WATCHING your loved one go through a psychotic episode can be alarming, confusing, and terrifying. When your loved ones show the signs of psychosis, acting quickly to get the necessary treatment ensures a safer, brighter future for them. Individuals with psychosis have a better chance of successful recovery when their family members are involved.

Caregivers need to balance their own needs and those of the person with psychosis. They should manage their own exhaustion, sadness, grief, stress, and sleep disturbances. In this way, we can alleviate the confusion in the family, rebuild the relationships, and find sustainable solutions for long-term recovery.

What is Psychosis?
Psychosis is not an illness in itself. It refers to the symptoms that occur in various psychotic, mood disorders, and substance use disorders, such as,

* Schizophrenia

* Schizoaffective disorder

* Bipolar disorder

* Substance use

Individuals experiencing psychosis have their perceptions confused, not knowing what is real. Their speech and behaviour make no sense. They can also develop anxiety, depression, sleep disturbances that affect their daily functioning in life. The two hallmarks of psychosis, hallucination and delusion, can further complicate their thoughts and understanding of reality.

Challenges of psychosis in the family:
Psychotic symptoms can cause a confusing shift between independence and dependence in the family. With the individual experiencing irrational thoughts and perceptions, they may lose their grip on their relationships and life responsibilities. These warrant increased time and attention from the family members to be involved in the person’s care.

Research evidence suggests that patients receiving informal care from family members have better outcomes, fewer inpatient admissions, reduced relapses, and better engagement with treatment. As a part of the caregiving role, many carers have to deal with distressing illness symptoms from their loved ones along with challenging behaviours that may at times include an act of aggression and self-harm. With challenging behaviours, stigmatisation can occur in the home. This can place a burden on the caregiver and cause a feeling of guilt if a relapse occurs.

Although caregiving can be rewarding for some, many have poor psychological functioning such as depression and other stress-related disorders. They may also experience exhaustion, sleep difficulties, feelings of loss, and grief. Their quality of life might get progressively worse for both the individual with psychosis and the caregiver, if they are not aware of managing their symptoms and life effectively.

Tips for caring for someone with psychosis:
Family members are an integral part of the long-term recovery for someone with psychosis. They can be an advocate, help find the best treatment options, communicate with professionals about the person’s symptoms, provide ongoing support, and compassion in their recovery journey. But caring for someone with severe mental illness can be an uphill battle. Here are some suggestions on how you can care for your loved ones.

* Reach out for professional advice and support to improve the quality of your life and that of your loved one

* Look and understand your loved ones from a compassionate viewpoint, as they are having difficulty in perceiving the reality

* When the psychotic episodes are mild, direct the conversation to different aspects other than the harmful thoughts and feelings

* Treat the person as a valued member of the family, so they don’t feel shame or guilt

* Create a crisis plan with the help of professionals that can be very helpful in times of crisis and relapse into illness
 
Self-help for caregivers:
Forgive yourself-You might find that you are blaming yourself when your loved ones are going through mental illness or when their recovery is not going well. So learn to be more kind and forgive yourself.

Acknowledge your feelings- Learn to acknowledge your difficult feelings of guilt, grief, sadness or frustration. It’s the first step in learning to manage them.

Be conscious of your limitations as a caregiver—Aim to be the caregiver who cares and is not the perfect caregiver. Give your best for your loved one, and when you cannot learn to get the necessary support from others in the family. Be clear on the limits of care and communicate this sensitively to the individual with schizophrenia or psychosis during times of wellness.

Talk to somebody—Talk to other caregivers who are going through similar experiences. Be a part of support groups or communities that educate and inform caregivers about psychosis. Address your own emotional issues by getting professional counseling services.

Be open and inquisitive—Listen actively, communicate in a calm and understanding way when you are talking to your loved one with psychosis. Knowing what your loved one needs from you when they have a relapse will help you provide them with the care, they have learned to be more comforting during challenging times.

Recognise the signs of stress—As a caregiver, you might experience stress, anxiety, and depression. Learning to recognise the signs of stress such as exhaustion, getting more sick than usual, not eating or sleeping well, getting irritated for no reason, and withdrawing from others is very important

Make time for yourself and other relationships—Plan your own time so you continue to maintain your interests and relationships outside the relationship of care. Stick to general daily routines as much as possible.

Managing grief—Many will experience a sense of loss or grief at some time when their loved ones have schizophrenia or psychosis. They may feel a sense of loss when thinking about their relationship with their loved one, their hopes for the future, or their own relationships and aspirations, which may have been affected by their loved one’s mental health. Give yourself time to grieve. Oftentimes, sharing your experiences with others will help to lessen the burden of grief.

Maintain hope—It’s important to continue to believe that your loved one will get better and you will see better days together.

Be kind and patient—It is normal for caregivers to experience bouts of anger and frustration. Try different positive ways to deal with these difficult feelings, like journalling, exercising, or talking to your friend.

Thank you for reading! If you require any help with mental health issues, kindly call me (Anju Vivekanandaraj, MSc., Registered Clinical Psychologist) at 613 9255. Kindly send in your feedback, questions, or any topic that you would like to address to innerpeacegy@gmail.com