Living with Schizophrenia: What it Means for a Caregiver

What if you lived in a world where you couldn’t trust your own senses? You might see or hear things that aren’t real, and constantly have to battle intrusive, disordered, and sometimes destructive thoughts. Sounds like a plot for a psychological thriller right? But for over 20 million people in the world living with schizophrenia, this is the reality. 

You may have heard of schizophrenia before, it’s commonly depicted in popular media, after all. But the disorder is often painted in a negative light by filmmakers and writers — usually as a villainous trait. Popular movies such as Shutter Island, A Beautiful Mind, and Karthik calling Karthik portray schizophrenia in an inaccurate, if not outright negative, light. With these exaggerated and sometimes false portrayals out there, it can be hard for the average person to separate fact from sensationalized fiction. Misrepresentation can make it even scarier when a loved one is diagnosed with it. But the first part of being a caregiver is thoroughly understanding the disorder. So let us help clear the air, as we dive into the causes, symptoms, and caring of people with schizophrenia, as well as options for neuropsychiatric disorder treatments. 

What is Schizophrenia

Schizophrenia is a mental disorder that is characterized by disturbances in thinking (cognition), emotional responsiveness, and behaviour. It often presents itself as hallucinations or delusions, which makes it hard for the afflicted to identify what’s real and what isn’t. And due to the condition's misrepresentation by the media, there are several common myths that people have fallen prey to. For example, schizophrenia is not a personality disorder. It has nothing to do with split or multiple personality disorders (which occupy a different category of psychiatric disorders altogether). And unlike popular media portrayals, most people with schizophrenia are not violent or dangerous, and they aren’t always hospital-bound. The complexity of the disorder also means it can be misdiagnosed. Other disorders that schizophrenia may be mistaken for, or that may develop in tandem are:

• Schizoaffective disorder
• Delusional disorder
• Brief psychotic disorder
• Schizophreniform disorder
•  Catatonia

Symptoms of Schizophrenia

The American Psychiatric Association has collated all recognized psychiatric disorders into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V). It is the most up-to-date and accepted manual for the diagnosis of psychiatric disorders. In order to be diagnosed with schizophrenia, the DSM 5 states that a patient must significantly present two or more of the following over at least one month:

• Delusions
• Hallucinations
• Disorganized speech
• Grossly disorganized or catatonic behaviour
• symptoms (A loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure.)

Causes of Schizophrenia

There are many possible causes of schizophrenia. Research suggests that it can be linked to genetic, psychological, and environmental factors. The onset of the illness usually occurs during late adolescence or early adulthood — a particularly tumultuous time in behavioral, emotional, and biological development. This moment of upheaval could make people more vulnerable to this disorder, especially if they are not able to adequately cope with the rapid changes that occur physically, mentally, and emotionally in this time.

Another essential consideration is the placement and number of neurotransmitters. Brain imaging shows a significant difference in the brain structure of people with and without schizophrenia. Equally important is the presence or absence of certain genes that could influence brain development or function. Other risk factors include:

• Family history of schizophrenia
• Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development
• Taking mind-altering drugs during teen years and young adulthood

Treatments for Schizophrenia

Like most psychological disorders, there is no cure for schizophrenia. However, there are a number of treatments that can help manage the symptoms. Antipsychotic medication is the most common and is prescribed to help manage the sensory symptoms such as hallucinations. These medications are often paired with psychotherapy to help cope with the cognitive and behavioral symptoms. Under this category the most common are:

• Individual therapy  — One on one with a therapist to learn how to deal with intrusive thoughts etc
• Cognitive Behavioral Therapy (CBT) — Focus on changing the way a patient thinks, used to help deal with hallucinations
• Cognitive Enhancement Therapy (CET) — Helps patients recognize social cues or triggers that can exacerbate their condition

These treatments are usually followed by psychosocial therapy to help patients create a strong support network and live a healthy, and happy life. In more rare, severe cases, such as patients experiencing catatonia, a doctor may recommend Electroconvulsive Therapy. Another important part of schizophrenia and other  neuropsychiatric disorders treatment is Occupational Therapy (OT). OT helps schizophrenic patients get back control over their daily lives, reteaching them how to interact appropriately with the world around them. It works with patients on four categories — sensory integration, activity groups, social skills, and living skills. Together, they help the patient feel more motivated, reduce the severity of symptoms, and make it easier for patients to confidently interact in the community. 

Caregiver Support

So what can you do if one of your loved ones is diagnosed with schizophrenia? The first step is to do your best to understand what the disorder is, and the challenges that come with it. Hopefully, we have helped a little with that first step. Living with schizophrenia is scary, and your loved one is going to struggle a lot. But remember that they can still live a full and meaningful life — and remind them of the fact whenever they need to hear it. Being a caregiver for someone with schizophrenia might involve:

• Helping them recognize and reduce environmental stressors which can cause the symptoms to flare up
• Taking them to therapy sessions, making sure they take their medications, and otherwise supporting them in their treatment journey
• Listening to them — people with schizophrenia often face a lot of stigma, it can help to know they have a sympathetic friend to talk to
• Working with them to help set realistic goals for treatment and recovery from symptoms

To adequately help support your loved one, the most important thing to remember is that you have to take care of yourself. Remember that this experience affects you as well. Create a support system that will help you cope with the challenges of care giving. Developing a routine can also really help both you and the patient. It creates a predictable environment that reduces stressors — it can be a lot easier for you to manage the day and spot ‘bad days’ when you know what to expect. Also, practice self-care. Make sure you’re eating well, exercising, and taking time for yourself. It can be easy to become resentful at your role as a caregiver, and factors such as poor nutrition and stress can amplify negative feelings. Most importantly, remember that neither you nor your loved one are going through this alone. Talk to each other, learn with each other, and maybe even join a support group. In most cases, simply having someone who understands can make the experience a lot easier to manage.

A schizophrenia diagnosis doesn’t mean that you and your loved one will live a life that is somehow lesser in any way. With a little care and support, you can both live rich and fulfilling lives. Look into neuropsychiatric disorders treatments, support groups, and other ways to make your lives easier — just remember, you’re on this journey together.