Is Caregiving For A Burden
Delusions, hallucinations and psychotic episodes can be hard to manage for caregivers. Such devastating experiences can be frightening, not just for the sufferer but also for their caregivers. Not only can it strain family relationships, it can also lead to high levels of stress anxiety and fear among the patient and their caregivers. According to a 2002 research paper 1, Families caring for a member with a chronic severe mental illness like schizophrenia have to cope with a lot of burden and distress. Reports suggest 2 that among family caregivers for patients with schizophrenia, around 41.8% experience moderate to severe burden, about 27.1% feel severe burden, for 23.5% the burden is mild to moderate, while only 7.6% of carers feel no to low burden.
What Is A Delusion
A delusion is a;fixed,;false belief. A delusion is a symptom of psychosis. No matter what you say, the person believes the delusion. If you insist on correcting the delusion you risk ostracizing them from you and frustrating yourself.
Read this post on;3 Types of Paranoia;to understand paranoia better.
Speaking To Your Loved One About Getting Help
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Finding The Support They Need
What Causes Schizophrenia
Nobody knows exactly what causes schizophrenia, it is likely to be the result of several factors. For example:
- Stress. Some people can develop the illness as a result of a stressful event, such as the death of a loved one or the loss of a job.
- Genetics. You are more likely to develop schizophrenia if you have a close relation with the illness.
- Brain damage. This is usually damage that has stopped your brain from growing normally when your mother was pregnant. Or during birth.
- Drugs and alcohol. Research has shown that stronger forms of cannabis increase your risk of developing schizophrenia.
- A difficult childhood. If you were deprived, or abused, as a child this can increase your risk of developing a mental illness. Including schizophrenia.
There is research to suggest that may be an association between menopause and schizophrenia. This may be due to the hormonal changes during this stage of life for women.
You can find more information about:
- Does mental illness run in families? by clicking here.
- Drugs, alcohol and mental health by clicking here.
- Cannabis and mental health by clicking here.
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Take Care Of Yourself
It can be draining to look after someone with schizophrenia. You need to make nurturing yourself a top priority every day. Itâs common for caregivers to feel sad, angry, alone, or afraid of what others will think.
Reach out to friends and family, and tell them what you need. They can:
- Listen to you without judging you
- Find information and doctors
When To Seek Other Housing Options
In some situations, living with family may be problematic. Examples include:
- The main caregiver is single, ill, or elderly.
- The person with schizophrenia is so ill that there is little chance of leading a normal family life.
- The situation causes stress in the marriage or leaves children in the home feeling afraid and resentful.
- Most family events revolve around the person with schizophrenia.
- Support services are unavailable.
Residential options can help your whole family, and it doesnt have to be a permanent thing either.;A lot of guilt can come with sending a family member to a facility to treat schizophrenia.
Try to remember that these facilities exist because of the challenges you and your household are facing. Using these services doesnt mean youre casting away your family member or that youve given up.;
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Avoiding Drugs And Alcohol
While alcohol and drugs may provide short-term relief from your symptoms, they’re likely to make your symptoms worse in the long run.
Alcohol can cause depression and psychosis, while illegal drugs may make your schizophrenia worse. Drugs and alcohol can also react badly with antipsychotic medicines.
If you’re currently using drugs or alcohol and;finding it hard to stop, ask your care co-ordinator or GP for help.
Look After Yourself Too
Seeing someone you care about experiencing paranoia can be distressing or even frightening. You may feel as if you have no time for yourself, but looking after your own wellbeing is important for you and for them. You may find it helpful to get support through talking therapy or peer support. This may be available at a local Mind or a carer’s group, such as Carers UK.
See our pages on looking after yourself when supporting someone else and how to improve your mental wellbeing for more information.
“Looking after someone with paranoia is incredibly draining having the same conversations day in day out. I learnt to be very clear and concise in my conversations with my father, to be very boundaried and always do what I said I was going to do, leaving no room for misinterpretation.”
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Remind Them To Keep Taking Their Medications
People with schizophrenia may not notice that their medication is improving their mental health or thought processes, but they can notice the side effects. These can include tiredness, dizziness, muscle cramps, and weight gain, and may cause people to stop taking their medications. Working with a doctor;to find the medication that keeps schizophrenia symptoms under control with the fewest side effects can help your loved one stick to his or her treatment plan. Medication calendars and weekly pillboxes can be used to help a person with schizophrenia remember to take medications regularly.
Taking An Active Role
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Crisis Helpline Contact Info
- National Suicide Prevention Lifeline: Call 1-800-273-8255
- The International Association for Suicide Prevention: Visit their website for crisis helplines and other resources outside the United States
- Meet them on their level:Your loved one has schizophrenia even when you cant see their symptoms. It can be more difficult for them to stay focused and concentrated, finish tasks, or follow through on simple household chores and personal hygiene basics. Be patient, and remember to adjust expectations.
- Assess their housing situation:Considering the examples below can help you determine what is best and if you have enough resources on hand to safely support your loved one.;
Diagnosing Anosognosia Does Not Give Anyone Court Or Physician The Inherent Right To Mandate Someone To Treatment
The way I describe it is when you see somebody walking down the street they have a transmitter in their head, it is not because they believe they have a transmitter in their head. They know it. Their illness tells them so. And this is the group who wont accept treatment, and treatment can restore their free will. Being psychotic is not an exercise of free will. It is the inability to exercise free will.
Diagnosing anosognosia does not give anyone, court or physician, the inherent right to mandate someone to treatment. What anosognosia does, Jaffe says, is provide a simple, if hard-to-pronounce, term to explain why so many people with schizophrenia and similar illnesses often behave as if they are unaware that their thinking and behaviour are so dramatically different.
Just as importantly, he says, AOT works. Six years after Kendras Law was implemented in New York, officials had logged a 77% decrease in psychiatric hospitalisations and a 74% decline in homelessness for people in the AOT programme; incarcerations had dropped by 87%. In 2015, seven years after the implementation of Lauras Law, Nevada County reported that people who had completed the AOT programme spent 43% less time in hospital, 52% less time in prison and 54% less time homeless than before they were treated.
The old psychiatric system kept people in facilities where their medication would be supervised
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How Is Schizophrenia Diagnosed
If symptoms are present, your doctor will perform a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose schizophrenia, the doctor might use various diagnostic tests â such as MRI or CT scans or blood tests â to rule out physical illness as the cause of your symptoms.
If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, healthcare professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for schizophrenia. The doctor or therapist bases his or her diagnosis on the personâs report of symptoms, and his or her observation of the personâs attitude and behavior.
The doctor or therapist then determines if the personâs symptoms point to a specific disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders , which is published by the American Psychiatric Association and is the standard reference book for recognized mental illnesses. According to the DSM-5, a diagnosis of schizophrenia is made if a person has two or more core symptoms, one of which must be hallucinations, delusions, or disorganized speech for at least one month. The other core symptoms are gross disorganization and diminished emotional expression. Other DSM-5 criteria for a diagnosis of schizophrenia include:
Consider If There Is A Basis For Their Beliefs
Even if you feel that their thoughts aren’t justified, it’s worth remembering that many paranoid thoughts will have developed from anxieties about a real situation. Try to explore whether there is a basis for their fears. This can help both of you understand how the thoughts have developed.
“The most helpful thing for me is to be taken seriously. On some level I know my beliefs can’t be real, yet to me they are utterly terrifying. Treating the fear as very real, even if you can’t go along with my reasons for the fear, is so important.”
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Tip : Monitor Medication
Once in treatment, careful monitoring can ensure that your loved one stays on track and gets the most out of medication.
Take side effects seriously. Many people with schizophrenia stop taking their medication because of side effects. Bring any distressing side effects to the attention of the doctor, who may be able to reduce the dose, switch to another antipsychotic, or add medication to counter the side effect.
Encourage your loved one to take medication regularly. Even with side effects under control, some people with schizophrenia refuse medication or have trouble remembering their daily dose. Medication reminder apps, weekly pillboxes, and calendars can help. Some medications are available as long-lasting weekly or monthly injections instead of daily pills.
Be careful to avoid drug interactions. Help your loved one avoid any dangerous drug interactions by giving the doctor a complete list of the drugs and supplements theyre taking. Mixing alcohol or illegal drugs with schizophrenia medication is harmful, so talk to the doctor if your relative has a substance abuse problem.
Track your family members progress. A mood-tracking app, journal, or diary is a good way to track changes in your family members behavior, outlook, and other symptoms in response to medication.
Here Are Some Things You Can Do To Help Your Loved One:
- Help them get treatment and encourage them to stay in treatment
- Remember that their beliefs or hallucinations seem very real to them
- Tell them that you acknowledge that everyone has the right to see things their way
- Be respectful, supportive, and kind without tolerating dangerous or inappropriate behavior
- Check to see if there are any support groups in your area
Some symptoms require immediate emergency care. If your loved one is thinking about harming themselves or others or attempting suicide, seek help right away:
- Call the National Suicide Prevention Lifeline at 1-800-273-TALK or text the Crisis Text Line .
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Assess The Intensity Frequency And Duration Of The Delusion
- Keep a log documenting the intensity, frequency, and duration of a persons delusion.
- Determine if their delusions tend to occur at a certain time of day or are related to certain activities or actions. This can help you look for ways to avoid situations that may trigger paranoia or delusions.
- Some delusions are fleeting and brief, while others are more long lasting and endure over a long period of time.
What Not To Say
You may not say the right thing every single time, and thats okay. Even the most well-intentioned people make mistakes. But knowing what not to say can make a major difference in preventing triggers for someone with schizophrenia.
Avoid statements that sound judgmental, stereotypical, and overly controlling. Remember that every case of schizophrenia is unique, and tone matters.;
Examples of what not to say may include:
- Did you take your meds today?
- Are you still seeing a therapist?
- Are you exercising enough?
- People with schizophrenia should or shouldnt
- But you always feel worse when
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Doing Everything For Them
When your loved one is unable to do chores, errands, or daily tasks, you might try to help by taking over those responsibilities.
But its often more helpful to encourage them to take steps toward doing these things themselves and offering support when needed.
You can also ask if theres anything specific getting in the way of tasks:
- If they havent done laundry because they ran out of laundry soap and feel afraid of leaving the house, you could offer to do a grocery run.
- If they cant prepare meals because a voice threatens them whenever they pick up a knife, you might help them chop a few days worth of vegetables in advance.
You can also offer to help them plan and schedule out weekly responsibilities when you spend time together.