About Supporting a Loved One with Psychosis
WHAT IS BEING A CAREGIVER OF AN INDIVIDUAL EXPERIENCING PSYCHOSIS LIKE?
Families, caregivers, and friends are the main allies of patients with first episode psychosis and have tremendous power to aid and advocate for them (Leff et al., 1990). The caregiver role can look quite different. As many of the first episode psychosis patients are young adults, often the parents of the patients take on this role, but many siblings are also taking on caring for their loved one, and their support in the recovery process is incredibly important as well.
The caregiving role is one of support and communication.
WHAT DO I DO IF I AM STRUGGLING TO COPE AS A CAREGIVER?
Families of affected individuals undergo many challenges, which can lead to marital conflict and strained coping behaviours. Caregivers often report feeling many negative emotions, such as guilt, anger, embarrassment, fear, and sadness, all of which can negatively impact their own wellbeing. Caregivers can experience feelings of helplessness or loss of control, with many struggling to understand what is happening to their loved one (Sagut & Duman, 2016). Another concern that many caregivers feel is social prejudice and stigma from others, regarding the condition of their loved one.
It is important to remember that all caregivers are doing their best to support their loved one and that the caregiver’s needs may differ greatly, especially given their social, economic, and family status. However, some techniques to help empower and support caregivers, include interventions like family psychoeducation (described below), reaching across one’s social network for support, and structuring time for social and leisure activities. Acts of self-care, such as social and leisure activities, including going for walks or talking to trusted friends, may be one way to alleviate the many stressors that come with supporting an individual with psychosis.
Remember, you are not alone, and if you need more support and resources for your own wellbeing, please refer to some of the services below:
LIST RESOURCES – ex. Ami Quebec
WHAT IS FAMILY PSYCHOEDUCATION?
In first episode psychosis (FEP) services, family psychoeducation is one of the most important interventions, and is known to improve clinical outcomes for the individual experiencing psychosis, like reducing relapse and re-hospitalization rates2, decreasing family burden3, and reducing positive symptoms of psychosis (MF, remember to cite from proposal).4
Family psychoeducation sessions are often facilitated by the clinical team, who provide a series of information sessions for groups of caregivers, to provide information about psychosis, listen to caregiver concerns and questions, support family wellbeing, help improve communication skills, and teach positive coping mechanisms.
Ask your loved one’s clinical team to find out when their next sessions will be hosted!
HOW CAN I HELP SOMEONE WHO IS EXPERIENCING A DELUSION, LIKE A FALSE BELIEF? SHOULD I TRY TO CHANGE THEIR WRONG IDEA?
Try to come across as non-confrontational and calm, expressing concern as a form of opinion, rather than judgement. It is best to talk to your loved one about your concern when they are not in the middle of their delusion. Try to stay neutral, calm, and patient. Even though you may not understand their delusion and become frustrated, it is not recommended to try and convince your loved one that their delusions are not real.
Encourage your loved one to talk about their beliefs or ideas with you and others who understand them. You do not need to pretend to agree with a delusion, and can say something like, “I understand that you believe these things, but I don’t understand/see it that way”. If the delusion is magical or supernatural, you can note that you do not know much about the topic. Most importantly, try to acknowledge how these thoughts might make your loved feel. For instance, if an individual was feeling paranoid about being followed by cameras and other technology, you could try saying, “It must be so scary to feel like your laptop camera is recording you”.
CAN MY LOVED ONE BECOME PREGNANT FOLLOWING A DIAGNOSIS OF FIRST EPISODE PSYCHOSIS?
Yes, one may become pregnant after being diagnosed with FEP, or begin to start their own family. Appropriate protection during sexual encounters should always be used to prevent unexpected pregnancy and sexually transmitted infections.
Individuals who desire to become pregnant should consult their physician for guidance. If someone suspects that they may be pregnant, it is recommended for them to immediately notify their physician, as some of the medications that are used to treat psychosis may not be safe in pregnancy. How to proceed with needed treatment during pregnancy is a delicate clinical decision that needs to be made with the treating team.
WHAT DO I DO ABOUT MY LOVED ONE USING SUBSTANCES LIKE CANNABIS OR ALCOHOL?
People with psychotic symptoms may be highly distressed and may turn to substances like cannabis and other substances to calm their anxiety or lift up their low mood. Unfortunately, any benefits of these substances are usually short-lived and only act to worsen the psychosis over the long term.
WHEN EXPERIENCING PSYCHOSIS, WILL MY LOVED ONE BECOME VIOLENT OR AGGRESSIVE?
No, most people with psychosis are not violent or aggressive. However, for some, during the Acute or “Active” stage of the first episode of psychosis, there may be increased risk of aggressivity and violence (Coid et al., 2013).
WHY DO THE POLICE GET INVOLVED IN CASES WITH INDIVIDUALS WITH PSYCHOSIS?
Sometimes the police are called by family, friends, or neighbors when a person with psychosis is not accepting to get help and their symptoms are getting worse. The police in these situations may bring someone with psychosis to the hospital emergency department to make sure that the individual is safe and can start treatment. When the police arrive in these circumstances, it is important that a family member carefully explain what is happening and help the psychotic person to go with the Police calmly and without struggle.
WHAT DO I DO IF MY LOVED ONE IS SUICIDAL?
Unfortunately, suicide is more common in young people with first episode psychosis than in non-psychotic youth. Suicide threats should always be taken seriously, and any loved one with suicidal thoughts, plans, or actions should be immediately referred to health care professionals for evaluation and treatment.
If you or a loved one are feeling suicidal, please contact …. Check out these resources for additional support: