Penny Frese, PhD, was studying fine arts at Ohio University when she met her future husband. They saw each other for several months, and she noticed he avoided talking about anything personal. "We took a walk in a park, and it was toward the end of summer -- a gorgeous, beautiful day. I confronted him about not being totally honest … and he said he had had a 'schizophrenic break.'"
For some couples, that might have been the end. Frese went to the library and read up on schizophrenia. She learned that people do best when they are in long-term, loving relationships. "I just intended to keep the friendship, but 6 months later we were married."
Learning to Socialize
People with schizophrenia tend to avoid social situations, and that makes it tough to form friendships. "Social relationships are quite impaired in people with schizophrenia," says Philip D. Harvey, PhD, a professor of psychiatry and behavioral sciences at the University of Miami. "If you're not interested in socializing, you won't."
"I went years and years without dating," says Elyn Saks, JD, PhD. She's a professor at the University of Southern California Gould School of Law and was diagnosed with schizophrenia during graduate school. "When I became ill, that part of my life fell by the wayside."
Reclaiming a social life usually requires three steps for people with schizophrenia:
- Work with your psychiatrist to find the right medication to control psychotic symptoms.
- See a therapist who can help you with the skills that are needed to form and keep relationships.
- Find ways to get "social exercise." This can be a job or a club or any activity that gets you out of the house and around other people, Harvey says.
Saks honed her social skills while pursuing a career in law and psychology. She met her future husband at the law library. "It was the best thing that ever happened to me," she says. With effort, medication, and therapy, "you can have good friends and relationships,” she says.
When to Tell
It can be hard to decide if and when to bring up your disorder in a new relationship or friendship. "The way schizophrenia works, it's not the kind of thing that you can hide," Harvey says. Even when treatment is working well, you may have communication problems or other symptoms "that would be noticeable to someone you are dating."
Frese and Saks suggest waiting a few months before opening up. "I didn't bring my [schizophrenia] up right away at all," Saks recalls. "Eventually I told him, and he had sort of expected that something was going on. He responded in as supportive a way as could be imagined."
Strong, positive relationships are always beneficial, but perhaps even more so when you have a serious condition like schizophrenia. "It helps having someone close to you, who knows you and loves you," Saks says. "I feel like I have another set of eyes to monitor my symptoms."
Frese says she stays alert to help keep her husband stable. "I could serve for Fred as a reality check. We have a trusting relationship, so if I suggested he needed his medication adjusted, he was receptive."
This kind of support doesn’t have to come from a romantic interest. A good friend, a parent, or another family member can monitor symptoms and watch for signs of relapse. "To have somebody that you trust is a really important part of recovery," Frese says.
Managing a Relapse
Psychotic symptoms can undermine the trust of a person with schizophrenia. People having a relapse may get suspicious of people or have delusions that friends or family members are plotting against them.
Don’t argue, Harvey says. Instead, "do a careful investigation of whether the person has stopped taking their medication," Harvey advises. "Provide a supportive environment, and make sure they take their medication."
Family members can also help keep patients stable by making sure they eat regular meals, get enough sleep, and avoid unnecessary stress.
Tips for Partners
Being married to someone with schizophrenia can be challenging. "Sometimes you feel like it is all on you to keep things together," Frese says. "Sometimes you feel lonely because your spouse is living in his head and just touches down on the Earth every now and then. But we work these things out."
Frese offers these tips for partners of people with schizophrenia:
- Find a support group.
- Attend couples therapy if schizophrenia is affecting the relationship.
- Spend time with close friends.
"You develop a circle of friends for those times when your spouse can't provide the everyday chatter and banter," Frese says. It also helps to remember how much your support means to your loved one. "The ability to have a job, a family, a [partner] -- all of those things contribute to a person's sense of well-being and motivation to work hard at staying well."