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How to Treat (and Not Treat) Someone With Schizophrenia

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When I was 19, I was diagnosed with schizophrenia.

This didn’t come as a shock or anything. I had been progressively moving up the diagnosis spectrum since my mid-teens. It started with depression, then moved to bipolar disorder, then borderline personality disorder (BPD), then atypical psychosis and finally schizophrenia.

The diagnosis didn’t really change much for me. I was still dealing with the same hallucinations I was before there was a word for it. All it really changed was the medication I was now given.

And how people treated me.

Schizophrenia is a scary word. This isn’t helped by how TV and movies portray it as the “go to” illness for any killer. They also manage to confuse it with dissociative identity disorder (DID) — or multiple personality disorder — all the time so many people think people with schizophrenia are actually going to change personality and start killing them at any moment.

This isn’t true. People who live with schizophrenia see and hear things others can’t. Often these things are not very nice and this can make them get angry and confused as they perceive themselves as being under attack. But the same would happen if you were actually being yelled at or harassed by a real person. The reaction isn’t wrong; it is just caused by something hard to understand.

By and large, people with schizophrenia are pretty peaceful. Most of their rage and confusion gets turned inward into self-harming behavior rather than outward to hurting other people. With all the people I have meet with this illness, I have only seen a couple of instances where the person was freaking out beyond control.

Most of the time, they simply want to talk about what is happening to them.

And most of the time, they have no one to talk to.

The worst thing about this illness is the loneliness. People think it would be the voices or the hallucinations, but for me, it isn’t. It is the pain of having no one to talk to who understands, or wants to understand. Because they don’t understand it, they fear it, and so we are lonely.

People with schizophrenia know they are “crazy.” They are very aware of the fact. They have moments of lucidity where they know exactly what is going on around them and they know they have had an episode and it is usually something they are very afraid of, ashamed of and wish didn’t happen. The medication I’m given to help with the psychosis often leaves me unable to feel anything, which is worse than seeing something that isn’t real. It is why some people living with schizophrenia come of their meds at one point or another. They just want to be out of the drug fog.

But even when they are lucid, they are lonely. Often, their friends and family have no idea how to deal with what is happening to them, so they avoid them. Some people in psych wards very rarely get visitors. Some people at home will be left there by themselves with only community nurses to check on them. No one wants to hear about their day when it may be filled with things that didn’t really happen.

They did happen, though. To the person who is hallucinating, those images are as real as real life is to you. And when they talk to you about them, they aren’t making things up; they are telling you about what really happened to them. You don’t need to tell them they are wrong or it didn’t happen.

So these are my top five points of dealing with people you may know who are living with psychosis:

1. Still be their friend. Go around for coffee. Talk to them about their day, even if it is filled with stuff you don’t understand. Love them.

2. Listen to what they are saying. It may sound “nuts” to you, but they are trying to communicate something with you. Are they telling you about someone who doesn’t exist who is scaring them? Reassure them and tell them you are there to protect them. Find a way to relate to them in the world they are in.

3. Don’t try and tell them that what they are saying isn’t real. It may be upsetting to hear your loved one talk about something not real, but it may not help them to tell them that. They have their own problems going on, and telling them those problems don’t exist doesn’t necessarily help them; it may only make them confused and upset.

4. When they are having a good day, let it be that. When someone is lucid, you don’t need to bring up all the times they weren’t. Unless they do, and then you can talk about it. But otherwise, it is just upsetting to them to be reminded that they have problems. Let their good days just be good days, where you can relate to them normally.

5. Be their friend. I am repeating this one because it is so important. If you were their friend before the illness, you can be their friend during. It might be upsetting to you, but them being lonely is worse. Visit them in the hospital like you would for someone who had a bad accident. Visit them at home like you would before the illness. Cry about it in the car ride or by yourself, because it is hard on everyone, but don’t let them become another lonely person with no one to talk to. Make the time. Change lives.

Photo by Priscilla Du Preez on Unsplash

Originally published: June 28, 2019
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