Managing schizophrenia in the long run

Co-author: Saanika Zanwar

Getting a schizophrenia diagnosis can be difficult. Commonly, it leads to struggles when it comes to thinking clearly and emotion regulation. While there is no cure for schizophrenia at the moment, it is possible to learn how to manage this through appropriate treatment, self-management, and having the right support system. As it is a life-long condition, it is essential for one to adhere to treatment plans to be able to live a productive and fulfilling life. 

How can it be managed?

Being an episodic disorder, the partial and full remission stages offer a good opportunity for individuals with schizophrenia to implement self-help strategies to regain some control over their  recovery process. Some strategies one can use include but are not limited to:

  1. Learn more about schizophrenia. Find out about the symptoms of schizophrenia, learn what to look out for and viable treatment options. 

  2. Take ownership over one’s well-being. Engaging in self help strategies have a huge impact on the individual’s self-esteem. By reducing stressors, it can help improve how one feels and lowers the frequency and severity of the symptoms. Some of these include:

    1. Accept the diagnosis and look out for warning signs in remission periods

    2. Maintain a positive attitude towards treatment plan

    3. Get help with stressful activities 

    4. Engage in pleasurable activities 

    5. Maintain your personal relationships to build a support system

    6. Set and work towards personal life goals

  3. Get active to improve focus and relieve stress. Take part in activities that make you calm and help maintain energy. Remove focus from your negative thoughts to calm yourself

  4. Get involved with support systems. Some ways to seek out support include:

    1. Talk to trusted family and friends

    2. Stay involved with one’s social circle, pursue passions or volunteer. 

    3. Meet new people and join a support group to learn alternative effective coping techniques. 

    4. Surround yourself with a supportive therapeutic environment for recovery. You should feel safe and able to manage treatments and self help.

  5. Manage stress. Stress results in higher levels of cortisol levels which may trigger schizophrenia episodes.

    1. Know your limits and do not take more than you can handle. Avoid getting overwhelmed

    2. Make use of relaxation techniques. These include meditation and deep breathing

    3. Understand, accept and manage your emotions. Acknowledge the negative beliefs to reduce stress. This can be done by identifying what you feel or keeping mood journals 

  6. Maintain a routined and healthy lifestyle to take care of yourself.

    1. Get enough sleep. This may be difficult with schizophrenia. Getting active and exercising can help manage proper sleep

    2. Avoid any alcohol and drugs to avoid addiction and prolonged symptoms of schizophrenia.

    3. Maintain a balanced, healthy diet

While these are some ways to manage it, it is important to remember that schizophrenia is a lifelong condition that has to be managed consistently. Management of schizophrenia does not mean being free of its symptoms or not being affected by the effects of schizophrenia; Instead it is being prepared to manage the symptoms while creating the support system you need through the process.

How can a caregiver play a role in helping managing symptoms

Understanding how someone can help their family/friend with schizophrenia can be a long process. However this is essential, especially for someone who is living together with the diagnosed individual. The following are some ways in which caregivers and friends can play a role in helping to manage symptoms:

  1. Show compassion. Learn about schizophrenia and debunk misconceptions to have an idea of what the individual is going through. This can help caregivers be more understanding and compassionate towards the individual with schizophrenia.

  2. Be patient. Listen and acknowledge their experience and emotions. For the individual going through the symptoms of schizophrenia, their fears and considerations are very real to them. Try to respond to hallucinations and delusions slowly and calmly using simple and concrete language. This would help the individual know that they are heard and the caregiver is there to support them rather than hurt them. This will also help in building a trustworthy relationship between the caregiver and the individual.

  3. The ‘do nots’ of schizophrenia

    1. Don’t interrupt them or be rude when talking and managing their symptoms.

    2. Don’t dismiss what they say

    3. Don’t assume you understand their needs

    4. Don’t threaten them

    5. Don’t blame them 

    6. Don’t argue with them or challenge their symptoms, emotions or thoughts

  4. Encourage the individual to find and stick to a treatment plan. Help them keep to the plan. Adherence to medication is crucial to maintain functionality for individuals with schizophrenia. 

  5. Provide/help find a stable living situation. Ensure a stable and peaceful household for the individual to avoid impact of interpersonal relationships or increase in stress.

  6. Keep a lookout for signs of relapses.  Being able to identify the signs and having a plan would allow one to respond effectively.

    1. Know what symptoms the individual faces and look out for those

    2. Keep the doctor emergency contacts and mental health professionals’ contact information close by

    3. Quick stress relieving activities can help while trying to manage delusions or hallucinations

    4. Ask the individual what they would like to do in case of a crisis. Identify what would help them feel better

    5. Set limits. If they talk about self harm or violence towards others, contact the necessary people like an authority or a mental health institute.

  7. Know what to do in case of a crisis or a severe episode of schizophrenia

    1. Give them ample personal space. When they have certain delusions, eye contact may be perceived in a manner that the caregiver wants to hurt them. Further, eye contact means making a social connection with someone which might be difficult. Hence constant eye contact should also be avoided.

    2. Do not get frustrated or angry at them

    3. Do not try to reason them out of their symptoms or thoughts and feelings

    4. Avoid sarcasm and jokes

    5. Keep in mind they are confused and unable to stay in control

When being placed in the role of a caregiver, it is possible to feel frustrated, angry or helpless. Other common impacts include anxiety, lack of social interactions and insomnia. 

Any of these negative impacts can add on to caregiver fatigue and affect one’s ability to fulfil their caregiving duties long-term. Further, it can impact both spouse and children. Hence, apart from taking care of the individual with schizophrenia, it is important to take care of yourself and check in with other members of the family.

Healthy coping mechanisms for caregivers as they provide support to individual with schizophrenia

  1. Find appropriate social support. This can be done through support groups or by talking to a friend, family or therapist in case of or to avoid a burnout

  2. Practice good self care. Engage in activities that make you happy to take a break from caregiving duties. Although feelings of guilt may arise, it is important to remember that your rest is important for the long run 

  3. Seek therapy. When it becomes too overwhelming to control on your own, it is ideal to seek help from a professional to learn ways to cope in a healthy manner. 

For more information on caregiver duties and related aspects, you may consider looking into the following articles. The first one provides a guide on how to provide emotional support and be a mental health supporter for all individuals. The second one aids in understanding compassion fatigue and ways to manage it.

https://thepsychpractice.com/plog/howtobeamentalhealthsupporter

https://thepsychpractice.com/plog/understandingcompassionfatigue  

Adhering to a treatment plan and actively engaging in coping methods allows one to manage schizophrenia more effectively. It can help both the individual and their family to a successful management of the symptoms to be able to live with a healthy mental health.


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