Different Ways You Can Respond:
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Finding Mental Health Services
There are a few different options available for clinical treatment. The best choice for you will depend on cost, severity of your symptoms and convenience, but not all services are available everywhere. For people in rural and remote areas, treatment options can be reduced or involve long travel or alternatively can be delivered through telehealth services. Ask your GP for more information about appropriate support options.
Early intervention programs for young people
Psychosis most often develops for the first time during youth. Identifying young people in the early stages of a psychotic illness and providing them with specialised support and treatment can make a huge difference to their future health.
The largest early intervention organisation in Australia is headspace, including their online service eheadspace. Specialist Child and Adolescent Mental Health Services are also available across Australia talk to your GP about finding a service near you.
Your public hospital
The treatment available through a public community mental health team ranges from acute inpatient care, where you are admitted and stay in hospital, to outpatient treatment in the community. The type of service provided can differ a lot from state to state and hospital to hospital.
Your state or territory Department of Health can help you identify your local community mental health services, or you can use the National Health Services Directory.
Treatment in a private hospital
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.
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Tip : Prepare For Crisis Situations
Despite your best efforts to prevent relapse, there may be times when your loved ones condition deteriorates rapidly and hospitalization is required to keep them safe. Having an emergency plan ready for an acute psychotic episode will help you handle the crisis safely and quickly. A good emergency plan for someone with schizophrenia includes:
- Emergency contact information for your loved ones doctor and therapists.
- The address and phone number of the hospital you will go to for psychiatric admission.
- Friends or relatives who will take care of other children or dependents while you deal with the crisis.
Its also wise to go over the emergency plan with your family member. The crisis situation may be less frightening to your loved one if they know what to expect during an emergency.
10 tips for handling a schizophrenia crisis
How To Best Support Someone With Psychosis
This article was first published here, on the blog of Dr. Melissa Welby
Psychosis can be a terrifying experience for everyone. When a loved one has a psychotic episode, families, and friends are usually not prepared. The first step is figuring out What is psychosis? and getting a basic understanding of what might be happening. After that, plans can be made for how to deal with the psychosis.
People are often too scared to talk to the person because they dont know how to respond to the psychotic thoughts. It is much easier to support them and stay connected if you know the best ways to communicate. Read this to learn how to help someone with psychosis.
I am not going to talk about the treatment options for psychosis or the importance of early intervention in this post. If you would like to read more about this check out this great resource.
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Build A Safety Net Of Real People And Ideas
Be with the people you care about. Think of them in your darkest hours. Find a way out of negative thoughts by having beliefs and ideas that are uplifting. These tactics and my family and friends are my own safety net. These tactics may be a good starting point for you, and can help you construct a safety net that is unique to you. They have helped me, I hope they help you.
Ways To Cope With Someone Who Has Delusions
Try to offer empathy and focus on the emotions that the person is experiencing. Arguing facts and details may cause the person to shut down and perceive you as judging them. By offering support with no judgement that doesnt confirm or deny the delusion, the person may feel consoled and trust that you care for them. Some things to keep in mind as you speak to the person:
1. Pay attention to the emotions of the person
2. Discuss the way you see the delusion
3. Express that you are concerned about the person
4. Offer to pursue therapy together but be strategic
5. Ask the person why they believe as they do and be open-minded
6. Avoid getting frustrated and expressing that to the person
7. Learn about Cognitive Distortions or Thinking Errors
8. Model engagement in reality testing
Information for these strategies are from Tamara Hills article on PsychCentral, an independant mental health website with information and content overseen and created by mental health professionals.
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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.
Dementia And Other Brain Disorders
Dementia progressively damages the brain, including regions involved with sensory processing. People in mid to late stage dementia may experience auditory and visual hallucinations.
Sometimes, they see people who have died. In other cases, their hallucinations may be terrifying and can trigger feelings of paranoia and panic that make it difficult for them to trust caregivers.
Medication may help ease these symptoms.
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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 whats 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 dont be afraid to access support!
Dont try to reason with them about hallucinations or delusions and dont 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 cant 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 dont 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.
Helping A Friend Or Family Member With Psychosis
When someone you care about develops psychosis, it can be difficult to adjust. You may have a lot of different feelings including:
All of these feelings are normal and OK. Finding out that someone you know has psychosis is a big change and everyone needs time to adjust.
Here are some things you can do to help your friend and yourself:
- Be there for your friend or family member. You cant fix their psychosis, but it will help them to know they have your support.
- Remember its not your fault. Your friend or family member may say or do unusual things when theyre experiencing psychosis. This is caused by their illness, not by what you say or do.
- Learn about psychosis and mental illness.
- Connect with others who have friends or family members with psychosis or other mental disorders. Visit Resources Around Me to find support groups or associations in your community.
- Raise awareness about psychosis and mental health. Challenge stereotypes and bullying when you encounter them.
- Take care of yourself by eating well, staying active and getting enough sleep. Youll be in better shape to help others if youre healthy yourself.
- Allow yourself to take breaks or feel frustrated youre doing the best you can!
- Ask for help from others when you need it. You can always call a counsellor at Kids Help Phone we can help you find resources in your area and it can feel good to talk.
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What Is The Cause Of Schizophrenia
The cause is not known for certain but there are several current ideas. It is thought that the balance of brain chemicals is altered. Neurotransmitters are needed to pass messages between brain cells. An altered balance of these may cause the symptoms. It is not clear why changes occur in the neurotransmitters.
Inherited factors are thought to be important. For example, a close family member of someone with schizophrenia has a 1 in 10 chance of also developing the condition. This is 10 times the normal chance. A child born to a mother and father who both have schizophrenia has a higher risk of developing it but one or more factors appear to be needed to trigger the condition in people who are genetically prone to it. There are various theories as to what these might be. For example:
- Stress such as relationship problems, financial difficulties, social isolation, bereavement, etc.
- A viral infection during the mother’s pregnancy, or in early childhood.
- A lack of oxygen at the time of birth that may damage a part of the brain.
- Illegal or street drugs may trigger the condition in some people. For example, heavy cannabis usage may account for between 8% and 14% of schizophrenia cases. Many other recreational drugs such as amfetamines, cocaine, ketamine and lysergic acid diethylamide can trigger a schizophrenia-like illness.
The Most Common Early Warning Signs Include:
While these warning signs can result from a number of problemsnot just schizophreniathey are cause for concern. When out-of-the-ordinary behavior is causing problems in your life or the life of a loved one, seek medical advice. If schizophrenia or another mental problem is the cause, getting treatment early will help.
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Do Use A Gentle Voice
Using an aggressive tone can make the person feel as if theyre backed in a corner. Again, schizophrenia is a difficult disease to cope with. You never know how the person is truly feeling, even if youve asked. Its important to remind yourself that they may do or say certain things without realizing the harm or pain they may cause. While it may be easy to become frustrated or angry with them, you should never yell, say harsh things, or speak in a strong voice to them. Instead, speak gently. Be honest, but dont be harsh or aggressive. This person is probably relying on your support, and its best to express your concerns in a gentle manner.
Tip : Watch For Signs Of Relapse
Stopping medication is the most frequent cause of relapse in schizophrenia, so its extremely important that your family member continues to take all medication as directed. While relapse can occur even if a person is taking medication as prescribed, you may be able to prevent a full-blown crisis by recognizing the warning signs and taking immediate steps.
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Dont Take It Personally
Schizophrenia can be a difficult illnessfor everyone. During episodes of psychosis, your loved one may experience frightening sensations that you cant understand. They may act in ways that you dont understand. Other symptoms of schizophrenia can make it hard for people to express emotions or feelings, communicate clearly, or seem interested in others. Its important to know that these are symptoms of an illness. They are no ones fault, but they can still be hard to cope with. Consider reaching out to a family and friends support group for your own support. The BC Schizophrenia Society has a directory of groups around BC at www.bcss.org/monthly-meetings-calendar/.
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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How To Deal With Psychosis:
How you respond to a loved one with psychosis can make a big difference in your ability to maintain a relationship with them. Bear with me while I try to explain:
Imagine standing next to your loved one while communicating. Try to see what they are saying through their eyes and not your own. You are by their side listening and not challenging them head-on. Focus on the emotion of the conversation not whether the facts are plausible. When they speak, listen to the themes in what they are saying. There are usually reality-based themes sewn in and that is what you can focus on.
Investigate How The Delusion Is Affecting The Person’s Life
- Assess if and how the delusions are interfering with a persons life. For example, are they are no longer able to function or participate in regular everyday life?
- Assess if the delusion is affecting a persons relationship with others.
- Determine if the person has taken action based on their delusion.
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Changes In Behaviour And Thoughts
A person’s behaviour may become more disorganised and unpredictable.
Some people describe their thoughts as being controlled by someone else, that their thoughts are not their own, or that thoughts have been planted in their mind by someone else.
Another feeling is that thoughts are disappearing, as though someone is removing them from their mind.
Some people feel their body is being taken over and someone else is directing their movements and actions.
Use Empathy Not Arguments
Symptoms of schizophrenia like hallucinations or delusions can take some time to stop even when people are receiving treatment and following their treatment plan. As a group, these very distressing symptoms are called psychosis. Many people have a hard time responding to a loved ones hallucinations or delusions. Its best to avoid arguing about these experiences. Remember that delusion are symptoms of schizophreniathey are not thoughts that you can talk someone out of. Telling someone that their experiences arent real or arent true doesnt help when the experiences feel very real to that person! A better approach is to empathize with the feelings that hallucinations or delusions bring upwithout confirming or denying the hallucination or delusion. For example, if a loved one is frustrated or upset when they hear voices, it isnt helpful to say something like, Youre okay! It isnt real. I dont hear anything. Instead, you might say, I can only image how upsetting that voice must be. I can see the voice makes you feel scared. Know that with good treatment and support, symptoms like hallucinations and delusions become much easier for people to manage and lose importance.
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