Encouraging Schizophrenia Self-Care
People with schizophrenia need a considerable amount of support from family members and other loved ones to finish school, find work, maintain relationships, and achieve other goals they’ve set for themselves. Although they may never live “normal” lives, says Krista Baker, a licensed clinical professional counselor and supervisor of the Early Psychosis Intervention Clinic at the Johns Hopkins Bayview Medical Center in Baltimore, healthy lifestyle habits can help people with schizophrenia achieve independence and improve their quality of life.
Keep Doctor Appointments
People with schizophrenia often don’t believe they have an illness, don’t like being told what to do, and don’t believe they need medical help. Despite these beliefs, keeping doctor appointments is critical, says John Wilson, MD, a psychiatrist with the Fairfax-Falls Church Community Services Board in Virginia. The longer treatment is delayed, he says, the harder it can be to control the symptoms. Arguing with people with schizophrenia or attempting to convince them that the voices they hear don’t exist isn’t an effective way to get them to seek treatment. Instead, Dr. Wilson recommends reminding people with schizophrenia how treatment can help them reach whatever goals they may have set for themselves. Try just a gentle nudge to get them to treatment, he says.
Stick With Medications
People with schizophrenia often don’t see how medication is improving their mental health or thought processes. “But they do notice the side effects,” Wilson says. These can include tiredness, dizziness, muscle cramps, and weight gain, and may cause people to stop taking their medications. Working with a doctor to find the medication that keeps schizophrenia symptoms under control with the fewest side effects can help your loved one stick to his or her treatment plan. Medication calendars and weekly pillboxes can be used to help a person with schizophrenia remember to take medications regularly.
Avoid Illicit Drugs and Alcohol
When people with schizophrenia experience symptoms, such as hearing voices, they want relief. Alcohol and drugs are stronger than prescribed medications and work quickly to help them feel different, Wilson says, so “they may take alcohol to stop the voices or to help them not care about the voices.” Caregivers can help prevent substance abuse by clearing the house of drugs and alcohol and by talking to their loved one about how abstaining from drugs and alcohol can help them maintain their overall health and achieve their goals.
Stress can make it hard for a person with schizophrenia to function and may trigger a relapse. When someone is living with schizophrenia, a loud, chaotic household and other sources of stress can intensify delusions, hallucinations, and other symptoms, Wilson says. The person may understand that the stress is coming from the family, but rather than recognize the shouting for what it is, “they may believe their family is out to get them,” he says. However, keeping quiet to avoid upsetting the person can add to the stress of other family members. Instead, use quiet but firm voices and create a calm and safe home environment. Wilson also advises therapy and, when possible, transitioning the person to either independent living or a supportive group home.
Maintain a Healthy Weight
Medications to treat schizophrenia can cause weight gain, which can increase the risk of obesity-related health conditions, Wilson says. Eating a nutritious diet is the best way to maintain a healthy weight. Since people with schizophrenia may not have much interest in meal planning, they may be less interested in choosing foods to keep themselves healthy. “Their thinking is disorganized,” he says. “It’s hard to make short-term plans, much less think 5 to 10 years down the road.” Baker says that caregivers can help by accompanying the person with schizophrenia to the grocery store and talking about healthy foods. A nutritionist can also help teach your loved one about making better choices and meal planning for self-care. Regular exercise is also an important part of managing weight, so encourage your loved one to stay physically active.
Limit Power Struggles
Schizophrenia usually sets in during late adolescence, a time when young people arecraving independence and freedom. But whatever the age of your loved one, people with schizophrenia don’t want to be micromanaged and hounded about everything from taking medications to cleaning their rooms, Baker says. Rather than using words like, “You need to go out and get a job,” she advises caregivers to focus on the person’s own goals and what needs to be done to achieve them. “We want to think about individuals moving down the same path they would have chosen if they had never been diagnosed,” she says. Family therapists can often help families avoid power struggles and work on dialogue that benefits a person with schizophrenia.
Maintain Social Skills
People with schizophrenia tend to reverse the sleep cycle, staying awake late into the night and then waking up in the afternoon, Baker says. Sleeping in late can disrupt routines and encourage isolation. Other symptoms of schizophrenia, such as social withdrawal and poor interpersonal skills, can also contribute to this isolation. Caregiverscan help their loved one maintain social skills by adhering to routines, including planned social activities and outings. Take an active role by getting the person into a community program, taking him or her to the park every Tuesday, or initiating contact with friends, Baker suggests.
Intervene as Needed
People with schizophrenia who refuse treatment or help of any sort may need to behospitalized. In some cases, families may need to call the police for help if a person with schizophrenia becomes a danger to him or herself or others. Once treatment starts and symptoms subside, families can redirect their loved ones back toward their life goals. According to the National Institute of Mental Health, each step toward these goals should be small, and they should be taken one at a time. People with schizophrenia need encouragement — criticism may cause their symptoms to worsen. When there’s a diagnosis of schizophrenia, family and friends need to stay calm and recognize that there are no quick fixes, Wilson says.