How to talk to relatives with a person with schizophrenia. How to deal with someone with schizophrenia

60 tips to help those caring for someone with schizophrenia

Translation: Irina Goncharova

Editor: Anna Nurullina

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How to help people with schizophrenia?

Tips for overcoming a crisis.
Tips for improving communication.
Tips for preventing relapse.
Setting boundaries.
Tips on how to behave with a person who has schizophrenia or a similar illness.
How to accept the fact that your relative has schizophrenia.

If you have someone in your family who suffers from a neurobiological disorder (formerly called mental illness), you should always keep the following points in mind:

1. You cannot cure your relative's mental illness yourself.

2. Despite your best efforts, your symptoms may get better or worse.

3. If you are filled with resentment and pain, it means you are too immersed in illness. loved one.

4. It is just as difficult for the patient to come to terms with his condition as it is for his family.

5. If all the people involved in the problem can accept the fact that a person close to you is ill, this is very good, but not necessary.

6. There is no need to discuss what cannot be changed.

7. By communicating with a sick relative, you will learn a lot about yourself.

8. Separate for yourself the person from his illness. Love your relative even if you hate his illness.

9. Try to differentiate side effects drug therapy, symptoms of illness and personality traits.

10. Do not neglect your own needs and desires; when taking care of a loved one, do not forget about yourself.

11. If you are the sibling or adult child of someone with a neurobiological disorder, you have a 10 to 14% chance of passing it on to you. If you are over thirty, then this opportunity is negligible.

12. The probability of your children getting sick is from two to four percent. In general, one percent of the population of our planet suffers from schizophrenia.

13. If your relative is sick, there is nothing to be ashamed of. However, you may face misunderstanding and discrimination from society.

14. There is no need to blame anyone.

15. Don't lose your sense of humor.

16. You may have to reconsider the personal relationship between you and your relative.

17. You will also need to reconsider your expectations.

18. Each person has his own level of success.

19. Recognize the amazing courage your loved one can demonstrate while living with a mental illness.

20. Your relative is free to choose how to live - just like you.

21. If all your actions are aimed only at surviving in difficult situation, your feelings may fade. Don't let this happen.

22. Not being able to talk about your feelings can hamper your emotional life.

23. Due to the illness of one of the family members, relationships within the family may become tense and disorganized.

24. As a rule, brothers and sisters of close age and the same sex become overly involved in the illness of a loved one, and brothers and sisters distant in age withdraw from the problem.

25. Brothers and sisters who care for the sick person regret that they cannot lead a normal life for their age. Having grown up, the children of the family worry that a difficult situation has deprived them of a normal childhood and forced them to play adult roles.

26. After rejection, despair and anger comes awareness of the situation and resignation to the inevitable, then along with understanding you will feel compassion.

27. Mental disorders, like other diseases, are part of a diverse and unpredictable life.

28. Get rid of imaginary suffering, accept your real pain.

29. Reason mental illness – biological disorders brain function. They are not related to a person's mental health.

30. It is absurd to believe that such physiological diseases, like diabetes, schizophrenia or manic depression can be cured by talking, but communication can have a positive effect on social relationships.

31. Symptoms may change over time, but the disease remains with the person for life.

32. Your relative’s condition may periodically change from remission to exacerbation and vice versa, regardless of your expectations and actions.

33. Regarding diagnosis and everything connected with it, you should contact professionals.

34. Schizophrenia is not one disease, but a whole spectrum of disorders.

35. The same diagnoses do not mean the same courses of treatment, similar symptoms and the same causes of the disease.

36. Strange behavior is one of the symptoms of the disease. Don't take it personally.

37. You have the right and must take care of your personal safety.

38. Do not take on the full burden of responsibility for the life of your sick relative.

39. Work with your own problems by involving professionals. You can't solve them yourself. Stick to your natural role - brother, child, parent of the patient. Don't change this role.

40. Everyone who is in one way or another associated with a mental disorder: professionals, loved ones and the patient himself - has ups and downs.

41. Forgive yourself and others for all the mistakes you have made.

42. The competence of psychiatry specialists varies.

43. If you can't take care of yourself, you can't take care of another person.

44. Perhaps someday you will forgive your relative for being sick.

45. The needs of the patient do not necessarily come first.

46. ​​It is very important to set clear boundaries and stick to them.

47. Most modern researchers who are searching for the cause of this disease, speak in favor of genetic or biochemical factors, complications during intrauterine development or exposure to viruses. In each individual case, the cause may be a combination of factors or one of them, or the cause may lie in completely different circumstances.

Behind genetic predisposition a number of individual genes or genetic combinations may respond.

48. Learn more about mental disorders. We recommend the books “How to Survive with Schizophrenia. A Family Guide" by Dr. I. Fuller Torrey and

"Overcoming Depression" by Dr. D. Papolos and J. Papolos.

49. From the book How to Survive with Schizophrenia: “Schizophrenia selects personality types at random, and families should remember that people who were lazy, manipulative, or narcissistic before the illness are likely to remain that way once they become ill.” Another quote: “In general, I think that most schizophrenics are better off living somewhere other than at home, but if such a person does live at home, then he needs two things: privacy and a clearly organized life.” And one more thing: “Treat a sick family member, not forgetting about his human dignity.” Also here you can find the following recommendation: “Make your communications short, concise, clear and unambiguous.”

50. If you cannot help your sick relative, then it may be useful and healing for you to help someone else.

51. If you accept that a person has limited opportunities, this should not mean that nothing can be demanded or expected from him.

52. The suicide rate is 10% of all human deaths. One of

these people could be your relative. Talk to him about it to avoid tragedy.

53. Mental disorders affect life more than physical suffering and illness.

54. Intrafamily conflicts can be unconsciously projected by you onto

relationships with other people.

55. In such situations, it is quite natural to experience strong and burning emotions such as grief, guilt, fear, anger, despondency, pain, embarrassment and so on. Remember that only you yourself are responsible for your feelings, and not your sick relative.

56. Eventually, in the darkness of your grief, bright rays of light will appear: knowledge, awareness, sensitivity, resilience, compassion, maturity, tolerance, love for your neighbor.

57. Allow your family to deny the fact that a family member is ill if they cannot accept it. Find other people you can talk to.

59. The mental illness of one of your relatives is a deep emotional trauma. If you do not receive support and help, constant stress can cause serious harm to you.

60. Seek help from the Association for the Support of People Suffering from Mental Illnesses (AMI) and the Association for the Support of Their Families (FAMI) and look for a way out!

How to deal with your relative during an exacerbation of the disease

The following recommendations are provided by the Hamilton County, Ohio chapter of the Mental Health Association. They should help you cope with the patient's worsening condition. Note, however, that each person is individual and these practical advice cannot be applied to all patients in a row.

Some actions will help you reduce the severity of the attack or even avoid it completely. You must stop the growing mental stress and immediately provide your sick relative with the protection and support he needs. Remember: situations always turn out favorably if you speak softly and use simple, short sentences.

It rarely happens that a person suddenly completely loses control over his thoughts, feelings and actions. There are warning signs, namely: insomnia, ritual preoccupation with certain activities, suspiciousness, sudden outbursts of anger, mood swings, and so on. On these early stages an acute crisis is averted. If a person stops taking their medication, it is advisable for you to encourage them to visit a doctor. The worse his condition, the less likely that you will achieve this. Trust your feelings. If you are scared, take action immediately.

Your main task is to help the patient regain control of himself. Try not to worry him. He may be very scared anyway. possible loss control over thoughts and feelings if he understands the change in his state. Domestic

“voices” can give him life-threatening commands; perhaps your relative sees snakes crawling on the windows, hears messages from lamps, feels toxic fumes in the room. Accept that the patient is living in a distorted reality and is acting on his hallucinations. For example, he may want to break a window,

to destroy the snakes. It is extremely important that you remain calm. If you are alone, call someone before you arrive. professional help do not be alone with the patient.

The patient may be hospitalized. Try to convince him to go with the doctors voluntarily, but do not use a patronizing or authoritarian tone. If necessary, take measures to compulsory treatment. If you think necessary, call the police, but prohibit brandishing any weapons. Explain that your friend or relative is mentally ill and that you called them for help.

Don't threaten. This can be perceived as a power play, increase fear and provoke an outburst of aggression.

Do not Cry. If a person cannot hear you, it is most likely because other “voices” are bothering him.

Don't criticize. It never helps, it only makes things worse.

Do not quarrel with other family members in search of a way out of the situation, trying to determine who is to blame. Is not best time prove your point.

Do not respond to the patient's threats to do something terrible. Do not answer them so as not to provoke a tragedy.

Do not stand over the patient: if he is sitting, it is better to sit down yourself.

Avoid prolonged eye contact or touching.

Comply with requests if they do not pose a threat and are within reason. This gives the patient the opportunity to feel in control.

Do not block the doorway. But position yourself between the patient and the exit.

Here are some other tips that may help you if you live with someone who has a neurobiological disorder. Some of them are prepared by the Association for the Support of People Suffering from Mental Illness, others are formulated by Dr. Jill Tunnell and Marion Burns.

1. Take your time. Overcoming a crisis takes time. Do not get ahead of events, do not spur their natural course. Take breaks, rest.

2. Don't heat up the situation. Keep your cool. Enthusiasm is good. But you better turn it down. It's okay to argue. However, resist the urge to argue.

3. Leave your loved one alone for a while, give him a break from communication, and be alone with himself. Breaks are very important for any person. You don't have to stop communicating completely. You can offer him something - that's okay. But if he refuses, there’s nothing wrong with that either.

4. Set boundaries and rules. Everyone should know and follow them. Some good rules will help keep the situation under control.

5. Don't try to control what you can't change. But never ignore manifestations of violence!

6. Don't complicate things. Say what you want to say clearly, calmly and

positive.

7. Make sure you follow your doctor's orders. Medicines should be taken only as prescribed by a doctor in the prescribed dosage.

8. Carry on with your normal social and business life. Restore normal

family routine as quickly as possible. Maintain family and friendship connections. Take a vacation.

9. No drugs or alcohol. They make symptoms worse.

10. Notice early signals impending crisis. Watch for mood changes, unexplained fears, increasing irritability, and so on.

11. Solve problems gradually, step by step. Select specific goal and work only on it, without being distracted by others.

12. You'd better lower your expectations for a while. Track your progress using your personal system. It is better to compare the small achievements of this month and last month than to compare the data of this, last and next year.

How to prevent relapses

Provide a clearly structured, calming environment, which will provide the patient with the necessary support and protect him from stress. Establish clear standards of behavior that everyone must know and follow. Give your relative specific tasks, but don't expect too much from him. Learn to wait and also tolerate deviant behavior within reasonable limits. Establish a specific daily schedule, a daily routine with a constant schedule for any events at home.

Keep the home atmosphere as calm as possible. Each family member must speak for himself and for himself what he wants to say. There is no need to read other people's thoughts and feelings. Let each family member have his own relationships with other relatives. Don't ask your brother to tell your sister something. Do it yourself. Remind your loved ones of this rule.

Try to maintain emotional distance, do not strive for constant control your relative. Let him walk or move around the house on his own. Keep criticism and excessive praise to a minimum. Don’t be intrusive, don’t try to think and feel for him, don’t say phrases like: “You won’t like this kind of work,” or “You definitely won’t like this.” Expect peaceful, calm and safe periods and enjoy them. Treat your relative's behavior with benevolent indifference, without focusing on the details.

Set limits on hostile or strange behavior. Manifestations of deviant behavior or delusions are often reduced if the patient is told calmly and not too emotionally that such things are unacceptable. If your relative suffers from paranoid ideas: for example, he believes that people want to harm him

harm - do not argue with him. Instead, sympathize, say that this must be very upsetting. If destructive aggressive behavior continues, think about its consequences as calmly as possible.

Provide treatment and stimulation opportunities. Learn to recognize signals that indicate that the disease is receding or, on the contrary, worsening. Inform your attending physician of any changes in the patient's condition. Provide stimulation in non-stressful conditions. Walks, visits and other social outings can help if your relative is interested in them and has good self-control. This can only be determined by trial and error. Families can benefit from available social programs. Find out as much as possible about them, take advantage of every opportunity to help your loved ones, protect and defend their rights. The more active your actions are, the best care your relatives will receive and the more stable their condition will be.

Take care of yourself. Families have a responsibility to take care of themselves. Share your emotions with other people. Join support groups. Look out for your own interests. Expand your social contacts outside of your family. Make sure that all your relatives do not forget about their needs, and do not live solely in the interests of the patient.

Remember: the future is unpredictable, live in the present. Do not wait quick results. Do not put pressure on your relative by expecting visible positive reactions. Maintain a healthy balance between being realistic and hoping for the best.

How to communicate?

Effective communication with people with schizophrenia is very important, as they are easily influenced external environment. Thoughtful communication can have a profound impact on the ability of patients and their families to solve everyday problems.

Effective communication requires that you understand what, how and when to talk to your relative.

When is the best time to start a conversation?

Don't discuss important questions when you are angry or upset. At such moments it is difficult to think clearly, listen carefully and accept Constructive decisions. Before starting a conversation with your relative, you should give yourself time to calm down.

What needs to be discussed?

Schizophrenia is serious illness, which affects not only the patient, but also all the people around him. Therefore, in their life together there are many problem areas that need to be discussed and then the issues related to them resolved. Work carried out in all directions at the same time will be ineffective and will throw your relative off balance. It's better to choose one specific problem

or a behavior you would like to change. Tell him, for example: “John, please stop listening to the radio at such a volume after ten in the evening.” Don't say, "John, you make a lot of noise at night."

How should you communicate?

Communication occurs at two levels: verbal and non-verbal. Verbal communication is what you express with words. Keep it short, simple and to the point. Nonverbal communication- this is what accompanies your words: your tone, posture, gaze, facial expression, the distance between you and your loved one. It often happens that the nonverbal message is more important than the words themselves.

The main principles of nonverbal communication

1. Do not stand next to your relative, do not invade his/her personal space.

2. Show interest, concern and anxiety through your body language and facial expressions.

3. Maintain eye contact.

4. Speak calmly and clearly.

How can I show my approval?

1. Look at the person.

2. Tell him specifically what action he did that made you so happy.

3. Tell your relative how their actions make you feel. ( Bad example: “It’s great that you live with us.” Good example: “I love it when you clean the kitchen so clean.”)

How to make a kind request?

1. Look at the person.

2. Tell him exactly what you would like him to do.

3. Let him know how you will feel when he fulfills your request.

4. Use the following phrases in conversation: “I would like you to...” or: “I

I would be very grateful if you..."

How to express negative emotions?

1. Look at the person. Tell him which of his actions upset you.

2. Tell your relative how you feel.

3. Suggest out loud how he could avoid similar actions in the future. (Bad example: “You scare us.” Good example: “I get really nervous when you pace around the room like that.”)

How to actively listen?

1. Look at the speaker.

2. Listen to him carefully.

3. Nod your head, say: “Uh-huh... Yeah...”

4. Ask clarifying questions.

5. Ask again.

Here are some examples positive statements, which you can use in conversations with someone suffering from a neurobiological disorder. They were compiled by Dick and Betsy Greer and can help you communicate with a sick relative.

HOW TO ENCOURAGE?

Phrases that can encourage your loved one and express confidence in his abilities

“I know you will do great.”

“You can do it, don’t doubt it.”

“I believe that you will solve this problem. Everything will work out!”

Phrases that can be used to express joy at the successes and achievements of your relative

“Look how much you've already done!”

“It looks like you put a lot of effort into this.”

“It’s immediately obvious that you tried very hard.”

"You've thought this through well."

“You did your best.”

"You've done more than you think."

“If you analyze your achievements, you will see that...(give specific facts below).”

“You have to be very courageous to do all this.”

Phrases that express approval

"I like your approach."

“I’m really glad you like studying.”

“I am very happy that you are so pleased with your success.”

“You look happy. I'm happy for you".

“Since you are unhappy with the situation, let’s think about what you can do to improve it?” "I know you're very pleased."

Phrases that express gratitude for any help

“I really appreciate your help, it made my job a lot easier and I was able to finish it on time.”

“Your idea helped us figure everything out.”

“Thank you, that helped a lot.”

“We really need help, and you have exactly the skills and knowledge that could be useful to us.”

“I really liked your suggestion. Your idea worked!”

"I would appreciate any help from you."

BOUNDARIES or “Why doing less for your sick relative should not make you feel remorseful.”

As you care for someone with a neurobiological disorder, you may be thinking, “This person needs special care. I will do everything I can for him as long as I have the strength.” Or this: “This person has special needs. I will try to satisfy them all, whatever they may be, I will help him always and everywhere.”

Such thoughts seem very noble, but they create serious problems for patient care. Always remember two important points:

You must set boundaries for your own good.

It is true that the other person needs you. You can help him and find special meaning in it for yourself. But you should never do absolutely everything yourself. And you should never do anything to your detriment.

When you are constantly around another person and taking care of them all the time, it does not give you the opportunity to remember your own needs. And your needs are also very important. If you don't think about them, you'll soon find yourself on the path to emotional exhaustion and burnout.

The boundaries you need to set also include physical boundaries. You have to do difficult things. There are long hours in a day that you find difficult to bear. Troubles and worries take up all your time, and you definitely need rest.

You should also set emotional boundaries. If you empathize too much with another person's painful emotions: pain, fear, or other strong feelings, – you can make them yours. You must deal only with your own feelings.

Remember also that if you somehow limit your care for the patient, this will give other people the opportunity to care for him. Other family members and your friends will be able to share your debt with you. For them, this is a way to cope with the situation and an opportunity to show their love.

You must set boundaries for the benefit of your sick relative.

One way to show someone your respect is to give them their space. Someone close to you who has a neurobiological disorder needs privacy just as much as they did before they were sick. He needs to be alone with himself, meditate, read, or just sit, looking out the window and doing nothing. Give him this opportunity.

Your relative needs freedom to act independently, for him it is a matter of self-respect and, possibly, further recovery. If you take on too much, you leave him little opportunity to exercise his own abilities - mental and physical.

Correct and firm boundaries give your loved one this additional advantage, making your presence in his life more useful and independent. You will be able to delve deeper into the essence of the problem and, accordingly, provide more effective support.

Overall, setting boundaries is one of the most important things you can do. It may even bring you closer together.

(Chapter 8 from James E. Miller's When You Are the Caregiver: 12 To Do If Someone

You Care For Is Ill Or Incapacitated")

Schizophrenia: how to behave?

How to behave with a person suffering from schizophrenia or a similar disease? This may seem like a strange question, but many people don't understand what makes it difficult to communicate with people who suffer from NBD. Most people feel awkward and even afraid when talking to a person with a mental disorder. Here are some tips for family members and strangers to help make communication with such a person effective and meaningful.

We learned that we needed to speak slowly and clearly, in simple, short sentences, making sure that the meaning of our words was conveyed to the listener. Why does this make communication easier? A person with schizophrenia answers this question: “Sometimes I lose concentration and can only hear part of a sentence. Perhaps two or three words will escape me. This makes it very difficult to understand. We recently went on a family picnic. Other families were present, people were talking, and I heard every word in their conversation. The noise of voices and the movement of people around me suddenly caused me to panic. I felt anxious and irritated at the same time, I needed some kind of protection. My dad took me to a quiet place where we sat down and asked for some tea. We didn't talk about anything. We just sat and drank tea, and gradually my fear subsided.”

We have often been told how much people with schizophrenia need clear organization. Everyday life. Daily, predictable routines are calming to a person whose unstable condition often disrupts the usual course of life. It is considered useful to create a schedule for each day and indicate several tasks that need to be completed at certain times and on specific days of the week.

Is it possible to do this? Some people with schizophrenia are disabled, either all the time or some of the time. In such cases, it is not always possible to follow a schedule, although in any case you should try to maintain a daily routine. If your relative, client or friend tries to do something and fails, it is wrong and not helpful

for you to respond to this with the words: “Can’t you do anything right?” or: “Let me do it!”, even if you are very upset. Break the task down into simple components so that success is inevitable, praise and encourage. Give one instruction at a time.

How to maintain balance? When your loved one is in acute condition, you may feel as if you are walking on broken glass. At such moments, you need to gather all your energy in order to maintain balance in the house and not lose the trust of your relative. Here are some ideas to help you cope with this task. They will be useful to your family and strangers.

1. Keep a friendly tone.

2. Express understanding.

3. Give encouragement.

4. Listen carefully and patiently.

5. Engage your relative in conversation.

6. Treat him with respect. What should you avoid?

1. Avoid a patronizing tone.

2. Don't criticize.

3. Don't put the person in an awkward situation.

4. Don't be moody.

5. Do not quarrel with your sick relative or other family members in his presence.

6. Don't lecture him or talk too much.

7. Don't lead to situations that will be difficult for both of you.

Sooner or later, a crisis will occur in the condition of a person with schizophrenia. When this happens, you can take some steps to avoid a spontaneous explosion or at least reduce the intensity of the situation. Here are some important points:

1. Do not try to discuss with a person who is in a state of acute psychosis.

2. Remember that he may be terrified that he is losing control of his feelings.

3. Don't show irritation or anger.

4. Don't shout.

5. Don't use sarcasm as a weapon.

6. Reduce distractions: turn off the TV, radio, dishwasher and so on.

7. Ask random visitors to leave: than less people, all the better.

8. Avoid prolonged direct eye contact.

9. Don't touch the person.

10. Sit down and invite him to sit down too.

Changes in life

Often our loved ones with NBD move or change their life circumstances without telling anyone. In such cases, social workers and other NBD specialists often tell families, “Let him take responsibility for this,” or, “This will be a learning experience for him.” These tips tell us that many professionals who devote themselves to helping other people often do not understand the nature of schizophrenia. Our recommendations look different.

We know from experience that many people with schizophrenia are often unable to take responsibility for their movements and are unable to communicate them to their loved ones. If we allow them to do as they please, we will likely end up with much more complex problems, which we will have to address when the consequences of our inaction become clear. For example, pensions and social payments cannot be delivered and the person does not receive his contents. Bank notices and invoices do not reach the addressee and are not paid. Rent is not paid, property remains abandoned, premises are not cleaned. Our advice: if you think that your friend or relative cannot deal with these problems, take care of them yourself.

People like to feel like they are in control of their lives. Sometimes it can be difficult to convince a person with schizophrenia to do what is best for them. Therefore, it is better to give them a choice: “Are you going for a walk now or after lunch?” as a way to suggest a walk, a shower, or any other activity that you find useful or enjoyable. People with schizophrenia often have mood swings, so what they don't want to do now may interest them later - in a day or a week.

Going to the doctor

Many people around me complain that psychiatrists are only good at prescribing drugs and injections. Perhaps this is true. Some people go to a psychiatrist for comfort and advice. They want to talk about their housing, what a psychiatrist can do to help them get back to work, or at least find themselves strengths. I don’t know if there is a psychiatrist in the world who could help in such matters. Typically these responsibilities are assigned to social worker. But one man I saw when I came to the appointment said that the social worker was never on site and he had never been able to find him. My problem is that I get so panicked when I enter the doctor's office that the moment he greets me, all I want to do is run away. He asks: “How are you?” I answer: “Okay.” He asks questions, tries to help me, I answer that he is supposed to, but I feel like I’m about to explode! So I’m wondering: are all psychiatrists good only for prescribing pills?

Holidays

I'm afraid holidays, when families usually gather around the table, eat, drink and be merry. For me, such moments evoke difficult feelings: disappointment, resentment, sadness and a whole range of other emotions. For example, Christmas has not been a happy time for me and my family for many years. My brother spent Christmas days either in the clinic or at home, although his condition could hardly be called completely stable. One

once he was taken to the hospital with festive dinner, another time we had to call the police. If I'm afraid, how scary must it be for him? When he thinks about what others expect of him, he copes and controls himself for at least a few hours, but what happens then when schizophrenia gets the better of him? When does he withdraw into himself or panic? Last year at our Christmas gathering, each of our guests took my brother aside and talked to him. This had a beneficial effect on him. At least he knew that they cared about him and understood his condition. But when the time came for everyone to gather together festive table, he disappeared into his room. He simply cannot stand so many people, conversations, noise - this is too great a test for him.

Do you help old ladies cross the road?

Do you want to help a person who suffers from schizophrenia and lives near you? Then rethink your attitude and treatment of him. This doesn't mean you have to be overly friendly, but don't ignore him either. Engage him in conversation, but don't be intrusive. People with schizophrenia are defenseless, like children or old people, they cannot stand up for themselves, even if they are physically very strong. In addition, they often take large doses of medications, which makes their speech unclear and their reactions slow. Please be aware that such a person may experience sudden attacks anxiety and suddenly leave the room. Don't stop him from doing this, but leave the door open. Ask him to visit you at another time when he wants. Offer a pie or a flower, or make any other friendly gesture. Send him birthday cards or just drop them in the mailbox.

Everyone has a natural fear of madness. After all, mental illness destroys a person’s consciousness, and he becomes insane and sometimes dangerous. What to do and how to behave if a loved one suffers from a serious mental illness - schizophrenia? When dealing with such people, it is important to observe certain rules.

It must be remembered that a mentally ill person looks at any life situation through different eyes than you - through “ false mirror"of your illness. His emotions and sensations are exhausted and damaged. Patients with schizophrenia often experience hallucinations, are obsessed with delusional ideas, may fall into apathy and lose touch with the outside world.

All this leads to the fact that in response to ordinary words, phrases and actions of loved ones, people with a defect in consciousness often give completely inadequate reactions - resentment, nagging, anger, accusations. Life with a schizophrenic in the family is truly not easy.

During the period of enlightenment of the mind, a schizophrenic, realizing that he is going crazy, experiences terrible mental anguish, fear, horror and shame of his situation. All this is accompanied by poor physical health, headaches, and depression. And this also affects relationships with other people.

What not to do when communicating with schizophrenics

To help healthy people For whom it is important to know how to behave with a schizophrenic - woman or man, clinical psychologists and psychiatrists have developed a number of recommendations. The most important rule that is worth remembering is that when communicating with people suffering from mental disorders, you should never provoke or inflate a controversial situation:

Note! Particular care must be taken in families where a man is sick and a woman is looking after him. Recommendations on how to behave for a mother with a schizophrenic son or a wife with an unhealthy husband will be the same, but in addition one must also take into account the fact that the man is physically stronger, that is, the consequences of an open scandal can be much more serious - not all people suffering from schizophrenia able to control outbursts of aggression.

If the patient behaves aggressively

Symptoms of schizophrenia include hallucinations and crazy ideas, the content of which often makes those suffering from this disease aggressive towards the world around them.

How to behave with a schizophrenic if he is excited, irritated and negative? You need to act in a certain way:

• make sure that the reception regimen is not violated medicines, and if the patient refuses to take them, mix the drug into food or drink;
• If possible, try to completely avoid communication, not to participate in dialogue - often this is enough for the angry patient to calm down over time;
• do not raise your voice, talk calmly, measuredly, this will help relax a mentally ill person, while a response cry will only aggravate his attack;
• try not to look him in the eyes, this may be regarded by the patient as aggression;
• put everything away dangerous items(piercing-cutting, suitable for striking, etc.), do it as discreetly as possible so as not to provoke another quarrel;
• remove people who contribute to irritation and outbursts of negativity in a mentally ill person.

If the situation is out of your control and the scale of the attack scares you, contact us immediately medical care. Always remember that the person suffering mental pathology, is real danger both for loved ones and for yourself.

General rules of behavior with patients with schizophrenia

If your loved one is mentally ill, this is a difficult ordeal. But it is important to realize how much the state of a mentally ill person depends on whether relatives, family, and friends behave correctly. This impact is huge!

Doctors especially emphasize that with proper communication with loved ones, many patients with schizophrenia live full life. Sometimes sustained remission can last for decades. While without help the fate of victims of this pathology is often sad, the disease quickly progresses, making the person completely disabled.

General rules home care for mentally unhealthy people are simple, the main thing is to follow them strictly:

• Make sure that all recommendations of the attending physician are followed: medications must be taken in full and on time, unauthorized discontinuation of medications or changes in recommended dosages are unacceptable, and the patient must attend the necessary psychotherapy sessions;
• it is important to adhere to the principles healthy image life and personal hygiene: refusal bad habits, adherence to daily routine, moderate physical exercise, maintaining cleanliness of the body and premises, order in things and personal space;
• even if the patient does not work, you need to involve him in household chores, find possible and interesting activities, since occupational therapy is one of the effective methods of prevention and rehabilitation for schizophrenia;
• It is also very important to communicate with family, relatives, and people who are friendly towards him.

All this will make the life of a schizophrenic as calm and comfortable as possible, protected from stressful situations.

When communicating with a mentally ill person, always remember the need for patience and compassion. Study the nature of this disease; the knowledge you gain will help you better understand what is happening in the soul of a person suffering from the disease.

Additional information in the video. Psychotherapist, Candidate of Medical Sciences Galushchak A. talks about the social adaptation of schizophrenics and gives recommendations to relatives.

Behave carefully and carefully, it is very important to maintain the fragile trust between you. The life of a schizophrenic is filled with fears and suspicions. In addition, many patients painfully experience the fact of their illness and are ashamed of it. Often their delusions and hallucinations tell them that the world around them is hostile and full of dangers, and people want evil. All this makes the schizophrenic irritable and aggressive. Trusting you will help your loved one maintain contact with reality.

Separate in your mind the patient's personality and his illness. It is very difficult and requires constant effort. But this is the only way to avoid becoming embittered in response to the common behavior of people with pathologies of consciousness: suspicion, anger and accusations against oneself.

Distance yourself if necessary. Remember that it is not always possible to reach an agreement with people with schizophrenia. Sometimes it is better and more correct to simply avoid a quarrel.

Support a sick person. Believe in the success of treatment, in the possibility of full and happy life for him. Your beliefs will certainly have an impact positive influence on the mood and condition of the patient - of course, with proper treatment, selected by doctors.

The modern world is often cruel to people in trouble. Often, loved ones, friends and even family members simply abandon people who have fallen victim to mental illness. Finding themselves in social isolation, mentally ill people often lose their property and find themselves at the very bottom of their lives. While basic knowledge about the disease, participation, patience and love give the patient a chance for a healthy and happy life.

Until recently, the diagnosis of “schizophrenia” was almost a death sentence, meaning that a person would never be able to be a full-fledged member of society. Patients were forced to undergo for a long time in psychiatric clinics. Sometimes medications were extremely helpful Negative influence on their personality.

However, today the situation has changed. Thanks to the development of medicine, many patients can be in their usual environment, receiving effective treatment in a calm home environment. In most cases, this is a huge plus for patients. However, their relatives are a completely different matter; for them this is an additional burden and responsibility.

After all, schizophrenia is an incurable disease and most often progresses over time. And regardless of the form of the disease and the severity of symptoms, family and friends must be prepared for any situation that may happen to a patient suffering from schizophrenia. And for this they need to have some information.

How to choose a hospital?

As a rule, hospitalization for schizophrenia is necessary in 2 cases - during the first episode (for the purpose of examination, diagnosis, prescribing adequate therapy) and during repeated exacerbations, with the appearance of symptoms of schizophrenia (excitement, the appearance of delusional ideas, etc.)

It is worth noting that treatment for schizophrenia is approximately the same in both private and public clinics. Therefore, more attention should be paid to choosing not a hospital, but an attending physician. It is necessary to make sure that he has experience in treating schizophrenia. In addition, mutual understanding between the doctor and the patient, the doctor and the patient’s family plays an important role.

After all, mutual understanding is one of the key points successful treatment, and the treatment of this pathology is always long-term and continuous. Despite this, extremes are not advisable, and care should be taken that the patient does not become too dependent on the attending physician. Continuity between the hospital doctor and the doctor who will monitor the patient on an outpatient basis is also very important.

Treatment of schizophrenia

It has been proven that therapy is more effective in the absence of psycho-emotional stress. To this end, it is necessary to involve healing process relatives of the patient. To do this, relatives must know and understand the main aspects of the disease.

Most often, exacerbations occur as a result of the patient’s refusal to take medications. Family members should understand once and for all that strict control over the use of medications is necessary. Relatives must be able to convince, persuade, and force the patient to take the medications prescribed by the doctor.

Also, many clinics have special psychotherapeutic programs for patients with schizophrenia. Their activities are also aimed at combating relapses of the disease. It would be a good idea for patients’ relatives to become familiar with these programs.

Rehabilitation

Unfortunately, some people with schizophrenia require constant isolation. However, most return to their usual life after the symptoms of the disease have disappeared. If relatives are unable to care for the patient, it is possible to place him in a special boarding school.

In these institutions, patients receive qualified psychological and medical assistance. They look not like a hospital, but like a dormitory. There, patients are in a favorable environment, which contributes to the rapid improvement of their condition. Employees regularly monitor reception medicines. These institutions operate programs aimed at the social adaptation of patients.

1. Feel free to send a sick relative to the hospital

Unlike outpatient treatment, the hospital has the opportunity to constantly monitor the patient, adjust therapy, study changes in laboratory tests. There is no need to be afraid of treatment in a hospital - after it, the patient may well return to normal life.

2. Let go of guilt.

There is no need to blame yourself for the illness of a loved one. IN this moment There is no proven evidence that poor upbringing or lack of attention from loved ones can cause the development of schizophrenia. Feelings of guilt in such a situation are absolutely inappropriate.

3. Contact a specialist in a timely manner

Quite often, people with schizophrenia have some problems in relationships with other people in childhood and in life. adolescence. However, it is not at all necessary that a child experiencing communication difficulties may be mentally ill. However, if any suspicious symptoms appear, it is better to consult a psychotherapist or psychiatrist.

4. Keep the peace

Remember that it is necessary to carefully protect the patient’s peace at home. Stress or any emotional overload can trigger an exacerbation of schizophrenia.

Although schizophrenia cannot be completely cured, long-term remission can be achieved with adequate therapy. In addition, do not lose hope - medicine is developing quite actively, more and more effective means. It is quite possible that scientists will find a method that will help get rid of schizophrenia.

When faced with a person with schizophrenia, most of us do not know how to behave with such a person. Many behave repulsively, try not to maintain contact, not to engage in conversation. You never know what might pop into a schizophrenic’s head?

But sick people are people just like you and me. It's not their fault that it's so serious disease affected them. Yes, during periods of exacerbation they can be subject to hallucinations, delusional ideas, various fears, can be aggressive, and commit unexpected and even fatal acts. But it's not their fault. These are all the consequences of the disease.

Repulsive behavior causes frustration and aggression in each of us, but what then can we say about people with a not entirely normal psyche? Thus, we ourselves provoke patients with schizophrenia, pushing them to unforeseen actions.

A person living side by side with a person suffering from schizophrenia must learn to respond adequately to his actions, help the schizophrenic, protect him, and support him. Relatives must learn to be tolerant. For example, if a patient’s statements contain delusional ideas, then there is no need to be offended by this person, it is not his fault, but only a consequence of the disease.

How to live with a schizophrenic?

Living with such a patient is not an easy task. No matter how much you love such a person, no matter how much you protect him, you will never know what is in his head. But if fate has decreed that you have to live next to a person with schizophrenia, then you need to do everything to help both the sick person and yourself.

During schizophrenia, it is necessary to distinguish periods of exacerbations and interictal periods.

How to help a patient during an exacerbation of the disease

During exacerbations, various hallucinations (auditory, visual), delusions ( special significance, invention, reform), fears. Patients may run away from home, wander, become aggressive, and even harm themselves or others.

During such periods, it is necessary to notice changes as early as possible mental state and seek medical help promptly. If a patient refuses to be treated, but his behavior is such that he cannot take care of himself, and may, under the influence of painful hallucinations, cause delirium to himself or others, then he can be forced to undergo treatment in psychiatric hospital forcibly.

It is necessary to take medications even during the interictal period. In this way, you can slow down the course of the disease as much as possible and prevent the development of exacerbation. If a person refuses to take pills daily, then you can resort to preventive injections, which are administered once every three to four weeks.

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Natalia

The diagnosis itself does not determine the social danger of a person, but there is no way to hide from this problem.

Schizophrenia is one of the most difficult mental illnesses. Why is it so hard to fight her? The head of the Department of Psychiatry, Narcology and Psychotherapy at Moscow State Medical and Dental University named after A.I. will talk about this. Evdokimova, Doctor of Medical Sciences, Professor Boris Tsygankov.

Every hundredth person in the world suffers from schizophrenia. This is true?

Boris Tsygankov: According to WHO statistics, every seventh person out of a thousand is schizophrenic. Moreover, most of them account for people aged 15 to 35 years. Today, 24 million people on the planet suffer from schizophrenia. In accordance with the standard DALY methodology, WHO experts calculated that the number of mental and mental disorders in 1990 amounted to 10% of all diseases in the world, in 2007 - already 12.3%, and by 2020 it will reach 15%. Experts note that many countries practically do not address the problem of mental health. Two-thirds of countries allocate no more than 1% of their health budget to psychiatry. Mental health Much less attention is paid than to the physical.

24 million people on the planet today suffer from schizophrenia

In Russia, 7.5 million people seek psychiatric help every year. This exceeds 5% of the country's population. The majority of psychiatric patients who have lost their ability to work become disabled at a young and middle age: 25% before the age of 29, 70% before the age of 40. Moreover, patients themselves often create the prerequisites for this. And primarily because they do not visit a psychoneurological clinic after inpatient treatment. Studies in one large city showed that up to 44% of people suffering from schizophrenia did not visit dispensaries. In 60% of cases, patients were hospitalized involuntarily. In 35% of cases, patients were in a state of exacerbation for more than a month without medical supervision. Almost 70% of patients did not follow the pharmacotherapy regimen, that is, they completely ignored medical prescriptions.

It turns out that people do not fulfill the basic requirements for conservation own health. Do we want therapy to be personalized?...

Boris Tsygankov: And everything must be done to personalize therapy. Manifold clinical picture, the course and outcome of schizophrenia makes the treatment of such patients extremely difficult. The life expectancy of such patients is on average 10 years less. 70% of patients experience an exacerbation of the disease within a year.

Is exacerbation of schizophrenia a serious danger?

Boris Tsygankov: In 40% of cases this is a social danger and suicidal risk. But 20-30% of patients, subject to adequate therapy, achieve “social recovery.”

What do you need to know when living next to a schizophrenic?

Boris Tsygankov: I would divide your question into two parts: what should relatives living with a sick person know, and what should people living nearby know. First of all, it is necessary to understand that the diagnosis itself does not determine the social danger of a person, and that all human diseases can be both chronic and acute, with long periods remission and even recovery.

Relatives living with the patient should be as aware as possible about the peculiarities of the course of their loved one’s illness and contribute to the implementation of the doctor’s recommendations. Cooperation between the patient’s relatives and doctors is a powerful factor in preventing exacerbations of the disease. People around a sick person need to know that no diagnosis infringes on a person’s rights and does not discriminate against them. On the contrary, the humanitarian foundations of a civilized society imply sympathy for the sick, providing them with help and support.

What if the response to sympathy is aggression?

Boris Tsygankov: In cases where others see gross forms of disrupted behavior, including aggression, neglect social norms and the like, they can submit written applications to law enforcement agencies, to psychoneurological dispensaries at the place of residence, to health authorities. And in certain cases hospitalization in a psychiatric hospital can be carried out involuntarily. This is written in Article 29 of the Law on psychiatric care. These include various states in people suffering from severe mental disorders in case of immediate danger to oneself and others; when the patient is helpless, that is, unable to independently satisfy vital needs, which can cause significant harm to the patient’s health if he is left without psychiatric help. The legality of involuntary hospitalization is verified by the court after the patient has been hospitalized.

2016, Nailya Safina, Russian newspaper- Federal issue No. 6919 (51)