Managing paranoid schizophrenia symptoms can be difficult as it is a chronic, disabling condition. As it can affect the sufferer severely, caregivers may often feel unsure and confused about how exactly to help the patient. Let us explore the role of a caregiver in helping the sufferer recover.
Caring For Someone With Schizophrenia
The support from family and friends plays a significant part in the treatment of paranoid schizophrenia. However, helping and supporting a loved one with this condition can be draining and frustrating, especially if the patient is unable to realize that they are suffering from mental health issues. It can often lead to feelings of frustration, helplessness and extreme stress for the caregiver. The best thing you can do to help a patient is to encourage them to seek medical care. It is also important that you establish healthy boundaries, have patience and look after your personal needs as well. As supporting a loved one through recovery can be a frustrating process, you also need to look after your own mental health and seek counselling or join a support group, if necessary.
Helping A Loved One With Paranoid Schizophrenia Symptoms
Here are a few ways you, as a caregiver, can help and support a loved one the right way to overcome paranoid schizophrenia symptoms:
1. Encourage to seek treatment
Be an advocate for treatment. Help your loved one to realize that they have a mental illness and inspire them to consult a doctor or a mental health professional. Their condition can be so severe that they may not even realize it or are unable to seek treatment by themselves. You can call a doctor and book an appointment for them. You may also accompany them and explain the symptoms to the healthcare professional. The doctor may also ask certain questions about the sufferer’s recent behaviors for better analysis. Encourage the patient to trust their doctor and work with them so that the right combination of medication and therapy can be found and the determined treatment plan is followed effectively.
2. Keep track of appointments
Patients with this condition may be reluctant to go for follow-up appointments or may be unable to keep their doctor’s appointments. You can put their appointments in a calendar and give gentle reminders or take them to the appointment, if necessary.
3. Help them follow the treatment plan
Sufferers can often stop taking medications and going for therapy once they start feeling better after initial treatment. You should encourage your loved one to follow the instructions of their doctor and take the medicines as prescribed. Adherence to long-term treatment is one of the best ways to ensure that the patient can recover from paranoid schizophrenia.
4. Educate yourself
Psychiatric disorders can often be hard to identify or understand for most of us. So make sure you learn about the condition as much as possible. Educating yourself about paranoid schizophrenia symptoms, causes, treatment and self-help strategies will enable you to be better prepared and make informed decisions when things get difficult. Information can also help you to provide better support to your loved one, develop coping skills, encourage them to use the right self-help tools and overcome issues as you move towards recovery.
5. Acknowledge their feelings
It is important that you recognize their symptoms, perceptions, thoughts and emotions. Although you may not be able to understand what exactly they are going through, acknowledging their symptoms will help the patient feel heard and understood. Remember that even though their delusions and hallucinations may not make any sense for you, their symptoms, perceptions and experiences are real for them. By trying to understand their symptoms, instead of mocking them, you can provide them the necessary emotional support and keep them from feeling isolated.
6. Provide unconditional support
Even if it is difficult at times, make sure you respect and support your loved one through the recovery process in an unconditional way. Regardless of how severe or mild their condition is, make sure not to be judgemental or critical of them. Offering them the support and respect they deserve as a human being is one of the most important things you can do as a caregiver. Make an effort to help your loved one feel heard in a safe environment. Do not force them to talk about their paranoia but be there when they are ready to share. Avoid arguing with them as it may make the condition worse. You should also ensure that the sufferer has enough personal space even with you around them. Don’t express anger or irritation.
7. Focus on realistic goals
The treatment plan set up by your doctor or psychiatrist will involve certain goals for your loved one. As a caregiver, you need to help the patient pursue these recovery goals and remind them to stay on track. You need to keep track of their progress, encourage them to take medicines regularly and stick to the plan so that these manageable goals can be accomplished. It is also important that you have realistic expectations from the sufferer as paranoid schizophrenia symptoms can be challenging and lasting. So learn to be patient with the pace of treatment.
8. Learn to reduce stress
Stress can often make schizophrenia symptoms worse. Hence, you need to create a supportive environment for the patient. However, it is also important to learn to manage stress for yourself. Engage in relaxation practices like deep breathing, meditation, yoga and tai chi, as these can help you both feel more relaxed and calmer on a regular basis.
9. Empower the sufferer
Make sure that you offer certain rights and options to the patients so that they can take decisions about their own treatment and life. If you are doing everything for them, then not only you will feel frustrated and exhausted, it will also make your loved one feel helpless. Allow them to do things they are capable of and encourage them to be independent and active. When the patient has some control over their treatment, then they may be more willing to consult a doctor and stick to the treatment plan. You may also recommend the name of different doctors they can choose from and let them decide who they want to accompany them to the doctor’s appointment, in case they are suspicious of you.
10. Encourage self-help
Coping and self-care strategies can greatly help in recovery. When a person is suffering from paranoid schizophrenia, then using certain self-help techniques in addition to medical care, can help to relieve symptoms, limit the adverse effects and boost their self-esteem. By encouraging them to be self-reliant, practice self-care and use coping strategies, you will help them be more hopeful. Common self-help strategies for people with paranoid schizophrenia symptoms may include –
- Having a healthy diet
- Exercising regularly
- Practicing relaxation techniques
- Seeking social support
- Avoiding alcohol and drugs
11. Plan for crisis
When your loved one is relatively stable or not paranoid, prepare and plan for dealing with crisis situations, threats and fears. A crisis may occur even during the treatment phase. Moreover, stopping medication can cause relapse. So it is exceptionally important that you encourage the patient to follow the treatment plan strictly. However, relapse may still occur despite your best efforts and the patient may be required to be hospitalized so that they cannot harm themselves or others.
When you have planned and prepared for a severe and psychotic episode, you will know exactly what to do and who to call to manage the crisis quickly and safely. Make sure to include the following in your emergency plan for paranoid schizophrenia:
- Contact information of doctors
- Address and phone number of the nearest hospital
- Contact details of family and friends who can care for your children or the elderly during an emergency, if any
- Discuss your emergency care plan with your family members, friends and the patient so everyone knows what to expect and do during a crisis situation
In case of a crisis situation, make sure to contact your doctor and hospital immediately.
12. Identify suicidal signs and behavior
Self-harm and suicide is a serious risk of paranoid schizophrenia. Contrary to how schizophrenia is portrayed in fiction and movies, patients are generally harmless to others. However, they can develop suicidal ideation and behavior due to their confused thoughts, depression, delusions and hallucinations. As a caregiver, you should be vigilant if the patient is talking about death or suicide frequently. They may also express their suicidal thoughts through notes, poems or other creative expressions. Also look out for signs of mania and quick transitions from depression to being hyperactive or cheerful. This can be an indication of suicide. Talk to a trusted friend or family or call your doctor immediately to prevent suicidal behavior.
13. Practice self-care for yourself
Caring for someone with paranoid schizophrenia symptoms can be mentally, emotionally and physically draining. Mental illness can put significant stress on the caregiver and lead to burn out. If you are stressed yourself, then that will transfer to the patient and worsen the symptoms. This is why you need to make self-care a priority and take care of your mental and physical well being. Taking care of yourself while caring for someone doesn’t mean you’re selfish. By taking care of your own self, you can also encourage your patient to practice self-care.
Here are some self-care tips that you must follow as a caregiver:
A. Identify your own limits
Know how much support you can offer. Have realistic expectations from yourself and set clear boundaries.
B. Stay socially active
Remain in touch with other family members and friends. Attend social events and share with people you trust. This is important both for you and the person affected by schizophrenia.
C. Stay physically active
Regular exercise can reduce stress and anxiety and keep you healthy. You can go to a gym or simply go for a walk outside to energize your mind and lift your spirits. Exercise can help you and your loved one with paranoid schizophrenia symptoms.
D. Eat healthy
Make sure to eat a balanced, nutritious diet full of omega-3 fatty acids from fish, flaxseeds, walnuts and vegetables to avoid sugary and packaged foods as well.
E. Practice relaxation strategies
Relaxation techniques like deep breathing, progressive muscle relaxation, meditation and yoga can help you manage your negative emotions, like stress. Also make time to do things you enjoy such as reading, eating good food, listening to music or getting a massage. Encourage the sufferer to do the same.
F. Be grateful and have compassion
Although the situation may seem unfair, accept the situation for what it is, acknowledge your difficult emotions, balance your moods and manage stress.
G. Practice self-love
Do not neglect your own medical, physical and emotional needs. Take good care of your health, take your medications properly and get enough sleep.
H. Seek support
Build your own support network. Seek help and support from family and friends, join a support group to meet people in similar situations and consult a therapist for yourself, if needed.
Apart from these, creating and following a daily realistic routine can be especially beneficial for both the caregiver and the person affected with paranoid schizophrenia. With a strong support network, you can successfully help the sufferer overcome the symptoms and recover.
Is Caregiving For A Burden?
Delusions, hallucinations and psychotic episodes can be hard to manage for caregivers. Such devastating experiences can be frightening, not just for the sufferer but also for their caregivers. Not only can it strain family relationships, it can also lead to high levels of stress anxiety and fear among the patient and their caregivers. According to a 2002 research paper 1, “Families caring for a member with a chronic severe mental illness like schizophrenia have to cope with a lot of burden and distress.” Reports suggest 2 that among family caregivers for patients with schizophrenia, around 41.8% experience moderate to severe burden, about 27.1% feel severe burden, for 23.5% the burden is mild to moderate, while only 7.6% of carers feel no to low burden.
The distress experienced by carers can last for the course of the illness and may increase during inpatient admissions in hospitals. Moreover, reports 3 suggest that exhaustion and burnout are also common among caregivers. It can also lead to poor physical health, social isolation and poorer quality of life for the carers. One 2016 study 4, around 40% of caregivers for people with psychosis experience depression, poor psychological functioning and various stress-related disorders. This is why it is imperative that you, as a caregiver, practice self-care and look after your personal needs while helping someone overcome paranoid schizophrenia symptoms. According to a 2015 study 5, coping mechanisms and self-care can help caregivers of patients with schizophrenia to manage the stress of caregiving. Self-care strategies can help with “caregiver burden, caregiving experience, expressed emotions, social support, psychological morbidity in the caregivers, quality of life of caregivers and psychopathology in patients,” states the study.
How Caregiving Helps Paranoid Schizophrenia Symptoms?
Research 6 indicates that informal carers can often help mental illness patients to accomplish better engagement with treatments, better outcomes, fewer hospitalizations and enhanced mortality rates. The role of caregivers is vital for patients as their support can also greatly reduce relapse. However, caregiving can also help the carer as well. One 2012 study 7 shows that helping a patient overcome paranoid schizophrenia symptoms can also be beneficial for the caregivers and help them grow as a person. Described as “caregiving gains”, caring for patients with schizophrenia can make carers become “more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength.” It can also make the carers build a positive relationship with the patient and value personal positive experiences.
Caregiving Can Be Challenging, Yet Rewarding
Stress among carers can make paranoid schizophrenia symptoms in the patient worse. As the patient may be unaware of their own condition, it is imperative that caregivers learn how to identify early-warning signs and know exactly what to do and who to contact for help and support. As paranoid schizophrenia symptoms tend to become more intense over time, caregivers must seek help from a mental healthcare professional immediately after identifying the warning signs. Otherwise, it may cause a lot of confusion and stress as the caregiver may constantly worry about doing something wrong that may worsen the condition. It is also important that the caregiver practices self-care and focuses on their own mental and emotional well being to avoid frustration.
If you care for a loved one with paranoid schizophrenia, make sure you care for yourself as much as you care for the patient. This is the only way to win against this disabling chronic condition.References:
- Chandrasekaran, R., Sivaprakash, B., & Jayestri, S. R. (2002). Coping startegies of the relatives of schizophrenic patients. Indian journal of psychiatry, 44(1), 9–13.
- Shamsaei, F., Cheraghi, F., & Bashirian, S. (2015). Burden on Family Caregivers Caring for Patients with Schizophrenia. Iranian journal of psychiatry, 10(4), 239–245.
- Hayes L, Hawthorne G, Farhall J, O’Hanlon B, Harvey C. Quality of Life and Social Isolation Among Caregivers of Adults with Schizophrenia: Policy and Outcomes. Community Ment Health J. 2015 Jul;51(5):591-7. doi: 10.1007/s10597-015-9848-6. Epub 2015 Feb 18. PMID: 25690154.
- Onwumere, J., Shiers, D., & Chew-Graham, C. (2016). Understanding the needs of carers of people with psychosis in primary care. The British journal of general practice : the journal of the Royal College of General Practitioners, 66(649), 400–401. https://doi.org/10.3399/bjgp16X686209
- Grover, S., Pradyumna, & Chakrabarti, S. (2015). Coping among the caregivers of patients with schizophrenia. Industrial psychiatry journal, 24(1), 5–11. https://doi.org/10.4103/0972-6748.160907
- Kuipers E, Onwumere J, Bebbington P. Cognitive model of caregiving in psychosis. Br J Psychiatry. 2010 Apr;196(4):259-65. doi: 10.1192/bjp.bp.109.070466. PMID: 20357299.
- Kulhara, P., Kate, N., Grover, S., & Nehra, R. (2012). Positive aspects of caregiving in schizophrenia: A review. World journal of psychiatry, 2(3), 43–48. https://doi.org/10.5498/wjp.v2.i3.43