In an earlier blog about psychosis vs. schizophrenia we talked about symptoms of psychosis and symptoms of schizophrenia and how they differ. Psychosis is a major symptom of schizophrenia but can also be due to many other diagnoses. People with urinary tract infections, for instance, can have bouts of psychosis. Alzheimer’s patients may also experience psychosis.
But what do those of us who are caregivers for loved ones with schizophrenia do when psychosis rears its ugly head? Psychotic symptoms can come out of nowhere, it seems. We can be enjoying a nice visit with our loved one, and something changes. He may start responding to internal stimuli. He may seem distracted. The conversation may turn to how the government is controlling him or he may laugh inappropriately. What do we do?
One thing we must always remember is to keep the stress level low. If we stay calm, our loved one can stay calm. It’s always best to educate ourselves on the illness of schizophrenia and symptom management. MyHealios offers skills coaching to help caregivers develop techniques to help their loved ones help themselves. These skills include listening to what’s going on with our loved one, trying to understand where they are and what they want at that moment, and knowing not to buy into their delusions and hallucinations, but rather to validate their feelings about what’s happening.
The last part can be very difficult. I know I’m often tempted to agree with my loved one when he’s hallucinating or having delusions. He gets upset with me because he thinks I don’t believe him. To him, that means I think he’s lying or faking it. It’s a fine line to walk to validate his emotion and fear without giving credibility to his delusions and hallucinations. I find that telling him that I absolutely believe how frightened he is or how annoying the ‘spirits’ must be, helps immensely. He hears the word “believe” even though I don’t say I believe what he sees. That seems to be enough for him, most of the time.
But what about the times that my belief in his feelings is not enough? What do I do then?
When he’s feeling frightened and tortured by the voices (or ‘spirits’ as he calls them), I not only have to make sure he’s safe, but I have to also be sure I’m safe. Psychosis can be very unpredictable and thus frightening. It’s frightening for our loved ones and it’s frightening for us. If we have other children, it’s good to have a plan. Author and mom, Liza Long, addresses this in her book, The Price of Silence. Liza and her family had a plan for when her son became unpredictable. The other kids would run to the family car and lock the doors. Fortunately, Liza’s son got the help he needed before anything tragic occurred.
Liza’s son was diagnosed with bipolar disorder. Like schizophrenia, people with bipolar disorder can sometimes experience psychosis. As mentioned earlier in this blog, psychosis doesn’t only present in schizophrenia. No matter when psychosis presents, it can be quite disturbing.
If you have an afflicted family member, I can’t emphasize enough the power of educating yourself about psychosis and schizophrenia. Knowledge is power, as they say. Being a caregiver to a loved one who experiences psychosis can make you feel powerless. The more you know, the more helpful you can be to your loved one.
When my family member first became ill, I was ignorant about schizophrenia and psychosis. I had heard of schizophrenia and knew that it was a life-long illness. But I didn’t really know what it meant to my family member’s future or to mine. I was optimistic that he’d be ok… that he’d be one of the people who recovered quickly and that I could help him with that. I admit, I was very naïve. But, because I threw myself into learning all I could learn, I’m no longer naïve to the ramifications of the illness or its symptoms. And I’m still learning.
Sometimes, psychosis in schizophrenia lingers. Treatment professionals will determine a patient’s baseline and make comparisons to what is typical and what is unusual for that person. Some people with schizophrenia are very psychotic at baseline, some do very well and can live independently and hold down jobs. My family member is typically quite psychotic. He doesn’t live in reality most of the time. Reality occurs for him when he needs something, like money. Then he can interact with me as though he is in reality. Usually, if I try to have a conversation with him about my life, or about his goals or anything else, I’m met with odd responses. The last time I asked him about his goals, he said he is working on becoming immortal. Other times, he says he is training to be a ninja. But if he wants something, like an energy drink, he can articulate that quite well. He can go to the store on his own and go through the process of making a purchase.
It dawned on me the other day that making purchases may be a way to keep the spirits in the background. He must do certain things and focus in order to make the purchase. Buying an energy drink is in the foreground, blocking out the background spirits. I’m not sure if this is the case, but so far it makes sense to me.
What have you noticed about psychosis in your loved one? Are there ways you’ve learned to bring them back to reality? What other questions do you have? I encourage you to comment on this page so that we can have a dialogue about psychosis and schizophrenia.
I hope this information is helpful to you. Please comment with questions, suggestions or other information. For information about how to receive caregiver-centric support, stress-management, and disease-specific tips and techniques (from the convenience and privacy of your own home via telehealth), visit MyHealios.