Managing Common Schizophrenia Symptoms

Caring for someone with schizophrenia means being able to identify and deal with challenging symptoms at times. Here’s what you need to know

By Mikel Theobald
Medically reviewed by Farrokh Sohrabi, MD

Schizophrenia symptoms influence the way people with the condition think, act, and experience the world around them. To be the best possible caregiver to a person with schizophrenia, you need to understand the three categories of symptoms as well as the healthiest ways to respond to them, says Andrew Savageau, MD, an assistant professor of psychiatry at the Ohio State University College of Medicine and an attending psychiatrist at the OSU Wexner Medical Center.

 “Positive” Symptoms of Schizophrenia

In terms of schizophrenia, the word “positive” denotes symptoms that are, in essence, add-ons to normal behavior — the addition of mental experiences to a person’s regular way of processing the world around them. These psychotic symptoms, which include hallucinations, delusions, and thought and movement disorders, make it appear that a person is losing touch with reality.

  •  Hallucinations: Hearing voices is the most common type of hallucination in people with schizophrenia. Individuals may believe they hear a voice telling them to do something or warning them of impending danger. They may also hallucinate objects or people, smell odors no one else can smell, or feel touches that don’t actually occur.
  •  Delusions: Schizophrenia can cause people to have beliefs not based on fact. They may feel paranoid, that people are out to get them, or that they’re being watched by a specific organization. They might believe they are someone other than who they really are, such as someone they’ve read about or seen on TV.
  •  Thought and movement disorders: These symptoms may cause people with schizophrenia to exhibit disorganized thought and speech patterns and agitated or repetitive body movements.

“It’s important for caregivers to recognize that a person with schizophrenia perceives ‘positive’ symptoms, such as hallucinations or delusional thoughts, as part of reality,” Dr. Savageau says. “A person with schizophrenia is usually unable to distinguish the difference between what’s real and what isn’t. Therefore, the emotional response these symptoms produce — fear, anger, shame, or guilt, to name a few — is legitimate and should be recognized as such by caregivers.”

When this happens, Savageau advises responding with empathy. Acknowledge the feelings caused by the hallucination or delusion and let the person know they’re cared about and supported. Attempts to convince the person that the hallucinations or thoughts aren’t real should be avoided. This isn’t helpful, he says, and may, in fact, lead to conflict or suspicion from the person with schizophrenia.

If symptoms worsen or if the person begins to demonstrate disorganized thoughts or behaviors, talk to his or her doctor to determine if a medication adjustment or hospitalization is necessary.

“Negative” Symptoms of Schizophrenia

The term “negative” in regards to schizophrenia symptoms refers to a decrease in the capacity for normal functions. Sometimes these symptoms are mistaken for depression. They include:

  •  Not being able to begin or sustain planned activities
  • Having difficulties with relationships and social interactions
  • Showing little or no facial expressions
  • Being unable to enjoy oneself or have fun

“For caregivers, it’s very important to recognize that ‘negative’ symptoms, such as lack of motivation, isolation, loss of interest in pleasurable activities, and diminished emotional responses, are due to schizophrenia and not to laziness or depression,” Savageau says. He suggests establishing a routine, making a written schedule, and setting clear and achievable goals to help a person with schizophrenia overcome the burden of these symptoms.

If social withdrawal is a concern, controlling exposure to social activities may be helpful. Savageau suggests minimizing time spent in crowded social settings until the person can manage these environments. Allow down time so that he or she can spend time alone without structure to avoid creating excess stress.

Cognitive Symptoms of Schizophrenia

These types of symptoms pertain to thinking processes. Cognitive symptoms directly affect quality of life because daily tasks require various levels of cognitive functioning. A person with schizophrenia may have trouble with:

  •  Prioritizing tasks
  • Making decisions
  • Remembering things
  • Focusing or paying attention

“Cognitive symptoms may be the most debilitating element of schizophrenia,” Savageau says. He recommends responding to cognitive symptoms by using simple memory aids, such as giving a person with schizophrenia a small notebook to write things down, making lists and placing them where they’ll be seen and followed, creating a routine and schedule, and putting medications and other vital items in the same place every day.

“If a person’s cognitive status declines drastically, it may be time for caregivers to consider pursuing legal payeeship or guardianship to help protect him or her further, such as by minimizing the risk of the person misusing money or being a victim of fraud,” Savageau says.


Last Updated: 06/09/2014
This post created and produced exclusively by the editorial staff of © 2014; all rights reserved.

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