Finding out that someone you love has schizophrenia can evoke feelings that are hard to explain and more so to manage, irrespective of whether they are a family member, friend, office colleague or just someone you know. Given the myths and misconceptions about schizophrenia and its inaccurate media depictions, we would like to help you move beyond this initial mystery, confusion and fear towards being a good ally to your loved one. Schizophrenia is not a life sentence and we are here to help you and your loved one through the process of recovery.

Educate yourself about what schizophrenia is and isn’t

The first step in being a good ally is to educate oneself about the condition. Myths and misconceptions surround schizophrenia, making it challenging to be supportive. By reading up on the symptoms, causes, and treatment options, one can better understand the challenges a loved one with schizophrenia faces. Knowing how to identify warning signs of relapse, such as insomnia, social withdrawal, increasing paranoia or hallucinations, and nonsensical or confused speech.

How to encourage your loved one to seek treatment

Standing on the outside, it might seem pretty straightforward to you – a person with schizophrenia must seek help for the voice and conspiracy theories in their head. To your loved one, however  – their hallucinations, delusions and paranoia are very real. It is difficult to encourage them to seek treatment if it is hard for them to even remember they are ill in the first place. Instead, try to:

1. Be supportive: Broach the subject gently and in an environment that your loved one is comfortable in. Let close and trusted family members or friends lead the conversation. Avoid using a threatening or confrontational tone, replacing it instead with how treatment might be meaningful to your loved one and the activities they enjoy. Say, for instance, “treatment can quiet the voices in your head” or “it can help you in doing things you enjoy like _”.
2. Focus on a particular symptom: Your loved one might also be resisting treatment to hold on to fragments of their “normal” life or to avoid being called “crazy”. You can make the process less threatening by suggesting help for a particular symptom like the hallucinations, lack of motivation or change in sleep patterns.
3. Provide options: Battling schizophrenia already feels like losing control of oneself. Ordering your loved one to seek treatment could be perceived as a further loss of autonomy and hence invite resistance. Instead, offer your loved one options of doctors and treatment plans so they can decide.

How to support your loved one’s treatment

If asking for help is hard, asking for help with one’s mental health might seem impossible. You can make the process easier for your loved one by reaching out and starting a conversation yourself.  A simple “What can I do to help?” could help them feel safe and find support without seeking it out.

1. Be collaborative: Your loved one is the best judge of the help they need. Ask them if you can monitor their medication, accompany them to appointments and look out for risks of relapse. A friend or family member’s insight can help your loved one’s medical provider understand specific symptoms or behaviours that your loved one might have missed. When your loved one has a voice in their treatment, they take ownership of their recovery.
2. Monitor medication: While regular medication can help keep the worst symptoms of schizophrenia at bay, your loved one might still be suspicious of taking them due to their predisposition. To get the most from their medication, encourage them to follow their schedules by using some of the pointers we discussed earlier for starting treatment. Medication reminder apps, weekly pill boxes and friendly check-ins can help. Take any side effects seriously and report them to the doctor so appropriate changes can be made. You can help avoid drug interactions by giving the doctor a comprehensive list of all drugs and supplements and being mindful of mixing medication with alcohol or recreational drugs.
3. Track progress: Logging your loved one’s behaviour, mood and the effects of various treatments can help not just their treatment team, but also you in better understanding their condition and even preventing relapse by identifying early warning signs.

How to respond to your loved one’s hallucinations or delusions

Maybe your loved one told you that they think someone wants to kill them or they can hear angry voices in their head or that Hitler is communicating with them or they think they are a millionaire. So what? Politicians say ridiculous things all the time and you believe them. Instead of challenging or agreeing with these hallucinations or delusions, acknowledge that you have heard your loved one and while you do not agree with them you can empathize with what they might be feeling. Then steer the conversation to a topic you both have similar opinions about.

Creating an action plan in case of a crisis

Despite your and your loved one’s best efforts, moments of crisis may come but thorough preparation and an open discussion about the plan with your loved one can help you manage the situation effectively and make it less frightening for your loved one. Some tips for handling a crisis are:

1. Keep emergency contact information and addresses of their doctor and therapists close.
2. Use a calm and quiet voice with and around them and speak to them at eye level. Reduce distractions like visitors, TV or fluorescent lights.
3. Don’t challenge their delusions and hallucinations because you cannot reason with psychosis.
4. Don’t express anger. Ask them how they are feeling instead.
5. If you notice any warning signs of relapse or other indications that your loved one’s symptoms of schizophrenia are getting worse, call the doctor right away.

How to redefine recovery and help your loved one lead a fuller life

Mental health recovery is not linear. There will always be challenges when it comes to schizophrenia, but you can help your loved one patiently achieve manageable milestones on their road to recovery. You can empower them by encouraging self-help in living a fuller life.

1. Treat them like a person: Our in-house programme manager told us that in the final stages of recovery, many friends and family members expect their loved one to apologize for the inconvenience they have caused. Don’t treat them like the schizophrenia is their fault. Support and encouragement in a non-judgemental and non-conditional way for their progress, active empathy, help with errands and spending time doing banal activities could mean the world to your loved one.
2. Encourage self-help: Don’t take away your loved one’s voice by babysitting them. Encouraging autonomy and treatment is an important element of recovery. Give them the opportunity to employ self-help strategies they have learnt for a healthier diet, managing stress, exercising and building meaningful interpersonal relationships that can speeden their recovery. Help them set SMART (Specific, Measurable, Achievable, Realistic and Timed) goals and an action plan to help them feel hopeful and motivated to succeed.

Caregiver’s burnout and taking care of yourself

Having a loved one with schizophrenia can be taxing not just for them but even those around them, including you. Sometimes, despite your best efforts, your loved one might refuse medication or have an episode and it can lead to difficult emotions like fear, guilt, anger, frustration and helplessness.

Don’t take it personally. Recognize your limits and remember that just a family member or friend is not the only support they have. You can’t do it all so take help from support groups, doctors or helplines if you feel like you are unable to provide the support they need. You can join a support group yourself, to connect with people who have first-hand experiences of what you are going through. And most importantly, make sure that you take care of yourself. Carve out time to do things that help you relax or you might end up having caregiver burnout. Caregivers who are attentive to their own needs can handle the ups and downs of supporting their loved ones better.

In conclusion, Schizophrenia is not a life sentence, and being a good ally can help someone with the condition live a fuller life. Understanding the challenges of the condition, encouraging treatment, and supporting the person’s recovery are all ways to be a good ally.