Everyday life with a schizophrenic patient
It is worth knowing that...
Living for years in chronic stress, anxiety and maintained vigilance, without any perspective for improvement, is an experience, damaging to the patient's family members as well as seriously affecting their relationship with the ill member of the family.
The fears may concern a relapse of the symptoms of acute psychosis, during which, the words, behaviours, aggression and the total change of the mental state of the ill person could be a psychological trauma for the relatives. Such a trauma is recorded in the emotional memory to be then manifested by fear of relapse to psychosis, of experiencing the same horrifying or threatening episode.
All this caused the above-mentioned vigilance and increased sensitivity to various signals in words and behaviours of the ill person, which could be indicative of repeated psychosis with its traumatic events. Such an enhanced sensitivity is then hardly surprising. It has its understandable psychological background and is also based on the neurobiology of emotional memory and the fear against repeated trauma.
Second, the everyday life with the ill person may also be associated with many difficulties in simple activities, such as personal hygiene, meals, the spending of time and the day's agenda. In this situation, any functional deterioration or improvement in the ill person and in collaboration with the person in the listed scopes may decrease of increase the stress level of the family members and add or take away their time, possibilities and scopes of performed activities (depending on how much supervision the ill person requires and how ill-suited his/her behaviours may be).
„The medication police”
Do you know that...
This situation is commonly defined as "the medication police" - by analogy to police functions, where the family members, just as policemen, supervise, control, monitor and look for "offences" committed against the regimen of pharmacological therapy.
Using the term of "medication police", one may see how difficult and constrained is the relationship in which, one side (the family) plays only one, unpleasant role of supervision, control, searching, vigilance and distrust, while the other side (the ill person) is merely the object of these activities (not to mention the fact than in conversations about traffic police, it is rather uncommon to hear someone telling how much he/she observed the traffic regulations on the road.
The stories are rather about how he or she escaped consequences of their negligence. In case of ill persons, a similar attitude may provoke to resistance and non-compliance with therapeutic recommendations, since medication is the only subject of talks at home).
It is worth knowing that...
All this seriously narrows the psychological space of both sides for any closer relations or even for simple human contacts or some activities together, which are not associated with the sphere of anxiety, fears or therapy (drugs).
A solution would be to use extended release injectable medications which could perhaps prevent the problems with non-compliance, while both family members and the patient would no longer be annoyed by the question 'Have you taken your medication yet?'.
In such a situation, it would be clear that the ill person is properly treated, as the administered drug is maintained for a longer time and doe not require daily control of its intake. It may considerably improve the relationship with family members, while reducing their fears of relapsed psychotic episodes.
The patient may demonstrate smaller variations of mood and well-being, what again reduces the level of stress, vigilance anxiety and waiting for negative episodes on the side of the family members. What is important - it may open more space for their own activities (since there is no need of strict control and supervision of the ill person, the family members may undertake other activities), as well as the space for mutual relationships, without the stressful burden.
Not only the attitude of the patient being treated for schizophrenia is important for the success of the treatment. The attitude of family members and friends is of great importance as well.