Schizophrenia:
How Should One Behave?
(contd.)

When a Crisis Comes

Sooner or later, when a person has schizophrenia a crisis will occur. When this happens there are some things you can do to reduce or avoid the potential for disaster. Here are a few pointers:

• Remember that you cannot reason with acute psychosis
• Remember that the person may be terrified by his/her own feelings of loss of control
• Do not express irritation or anger
• Do not shout
• Do not use sarcasm as a weapon
• Decrease distractions - turn off TV, radio, dishwasher, etc.
• Ask any casual visitors to leave - the fewer people the better
• Avoid direct continuous eye contact
• Sit down and ask the person to sit down also

Changes in Circumstances

Often, a relative or friend will move or change his circumstances in some way without informing anyone. Social workers and other mental illness professionals are inclined to tell parents, "Let him take responsibility for doing this," or "It will be a learning experience for her." This type of advice indicates to us that many people in the helping professions do not understand the nature of schizophrenia. Our advice differs.

We know from experience that many persons with schizophrenia are often unable to take responsibility for informing others about such matters. If we leave them to do so we are likely to end up dealing with the much more complicated mess that will have to be sorted out when the consequences of this lack of action come about. A pension or social assistance cheque fails to arrive and the person is cut off from benefits. Bank communications, bills, etc., are not received and not paid. Rent is neglected and the person is evicted. Possessions are left behind. Premises are left uncleaned. Our advice is look after these matters if you suspect your friend/ relative won't.

Offer Choices

People like to feel that they are in control of their lives. Sometimes it is difficult to persuade someone with schizophrenia to do what is best for them. Thus it is useful to offer a choice. "Will you take a walk now or after lunch", might be a way to suggest a walk, a shower, or any activity that you may feel useful or enjoyable.

People with schizophrenia often have feelings that change very frequently, so that what someone may refuse at this moment he or she may agree to do later in the day or week.

Going to the Doctor

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A person with schizophrenia gives their perspective: "A lot of people of my acquaintance complain that all psychiatrists are good for is prescribing pills or giving injections - and perhaps that's true. Some people seem to want to go to the psychiatrist and get some real counselling. They would like to talk about their housing and they would like to talk about what the psychiatrist can do to help them get back to work, or at least what would be their strengths if they tried. I don't know whether anyone has a psychiatrist who will help like this. Usually it's, 'See the social worker'. But one of the men I see when I go for my appointment says the social worker is never in when he comes for his appointment. The trouble with me is that I have such high anxiety just walking in the out-patient door that by the time the doctor says 'Come in,' all I want to do is get out of there! So it's a case of him saying 'How have you been?' and me saying, 'Fine,' and then responding that way to every question he asks me. He's trying to help but I'm about to explode. So I guess all my psychiatrist is good for is prescribing pills."

Holiday Time

"I dread holiday times when families are all supposed to get together, eat and drink and generally enjoy each others' company. For me, times like these bring back feelings of disappointment, resentment, sadness and a whole host of other emotions. Christmas, for example, has not been a good time for me or the family for many years. There were times my brother was in hospital, times he was home but barely stable, times he had to be taken to hospital during the holiday, times the police came. If I dread it, what does it mean to him? When he thinks a lot is expected of him, he usually handles it well for a few hours, but after that he 'crashes' - I mean he retreats to his inner self, or he gets extremely agitated. Last year, each visiting family member took my brother aside for a mini-visit, a one-on-one chat and that seemed to work a little. At least he knew everyone cared. But when it came to the big dinner he disappeared to his room. He just cannot process a lot of noise, people, snatches of conversation - it's just too much for him."

Final Thoughts

Do you help frail, old ladies across the street? Use some of that attitude in rethinking your treatment and interaction with a person who suffers from schizophrenia who may live near you. This doesn't mean that you need to be overly friendly, but don't ignore them. Engage them in conversation, but don't be intrusive. People with schizophrenia, like a physically frail person, cannot defend themselves as well as a person in full possession of physical and mental powers.

Some people are on heavy doses of medication that may slur their speech or make them react slowly. (Quite often this is mistaken for drunkenness.)

Take into account that sometimes the person may be anxious and may withdraw. Let people withdraw, but leave the door open. Maybe ask them to visit you when they feel they are able. Offer a cake or a plant or some other friendly gesture. Send or drop off a postcard or greeting card with a brief, friendly message every so often.

top | next - where to get mental health help
also in this section:
how can others help the schizophrenic?
maintaining your own health
schizophrenia: how should one behave?
helpful resources
where to get mental health help

home | schizophrenia defined | causes | treatment
patient support | prognosis | schizoaffective disorder

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