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Caregiver and Schizophrenia:
How to Handle the Psychosis

(Page 1 of 3)

Psychosis or psychotic episodes can be very difficult for caregivers to know how to handle in just the right way. These episodes can be frightening for everyone, especially the person experiencing them, triggering extreme stress and fear which can make their symptoms escalate. Psychosis is defined as a loss of contact with reality, unable to distinguish between what is real and what is imaginary, and includes delusions (false ideas about what is taking place or who one is) and hallucinations (seeing or hearing things which aren't there). Many times when someone is experiencing a psychosis, they may actually be unaware that anything is wrong. It’s important for caregivers to know how to recognize the early-warning signs indicating that a psychosis is developing, and to know where or from whom to seek assistance.

Some of the early warning signs to look for include: anxiety, depression or irritability; suspicion, hostility or fearfulness; difficulty sleeping, or unusual waking hours; appetite changes; loss of energy, motivation and interest, or hyperactivity, or alternating between the two; concentration or memory problems; preoccupation with certain ideas (such as religion); social withdrawal - not wanting to spend time with friends and family members; thinking problems such as racing thoughts or slowed down thoughts; difficulty meeting responsibilities such as work or study; deterioration in self-care and personal hygiene; appearing perplexed; and personality becoming different in some way. None of these signs by themselves necessarily mean that a psychotic episode is about to happen, because some may be caused by a physical illness, or by the stress and strain of work or school, or problems with important relationships. However, if a loved one shows several of these signs without them going away fairly soon, or if they become more pronounced over time, then it would be a good idea for them to seek assistance from their mental healthcare specialist.

Knowing what to do for the symptoms of psychosis can be very difficult because you may not know what to say or do. This can be a very stressful and confusing time for everyone, so just know that there isn’t really a “right” thing to say or a “correct” way to behave or react. There are some things that you can keep in mind that may be helpful. Try and understand what the person may be experiencing, like hallucinations or delusions, which will seem very real to them. Try not to take anything that they may say personally, keeping in mind that they aren’t behaving and talking as they normally would. Avoid long debates in which you try to convince them that their delusions or hallucinations aren't real, because this will make them feel like they can't talk to you about what they’re going through. Try to find things to talk about that are neutral, instead of concentrating on their mistaken beliefs; this will most likely not upset them or get you frustrated. As tempting as it may be, don’t go along with their delusions or hallucinations, just listen and sympathize with what the person is experiencing. You might want to say something like, although you’re finding it difficult to understand what they are going through, you do realize that they must be very scared, frustrated, or angry. If it’s at all possible, try and minimize the stress and stimulation around the home during these times. Also, when someone is experiencing or recovering from a psychosis, they can almost seem child-like, and may need your help in making decisions. Show your concern and care for the person by avoiding confrontations, and not criticizing or blaming them.

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