you and your loved one.