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A number of changes can take place in the life of an individual and his family who has been diagnosed with schizophrenia . It is important that a person with schizophrenia has a support system to help manage the necessary lifestyle changes. A healthy support system is an essential component to any successful treatment plan. The support system may come from a variety of sources, including family, doctors, residential supervisors, day program providers, friends, roommates, clergy, other religious affiliations, among others. It is vital that whoever is providing the primary support seek and utilize as many additional resources as possible.
Here are some tips on helping a person with schizophrenia make some adjustments and necessary lifestyle changes:
There are numerous situations in which people with schizophrenia may need help from people in their family or community. Often, a person with schizophrenia will resist psychiatric treatment, believing that the symptoms experienced (eg, psychotic delusions or hallucinations) are real. At times, family or friends may need to take an active role in having the person seen and evaluated by a professional, although this can often be a difficult and frustrating experience
Balancing an individual’s need for treatment against his will, without violating his civil rights, can create difficult ethical dilemmas for family, friends, and doctors. The laws concerning involuntary commitment vary widely from state to state. In general, when people are considered dangerous to themselves or others as the result of a mental disorder, the police can assist in obtaining an emergency psychiatric evaluation and, if necessary, hospitalization. In some places, staff from a local community mental health center can evaluate a person's illness at home if he will not voluntarily go in for treatment.
Sometimes only the family or others close to the person with schizophrenia will be aware of strange behavior or other symptoms. People with schizophrenia often do not fully disclose such information during an examination. Family members or friends should ask to speak with the person evaluating the patient so that all relevant information can be considered when deciding on a treatment plan.
It is very important that a person with schizophrenia continues to get treatment after discharge from the hospital. Discontinuing medications and/or noncompliance with follow-up treatment often leads to a return of psychotic symptoms. Encourage the person to continue treatment and assist him in the treatment process. This can positively influence recovery. Without treatment, some people with schizophrenia become so psychotic and/or disorganized that they cannot care for their basic needs, such as food, clothing, and shelter. This can lead to people with severe mental illnesses, such as schizophrenia, ending up on the streets or in jails, where they rarely receive the kind of treatment they need.
Those close to people with schizophrenia are often unsure how to respond when patients make statements that seem strange or are clearly false. For the person with schizophrenia, the bizarre beliefs or hallucinations are real. Instead of “going along with” a person's delusions, family members or friends can tell the person that they do not see things the same way or do not agree with his conclusions, while acknowledging that things may appear otherwise to the patient.
In addition to involvement in seeking help, family, friends, and peer groups can provide support and encourage the person with schizophrenia to regain his abilities. It is important that realistic goals that are attainable are set. A patient who feels pressured and/or repeatedly criticized by others may experience stress that can lead to a worsening of symptoms. Like anyone else, people with schizophrenia need to know when they are doing things right. A positive approach may be helpful and perhaps more effective in achieving long term stability.
It may also be useful for those who best know the person with schizophrenia to keep a record of the following:
By knowing what symptoms have been present in the past, family members may know better what to look for in the future. Families are often able to identify early warning signs of potential relapses, such as increased isolation or changes in sleep patterns, even better and earlier than the patients themselves. Early detection can lead to an adjustment in treatment that can prevent a full-blown relapse.
References:
Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier Mosby; 2004.
National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ .
Weickert TW, Goldberg TE. First- and second-generation antipsychotic medication and cognitive processing in schizophrenia. Curr Psychiatry Rep. 2005;7:304-310.
Wolf, DH. Anhedonia in schizophrenia. Curr Psychiatry Rep. 2006;8:322-328.
Last reviewed March 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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