Supporting someone with schizophrenia

If you know someone with schizophrenia or experiencing psychosis and don’t know how to help, here’s where to start.

What is schizophrenia?

Schizophrenia is a severe mental disorder that alters a person’s thoughts, behaviours and experience of reality, and has a significant impact on their ability to function in everyday life.

If your friend, family member or somebody you care about has schizophrenia, it can be confusing to know how or even if you can help them.

Let’s look at what schizophrenia is, and how you can support someone who has this condition.

Contrary to media representation and popular belief, schizophrenia does not involve having ‘split’ or ‘multiple’ personalities.

What happens when someone has schizophrenia?

The main symptom of schizophrenia is ‘psychosis’, which alters a person’s experience of reality.

Psychosis includes:

Delusions – a belief that conflicts with reality.
Hallucinations – perceiving something not there.
Disordered thoughts and speech – thoughts that struggle to form or come all at once, stopping mid-sentence, not making sense, etc.
Disordered behaviour – strange actions or gestures, or showing inappropriate emotions in the wrong context.
Catatonic behaviour – a condition in which there is a disconnect between thoughts and movements, like being unresponsive (frozen), copying others’ words or movements, or being unable to speak.

Some people with schizophrenia may also experience other symptoms, like reduced emotional expression (e.g. being ‘flat’), low motivation, memory or concentration difficulties, or loss of interest or pleasure in things they used to enjoy.

Supporting a friend or family member with schizophrenia

Family and friends play an important role supporting someone they care about living with schizophrenia. Here are some things that can help:

Get educated. Learn about schizophrenia.
Look after yourself. Know your own limits and make sure you are engaging in self-care!
Be supportive. This might look like lots of things, such as encouraging independence, having fun together, exploring self-help options, being there to chat, etc.
Join a support group. There are groups for those who are supporting a loved one with a mental health issue. Having the support of those living with similar experiences can really help.
Be part of their safety plan. People close to a person experiencing schizophrenia are the most likely to notice early warning signs that something is wrong, or that a relapse might happen. Knowing the triggers and warning signs and what to do can help prevent things escalating.

Coping with a crisis or acute psychotic episode

Witnessing a friend or family member experiencing a psychotic episode or relapse can be frightening. Here are some things that can help you be prepared, should you have to deal with a crisis in the moment.

Common relapse warning signs:

Refusal to take medication
Changes in sleep habits
Lack of hygiene, e.g. not showering for days
Irritability, aggression or paranoia
Withdrawing/isolating self
Acting strangely, e.g. laughing at odd moments
Speech doesn’t make sense

When psychotic episodes occur

Here are some things you can do to handle a psychotic episode in the moment.

If you or they are in any immediate danger, contact emergency services
Stay calm, ask questions about what’s going on and listen without judgement
Support them to access support people as soon as possible, e.g. their treating GP
After the crisis has passed, look after yourself and don’t be afraid to access support!
Don’t try to reason with them about hallucinations or delusions and don’t ‘go along with’ hallucinations or delusions
Show concern and empathise with their emotions, e.g. “It sounds like you are feeling really depressed. That must be hard.”
Try to avoid touching them, too much eye contact, sudden movements, making promises you can’t keep, raising your voice or getting into arguments with them
Try to decrease their stress and increase their sense safety – you might ask other people to give you space, or try to find somewhere more private/with less distractions to give them space to calm down

People who don’t know much about mental health can misunderstand schizophrenia and think that people who are experiencing it are dangerous or violent. This misconception can be really damaging and stigmatising for those experiencing schizophrenia. Learn more about schizophrenia here.