symptoms
How Does Schizophrenia Affect Families?
Introduction
Schizophrenia not only results in serious effects on those who suffer from this illness; it also affects their families and friends in a number of ways. These effects relate to the changes that the illness necessitates in both patients and families as well as the emotional consequences of these changes.
Adjusting to Change
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Personal Change
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Just as patients are forced to adjust to their symptoms, family members must also accommodate to those same symptoms and whatever new behaviors may result from them. Family members must become familiar with the symptoms of this illness and their origins; and all aspects of treatment. They may need to learn new ways to approach the afflicted person; and deal with their loved one’s withdrawal and isolation, episodes where psychotic symptoms are particularly evident, or simply the numerous lifestyle changes that are a consequence of this disease.
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Brain Function
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Those afflicted may demonstrate radical changes in their cognitive abilities and in demeanor and behavior. Speech and thought process may be altered. Their posture toward other family members might be different; particularly if they are experiencing paranoid thoughts. Family members must acquire an understanding of what is happening inside their brain and discover new ways of communicating and interacting in other ways. This usually requires both patience and time, but both patients and their families generally make this transition.
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Social Change
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Patients with schizophrenia may experience shrinking social networks and demonstrate less interest in family gatherings, recreation and hobbies. They may spend less time with family members. Sometimes, specific relationships within a family become strained or dissolve altogether. Families are forced to restructure how they involve the family member with this illness; proceeding cautiously in the beginning. With time, a new framework is established.
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Expectations
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Schizophrenia often diverts sufferers from academic and vocational pursuits. Supportive families learn to envision more realistic goals for their family member; or embrace ones that may ultimately be achieved, but in a different time frame. These new goals help to inspire or renew confidence that may have been lost as the disease developed. These efforts will likely strengthen the bond between the family and the patient.
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Routines
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Along with all of the other changes that come with schizophrenia, patients are obligated to establish new routines. Their schedules must now include time for treatment and monitoring. This may involve appointments with therapists, doctors and other professionals. Over time, there may be episodic or frequent hospitalizations, or stays in residential facilities. If these facilities are not close to where the patient has lived or where their families reside, travel may be necessary. This often requires that schedules be modified.
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Finances
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Fortunately, in many areas of the country, public assistance is available to address the costs of medical care and housing. However, this funding usually does not provide for more than basic needs. While some patients with schizophrenia can work to supplement this income, many cannot. Families often feel obligated to offer some financial support. Some families are simply unable to do this. It may help if caregivers are reminded of the constraints that some families face with respect to financial support. Those professionals can then reinforce with the patient that the family is doing what they can.
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Emotional Consequences
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Before the Diagnosis
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During this period families routinely experience fear and apprehension. This may lessen dramatically after a diagnosis is made. Before that time, they must be dealt with in some way. Many families draw support from friends or relatives to support them during this difficult time. Others find resources in the community. They may include clergy or members of the congregation of a church or other place of worship. Sometimes families are aware of other people in a similar situation. Some find support groups or obtain information from community agencies.
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After the Diagnosis
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While anxiety may have been reduced once a working diagnosis of schizophrenia has been made and the treatment process has begun, concerns will continue. Those concerns may be related to ongoing symptoms, or other complications such as financial or housing issues. If the person with schizophrenia is responding slowly or only partially to current treatments, family members may experience the same degree of fear and apprehension that was present in the beginning. Support is particularly important at this time. Brief individual therapy or group therapy for the entire family should be considered.
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Guilt
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Modern psychiatry has effectively dispelled the notion that parents were somehow responsible for their child's illness. However, new research in the areas of genetics and potential environmental causes for schizophrenia may renew some of the feelings that parents had in the past when they erroneously assumed responsibility for the emergence of schizophrenia in their child.
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Even when these convictions are not present, some parents believe that they are not doing enough for their affected child. Professionals must do their best to reduce these concerns. Knowledge about the risks that genes carried by parents of people with schizophrenia pose for their children are not likely to change the decisions we make about childbearing. Potential environmental factors are only tenuously linked to the development of schizophrenia. There are currently no environmental factors that can be changed to reliably alter the risk for schizophrenia.
(Sources: The author’s knowledge base, unless otherwise noted.)
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