How to Help Someone Stick With Schizophrenia Care

If you’re helping a close relative or partner with schizophrenia be consistent about taking medicines and keeping up with care, you’re a team. So if he pushes back on a treatment plan, you’ll want to understand where he's coming from.

Ask him about his fears, concerns, and complaints -- and listen without judging. Make decisions about medications together, along with your loved one’s doctor. Work to build and keep trust, so he feels safe to let you know how he's really doing.

There may be times you need to steer the ship, and times when you follow his lead. There will be victories and setbacks. But the key to successful support starts with putting yourself in his place.

Medications

Many people with schizophrenia have a hard time taking medication as prescribed. And there are some very good reasons for that.

First, they may not realize that anything is wrong. Among people with schizophrenia, 50% may have anosognosia, a brain problem that makes them think they’re not ill. And if you’re not ill, why would you take medication?

Second, they may not accept the diagnosis. Many people with schizophrenia get diagnosed when they’re young. Finding out that they have a serious mental illness can be hard to take in. Every time they take that medicine, it’s a reminder of something they don’t agree with.

Third, these are some of the harder psychiatric medications to take. Finding the right dosage or combination often takes time. Prescribing doctors may have to try three different brands before settling on something that works. In the meantime, your relative or partner may find the side effects tough to take. It can be a hard process to ride out.

Finally, some people with schizophrenia stop taking medication when they feel better. But that can backfire. Cutting back on or stopping the medication too soon can cause your symptoms to come back. Most people with schizophrenia take what doctors call a maintenance medication to keep things stable.

Learn All About It

Even if someone with schizophrenia may not understand why he needs to take medication, you should. Read everything you can from reliable sources and educate yourself on every aspect of the disease, including resources, medication and how it works in the brain, and the mental health laws in your state.

You also need to understand what schizophrenia is like for your loved one. Does he hear voices that aren’t real? Have delusions? Think his thoughts are being broadcast for everyone to hear? Knowing what he's going through helps you know if the medication is working -- and what it looks like when it isn’t.

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If They Quit Their Meds

Some people with schizophrenia choose to stop taking their medication. Ideally, it’s a decision you’ve discussed together -- along with their doctor. If your loved one does it without letting you know, you’ll start to see changes in him.

Is he having trouble sleeping? Stopped doing things he's normally interested in? Watch for his symptoms. With schizophrenia, stopping meds starts the countdown to relapse.

And it’s not just the brain that goes back to its old ways. Relapse also means routines like school and work, plus social relationships, go off track.

Depending on the medicine, going cold turkey can have rough side effects, including headaches, extreme anxiety, mania (unhealthy surges of energy and excitement), crying spells, depression, panic attacks, and thoughts of suicide.

Weaning to smaller doses, or tapering, is a gentler method that sidesteps the cold turkey withdrawal. Antipsychotic medication isn’t addictive, but the body comes to depend on it and needs time to get used to not having it.

Stay Hopeful

Treatment is about more than medication. People with schizophrenia may feel very lonely, depressed, and frustrated that they don’t act and feel like everyone else. They need hope -- and it doesn’t all have to come from you.

Seek out a therapist with training in schizophrenia who can help your partner or relative live with the illness. Peer counselors, or those further down the road in remission, can speak from experience and remind you and your loved one that schizophrenia isn’t a weakness or character flaw. It’s a long-term medical condition, and it can be treated with the good care, including the right dose of the right medication, patience, a positive attitude, open communication, and support.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on August 08, 2017

Sources

SOURCES:

National Alliance on Mental Illness: “Helpful Tips for Families,” “Anosognosia.”

Jeffrey Lieberman, MD, chairman, psychiatry department, Columbia University College of Physicians and Surgeons; past president, American Psychiatric Association.

Keith Valone, PhD, PsyD, CEO and chief clinical officer, Arroyos Treatment Centers; CEO and clinical director, Arroyos Psychological Associates, Pasadena, CA.

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