Advice for supporting a friend diagnosed with Schizophrenia?

Be his friend. Don’t treat him any differently than you would any other friend.

Yeah, that’s what I’m doing. I guess I want to make sure I’m sensitive to what he’s REALLY saying when he tells me his problems, if that makes sense. For example, now that I know, I think back to things he’s told me and realize he’s likely experiencing it to an exponential degree greater than I first interpreted. Like, ‘get some sleep you’ll feel better in the morning’ might not be as applicable if he’s dealing with bigger issues then minor sleep deprivation I imagine.

Should I read more about the disease to help put what he’s going through in context? Or would I likely end up filtering everything he says through his diagnoses? Should I just ignore that he’s been diagnosed and carry on as usual?

Example: he updated his facebook the otherday with ‘the demons are coming’ .... which seemed a little out of character. I mean, I’m not afraid to explore the darker sides of life intellectually, but then if you know someone is diagnosed schizophrenic and says something like that…. it seems like you SHOULD hear that with the disorder in mind.

I guess a part of what I’m asking too is if Schizophrenics have ‘triggers’ ... sort of like certain things might trigger someone with PTSD for example. I imagine they would be highly personal, but say, if he has issues with ‘demons’ perhaps avoid the subject of ‘demons’?

I work for a disability rights agency and in that capacity have met some people who have schizophrenia. It’s a heartbreaking disease. I think you’re on the right path – continuing the friendship and treating him as you have in the past. The line you have to be aware of is whether your friend is endangering his own life or the lives of others, and I mean that in an immediate sense. Schizophrenics have the same right as the rest of us to make stupid decisions

It might help if you want to learn more about Schizophrenia, to read up on it. Just have to keep in mind you aren’t a professional in the mental health arena, unless of course you are.

It sounds like you want to know if you should walk on eggshells as it were, around him, if that is the case, personally I would say no. But that depends on him. Like the demon thing, perhaps he would like it if you avoided it, then again he might be pissed if he noticed you were censoring yourself. Talk to him, ask him these things, get the answers right from him :)

@lynfromnm yes, that is part of what I’m worried about. I suppose unless he verbalizes a direct threat to himself or others, there’s nothing I can do. I mean, I don’t want to freak out and contact his local facebook friends who may know his family unless it was a true emergency, for example.

@rahm_sahriv good idea, I suppose I shouldn’t be afraid to ask him about his experiences and preferences and questions I may have. I think I’m less afraid of walking on eggshells than I am of ignorantly trampling all over any fresh made eggs! :) Or something… that metaphor doesn’t really work, but hopefully you know what I mean! Then again, the first time I encouraged him to take meds/talk to a professional was when he was talking about ‘feeling psychotic’... which may be something people say to make a point, but…. if he’s Schizophrenic he might really be feeling psychotic, IDK. Anyway, he didn’t talk to me for awhile after that, it was like I broke his trust in recommending professional help. So I feel like I have to figure out how to walk the line of being a friend and knowing when to remind him I’m not a professional and for some things he needs professional support.

It might be more neutral to tell him what you just said. Remind him “I’m not a professional and for some things he needs professional support.” rather than “Take your meds, and see a doctor.”

Ask what he means when he says he is “feeling psychotic”. That may give you some direction if it happens again.

Here is something else that respects the dignity and preserves the rights of people who have mental illness. It’s called a Psychiatric Advance Directive. It’s a document in which a person can state his preferences for doctors, facilities, meds, who can make decisions if he cannot and what works best for him. He can also state what he doesn’t want. One big fear of people with MI is that they will be drugged into a stupor. If they can make a document that formalizes the treatment that works best and gives decision making authority to someone they trust, it’s usually quite a relief. The PAD should be part of the person’s client file with his physician or psychologist, and it wouldn’t hurt to have one handy around the house. In my state, PADs are legally recognized and MUST be followed, but I don’t know about their efficacy in other states at this time. It IS an encouraging trend however.

@snowberry I do. Maybe I’m being invasive by mentioning doctors/meds at all, and should just stick to ‘professional’. Thanks.

@lynfromnm Thanks. I’m realizing that I need to be able to talk to HIM about this… but that’s the exact sort of thing I was hoping to realize in asking this question. If something sticks out like ‘feeling psychotic’ or ‘the demons are coming’ I guess the best thing I can do is just ask him what he means and go from there. And thanks for the info on PADs, perhaps I’ll ask him if he knows about that. He’s 20, and he said a couple years ago he quit his meds and doctors cold turkey… I suppose that would have been when he turned 18 and was able to choose to do so. It seems to me he is now struggling with knowing he needs (more) help and not wanting to loose control completely to outsiders (balancing that with loosing control with the illness- something he mentioned himself). So I imagine PADs are extremely useful in helping someone feel comfortable reaching out for help.

Be patient with them and make sure they are taking their medication.
Schizophrenic patients have a bad tendency to stop medicating when they feel better and then they slide backward.

When or if his conversations with you become strange and don’t feel right to you, don’t get dragged into that, don’t fuel it.
Keep it where you feel emotionally right.

Depression might be more reason to feel you have to walk on eggshells than Schizophrenia. Working in a psych hospital (but I am not a medical professional) I can tell you the suicide attempts happen more among the otherwise average hard working responsible person who is very depressed. The schizophrenics rarely were suicidal from what I observed. My grandfather was schizophrenic, but that was long ago, medications were different then, and other treatments. Schizophrenia almost always needs meds to control it I think. You can’t work through it in therapy. Once the patient is stabilized on medication, then therapy can help if there is another diagnosis to address.

Just be a friend, supportive. If he does not feel better on his medicine encourage him to ask his doctor for a different perscription or see another doctor.

It sounds like he wants to be better, just feels out of control?

Be a friend. Schizopherics need prescription meds; there is nothing “natural” that will replace antipsychotics. That’s just a fact. If he is smart, he probably already knows the possible side effects of the drugs. People with this diagnosis generally refuse to stay on the medication.

Thanks everyone. I just want to be a good friend, not an ignorant friend. He just wrote me a very sweet email so I guess I’m doing a good job so far! Phew… !

@anartist good to keep in mind. He’s communicated to me that he’s afraid of that, he looses a lot of friends, well pretty much all of them when he gets weird. It’s not easy knowing someone’s having a hard time, would be easier to just disconnect completely. I guess part of being his friend will be being able to just wish the best for him and let him go at times, if he snaps back he snaps back. I mean that as I can’t let myself get dragged into what he’s going through to the point that I don’t want to deal with him anymore. In fact I promised him that if I it was getting too weird I’d let him know and not just cut him off. (I didn’t say that out of nowhere, it seemed he needed the reassurance). He usually seems fine, I mean, you could say I wasn’t too surprised when he told me his diagnosis! But if this is as bad as it gets than it’s not that bad. I’m sure it’s much more difficult for his family in everyday life, but as far as basically being a pen pal, well, the hardest part is just knowing how much he suffers and at worst worrying about him hurting himself/others. Which is an awful thing to worry about. But… IDK. So far I appreciate his friendship so I guess all I can do is just let it be what it’ll be. And encourage him to continue with his meds.

@emergence Your friend is lucky to have your friendship. Best of luck to both of you.

Yes it is much more difficult for his family in real life. I once met someone [had dinner in her home] who had a schizophrenic adult son living with her. She was involved with an organization that provided support for the families of the mentally ill. Her son was a talented musician but had trouble socially. She kept him at home as long as he would make the effort [including meds] to keep himself together. Eventually she had to [this is such an awful tern] “release him to the street” meaning not let him come back after leaving during one too many wild episodes.

@anartist wow, I really can’t imagine being in your friend’s situation! My heart goes out to her. And her son. I think about my friend’s family, and it’s like, wow. It’s kind of amazing they still have him live with them, after a few of the episodes he’s mentioned. He’s mentioned them as if they were in the far past, when he was a minor, but still. He’ll make the occasional random reference to sleeping on park benches… I didn’t really ask him what he meant when he mentioned that, I assumed he was being empathetic with the plight of the homeless, but maybe it’s something he’s experienced or is afraid of experiencing if he’s been having issues at home. I guess this is another example of not being able to simply ignore the diagnosis and not have things like this put up a little red flag that something might be going on.

remind him to take his meds