Supporting someone diagnosed with schizophrenia

Psychosis describes experiences such as hallucinations, delusions and disorganised thinking. It can happen with schizophrenia, bipolar disorder, severe depression and other causes. It may happen once, recur or continue over time.

Schizophrenia is a diagnosis made through a professional assessment. It does not mean a split personality. Someone may have periods with few or no psychotic symptoms while still needing help with other difficulties. Recovery varies; the diagnosis alone cannot tell you what their future will look like. ^[11]

Ask the clinician to explain what the diagnosis means for this person, what support is available and when their care will be reviewed. The guide to the first days after a diagnosis covers questions, information and who to tell.

Losing motivation or enjoyment, speaking less and showing less emotion can be what clinicians call negative symptoms. These difficulties can be mistaken for laziness or not caring. They may continue when voices or unusual beliefs are less noticeable. ^[12]

Do not assume every change is part of schizophrenia. Depression can look similar, and medicines can cause drowsiness. Tell their team what has changed and ask for a review. ^[13]

• Offer help getting started with one agreed task.
• Keep requests clear and give them time to respond.
• Keep making room for interests and time together, without every visit becoming a check on chores.

These suggestions draw on Lancaster University’s REACT toolkit. They are options to try together, not a test of how hard either of you is trying. ^[14]

Schizophrenia can affect remembering, learning, concentrating and making decisions. An appointment or a task with several steps may be harder than it looks from outside. Tell the team which everyday activities are difficult and ask what practical support could help. ^[15]

Use clear, brief explanations and check what they have understood. If they want help with reminders or getting started, agree what would be useful rather than taking over. Helping without taking over has more ideas.

Offer to help them prepare for a review with their prescriber. Include what has improved, what is still difficult and any side effects affecting daily life. Medication decisions belong to the person and their clinician; do not change doses for them or encourage sudden stopping. ^[16]

If psychotic symptoms remain troublesome after two different antipsychotics have been tried for several weeks each, ask the psychiatrist whether clozapine should be considered. The clinician needs to assess the previous treatments and whether it is suitable. The medicines guide covers reviews and precautions, including clozapine. ^[17]

Ask about psychological and practical support as well. Family intervention can help you understand what is happening and work through difficulties together.