A Pitfall in Treatment with Schizophrenia

There is a common pitfall that many people with schizophrenia and other mental illnesses fall into. That pitfall is a serious concern that many in the mental health community share. I am talking about when people with a mental illness receive inadequate care for other ailments. Today I will discuss in more detail why this happens, how to avoid it, and how to watch for it. Lets dive in shall we?
Many people are aware of stigma and the impact it has towards getting treatment for your mental health. Unfortunately, this stigma can be found in unexpected places such as hospitals and other medical facilities. While there are many people who are caring and compassionate towards those with schizophrenia, there are some people who are uneducated on the subject that may inadvertently or knowingly mistreat people with schizophrenia. This is particularly noticeable when being treated for something separate from the illness.
Some medical professionals make assumptions about their patients. For example, they might assume that a patient with schizophrenia who is complaining of pain may be hallucinating it or faking it. While this is the exception to the rule, it does happen and can have devastating consequences for the patient involved. While there are some instances where a patient may be hallucinating or faking something, it should never be the initial assumption.
Family and caregivers of people with schizophrenia are often put into a position of advocating out of necessity. It is important to be determined in making sure that your loved one receives proper and adequate care. While you should always try to remain polite and courteous with your loved one’s treatment team, it is vital to ensure that the patient’s medical needs are met. The main avenue of accomplishing this is through advocating for your loved one.
To summarize, there are a few people within the medical community who may not take physical ailments seriously when they work with somebody with a mental illness. One of the best ways to deal with this is to take your loved one’s concerns seriously and to advocate on their behalf. The top priority of all those involved should be the proper and sufficient treatment of your loved one.
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Strategies for Caring for a Loved One in Psychosis

Psychosis is often a legitimate and common driver of fear for those who experience it as well as those caring for them. For some, psychosis can appear suddenly; for others, it comes on over a longer duration. Regardless, it rarely fails to catch people by surprise, especially when you are not prepared or are still coming to terms with it. Thankfully, there are things that you can do as a caregiver that can make it a little less stressful. Bear in mind, psychosis is a very stressful experience for all involved, but the distress can typically be mitigated through certain actions and behaviours. So, what are the do’s and don’ts when you are handling a psychotic episode?

Do’s

Firstly, remain as calm as possible – getting all flustered about what is going on will not help the situation and it can even exacerbate it. As I often tell myself “don’t lose your shit!”. No matter how intense or bizarre the situation may become, do not freak out. You know the saying that dogs can smell fear? I find people are the same in that we can pick up on each other’s emotional state through mediums like body language. Let me give an example. Say somebody walks into the room stomping their feet and clenching their fists with a look that could kill. They seem angry right? I can only speak for myself, but I would pick up on that, might even get uncomfortable. So, with that example in mind, how do you think somebody in psychosis would react when they pick up on your tension and stress? I have seen from my own experience that giving off the wrong emotional vibe can make a tense episode plummet into a tailspin. It can be extremely stressful, but don’t worry – there’s time once things are a little more calmed down, once the situation is under control, where you can let the stress out.

Secondly, you may find it helpful to focus on the task at hand. Try not to worry about all the concerns that may arise after your loved one is stabilized. In fact, I will make it even more simple, because I believe in the K.I.S.S. principle (keep it simple stupid).  You have two jobs:  keep the situation as under control as can be expected, and do the best you can. It would be folly to think that things won’t go wrong, or that you won’t make mistakes, because hey, we are only human, we can’t be perfect all the time. It’s okay to make mistakes and fudge up in a situation like psychosis, it happens, but we must learn from our mistakes so that we can be ready for the next episode. Anyway, back to the main topic, (can’t believe I just got off topic when the topic is to focus) when an episode strikes, the only time that matters is the moment you’re in. The past is not important, and the future is a long way off. Your focus should be on keeping the situation relatively under control and getting any necessary assistance such as an ambulance or crisis team. Alright, onto the next tip.

Third, eliminate any distractions. This could mean turning the tv off, turning down the radio, or politely asking anybody who does not need to be there to leave. When somebody is in psychosis, there is so much going on for them that they can have a really difficult time sifting through what is real and what is not. So, having a tv blaring or having somebody talking that shouldn’t be in the room, that only adds to the cacophony of sensory overload that the person is going through. In short, remember the K.I.S.S. principle.

Lastly, as a little tip that I have used extensively, this one is a life saver when done properly. Try to help the person in psychosis to remain anchored in reality. You can do this by talking to them, trying to keep them calm, and by showing through your emotion and body language that it will pass. When talking to a person in psychosis it is important to be clear and to the point, without raising your voice any more than necessary. While it may feel nearly impossible, it is critical that you try to remain confident and try to instill a sense of security for your loved one. You must be strong in this moment, because they are busy fighting their own struggles, so to say they are vulnerable would be an understatement. Keeping them anchored in reality is vital, as it can sometimes help them to know that there is somebody who loves them and is there with them.

Don’ts

One of the biggest no-no’s is ridiculing or being critical of what your loved one is experiencing. It is important to keep in mind, what they are perceiving as real, is not any less real than you or I. I have heard that it is like dreaming when you are awake. The point is that it feels real, and now is not the time to be condemning a loved one over something that they have as much control over as a person and their skin colour. This one may seem obvious, but many people make this mistake in the heat of the moment.

Similar to the first item in the “Do’s”, do not freak out. When somebody is in an episode it is important that somebody takes charge and tries to keep the situation from escalating, and that can’t happen if everybody is getting stressed out can it? I am not saying that you can’t feel fear, or concern, or any other emotion. What I am saying is that you have to try to keep your own emotions in check and not let them make the decisions for you. It sure as hell is not easy, but it is easier than trying to pick up the pieces after the situation has escalated.

Finally, do not lose hope. It is often in the aftermath of an episode that despair really comes into play. When you get a moment to think and process what has just happened, then all the emotions and fears tend to hit you like a ton of bricks. Try to remember though not to lose sight of hope. Hope is the torch that illuminates dark roads of mental illness. Being in the dark sucks, trust me. So, take hold of that torch and let it burn all the brighter in that night! I know this all sounds corny, but if it wasn’t for hope, I likely wouldn’t be able to manage my life too well. Hold onto hope, no matter what.

Summary

Psychosis, at least with regards to schizophrenia, is often when symptoms flare up to a level that is unmanageable in the moment. Psychotic episodes are typically dominated by hallucinations and delusions. In general, it is often described as losing touch with reality, not being able to tell what is real and what is not. As a caregiver it can be terrifying to witness a loved one go through this, only being able to imagine what they must be going through. Thankfully, psychosis usually is episodic in nature and as such is not always present. I hope that with this article I have been able to share some of the things I have learned the hard way with you.

Stay Strong.

A Year in Review: Lessons Learned as a Caregiver and Husband

It has been quite a journey since being told of my wife’s diagnosis. Teeming with memorable ups, painful lows, and everything in the middle. There is a plethora of blessings and curses alike to be taken from such a journey. Wisdom and understanding are two such attributes that can be attained as both a caregiver and as somebody with mental illness. But in order to gain insight into wise ways and empathetic understanding it is often necessary to take some lumps and bruises along the way. So what exactly have I learned from our new way of life? Well, let’s look, shall we?
If I were to simply lay out a nice, clean-cut, and definitive list, that would hardly resemble the menagerie of lessons I have had to decipher along the way, would it? I will, however, do my best to lay it out in a way that hopefully allows you to take something from it.
Without a doubt, one of the most prominent lessons I have absorbed is empathy. Looking outside of myself and trying to genuinely see the world in a way that others experience. For instance, in the past I have often looked at my situation and thought “poor miserable me.” What I should be thinking though is “what can I do to make your day better?”. Attempting to “walk in their shoes” would force me to see that while, yes, my situation might not be optimal, there are people around me who could really benefit from me putting on my big boy pants and trying to help them through their struggles. And guess what? It makes me feel better, too. Not only does this empathy open my eyes to helping others, it also allows me to get a very rough idea of their struggles. For example, trying to truly imagine how it would feel to experience even a fraction of her symptoms on a bad day. All I can say is that she handles it better than I could. That brings us to the next lesson, patience.
I have often been told that patience is a virtue. Little did I know just how those words were to ring true. Not only is being patient a useful skill when waiting on results and doctors, it’s also highly beneficial when having to face the inevitable symptoms of mental illness. Marriage makes that importance that much more important. For example, say your partner is on the verge of a psychotic episode, or perhaps they are on the verge of suicide. It is safe to say that these are moments where you do not want to be in a rush or pushy to conclude this stressful scenario. If, however, you allow the resolution to take as long as is necessary, it can help to keep the situation from escalating. Another benefit, especially when working with psychosis, is that being patient can result in making the individual with symptoms feel more calm or assured than if you were to panic or react in a negative manner. This by no means indicates that the situation will resolve immediately. It simply means that it can potentially mitigate stress and harm to everybody involved.
A hard-learned lesson for myself and, I am sure, many other caregivers, is the act of self-care. You strive to be the best caregiver you can be, pushing yourself past limits that would normally break you. Yet you persevere because really, what other option do you have? Your loved one needs you, so you play the herculean role; maybe you have other children who need you too. More than likely you have multiple responsibilities to look after. And you play the role of Atlas, the weight of the world borne upon your shoulders. It’s noble, and many of us do just this for weeks, months, or even years. There is just one problem – we are only human. That means we are vulnerable to that dreaded “b” word. Yup, that bane of any caregiver’s existence, burnout. Many of us have walked this thin line before. How can you avoid burnout? The answer is simple, yet not remotely easy. Self-care, that’s the remedy that can stave off burnout. I will be the first to admit that I was sorely lacking in this department. I poured myself into being a caregiver, on top of my other responsibilities. Things like school, work, family, pets, household chores. I told myself that I could handle it all. Then I started to wear out. The fatigue, loss of drive and ambition, not eating or sleeping enough, the bottoming out of my stress tolerance; even the most minor of stressors like a wrapper on the floor and boom! Day ruined. I lost myself in my role as caregiver. So, what did I do? I started slowly practicing self-care, treating myself to moments where I tried to only worry about myself. That’s not to say I stop caregiving; my role as caregiver and husband has always been a top priority. Along with a billion other things. I just put myself in the top five priorities so as to climb out of the burnout trenches. Think of it like this, when they do the safety presentation on airplanes, you know the ones with the oxygen masks? What do they say? You are instructed to take care of yourself and then any dependents. Sounds a bit ass-backwards, doesn’t it? But how can you help anybody if you are passed out from lack of oxygen? You can’t. So, by taking care of yourself, you are also taking care of those around you. If your wife, kids, parents, or anybody else depends on you then doesn’t it make sense to make sure you are ok? You wouldn’t want to let them in a worn out and unreliable boat. You would want them to be safe and looked after. So why would it be any different as a caregiver? If you can’t take care of yourself, you can’t help anybody else. In order to be an effective caregiver, it is imperative that you be in as good of shape physically, mentally, and emotionally as possible. So, by helping yourself you are also helping those who rely on you. So, help others by helping yourself a little to.
While I have learned countless things over the past 18 months, these three are probably the most critical – at least in my mind. Hopefully there is a little something here for you to take and help you or somebody you know. I wish you all the best on whichever path you are on. Anyway, that’s it from me today.

Burnout: The Silent but Deadly Threat

It’s the bane of any caregiver’s existence. That looming silent shadow at the back of your mind. it’s always there, patiently waiting to worm into the fabric of your life. I’m talking about burnout, specifically as a caregiver. It really isn’t fair, is it? You want nothing more than to help your loved one as best as you can, most of us would happily sacrifice everything in the hopes of helping them. But you can’t, because you know what happens when you give up everything? When you lose yourself in what you do as opposed to who you are? That’s right, burnout. The fact of it is that even with an act like caregiving, you can’t give everything of yourself and hope to get by without yourself.

Caregiver burnout is usually what happens when you’ve been stretched to the max, you just can’t give anymore of yourself. You can be tired, irritable, depressed, anxious, any number of nasties really. It happens when you push too hard and too fast and give all you’ve got until you have nothing left.

That dark looming cloud overhead doesn’t have to stay there though. You can make it go away, its not easy, but its probably worthwhile. Reach out. Hold out your hand and ask for support. Asking for help doesn’t make you weak, far from it. Anybody who has swallowed their pride and allowed others to share the weight will tell you that it only makes you stronger. Think of the bundle of sticks analogy. One twig is pretty easy to break, right? Well try grabbing a handful and break them at the same time. It’s quite a bit harder, isn’t it? The point is, you don’t have to do this alone. I’ve often found that many people want to be helpful but just aren’t sure what to do, so if somebody offers their assistance, take it, be up front about what you could use help with. Many hands make light work, right?

Its all about you finding balance in your life. If you can find that middle ground. That spot where you can be a caregiver AND yourself, it will be better not only for you, but also the loved one who you care for. Just remember that every storm breaks.

Stay strong!

The Pendulum of Mental Illness

It swings back and forth, side to side. Some days you’re at one extreme, other days you’re at another. But some days, you’re right in the middle, and life is good. Those are the moments to be cherished. What are these extremes you ask? Well the one, let’s say on the left side, is when things are difficult. Maybe you’re in hospital, maybe you’re experiencing residual symptoms, in short, this is the low end of mental illness, it feels like crap. Then on the right side, its when things are going a little too well. Maybe you’re lulled into believing you’re cured, maybe the treatment doesn’t seem so critical now, you’re on cloud nine. And then there’s the middle of the pendulum, that sweet spot. Where life is good, but your feet are still on the ground. Those are the days that make it all worth it.

So, what is it like on the proverbial left side? Well I’d say those are the moments that leave you feeling drained and helpless, maybe they make you want to scream out in frustration. Perhaps the left side leaves you wanting it all to just stop already. For many people, there are just as many reactions and responses. Many negative emotions and thoughts can crop up on the left side. Sounds pretty rough, right? Well, guess what? You know how a pendulum works? It swings back and forth, it never stops in any one spot for too long. That can only mean that we won’t be trapped on the left side forever, because we are gonna swing back into the middle and the right.

The so-called right side? That’s when things are going a little too well. Maybe you feel that treatment is no longer necessary, or that its all under control. This time its dealt with, the war is won! Or is it? It may not sound that bad at first but in my experiences its often a trap just waiting for me to walk through. SNAP. And then the pendulum goes flying back into the left side. It can be a pretty nauseating ride, that’s for sure. But have no fear! Because somewhere in between lies the middle.

Ahh finally, the mysterious middle. It’s the spot that everybody yearns for. Just what is the middle like? Well, its those moments that never seem to last quite long enough, yet they last an eternity. Its when it feels like you can handle tomorrow, because you handled today. It’s a difficult space to explain, the experience is different for everybody, but I can imagine that the feelings are nearly identical. Peace, serenity, and determination often arise from the middle. Bring it on mental illness! because we’re ready, we are no strangers to this fight.

Whether you’re on the left, the right, or you’re in the middle, just remember that “this too shall pass.”

The Therapy That Lives in Caregiving

Caregiving can be both exhausting and rewarding. Personally, I’ve found so much positivity through caregiving. Through being of service to my wife, I’ve found my voice and strength I’ve never thought I had. I’ve often wondered what my purpose in life was, and I feel confident in saying that helping my wife where I can has given me direction.

That’s not to say that caregiving is my sole driver in life. I’ve also found myself. Through being apart while my wife was in hospital, it gave me quite a bit of time to reflect on who I was and wanted to be. I’ve always had a constant desire to be helpful to people and try to assist in any way I could, helping my wife has given me an outlet to help and be of service to somebody.

Through my experience caregiving, my opinions and outlook on the world have changed dramatically. For the better I hope. Its made me much more compassionate and understanding towards others. In fact, its been my desire to help others that has driven me to begin this blog. Its been the hope that the experiences of my wife and I would maybe, just maybe, be of benefit to other people.

I imagine I’m not the only one who has found caregiving therapeutic. It can make you feel really good about yourself because you’re giving as opposed to taking from somebody. Plus, what doesn’t kill you can only make you stronger right? How many of us have had dreams growing up of wanting to be a hero? To help others when they need it? To give somebody else a lending hand. I grew up full of those dreams. Dreams of being a doctor, a firefighter, just a good Samaritan, and you know what? I’ve done one better for myself. I’m working with my wife to help both her, and our marriage to thrive.

I feel as though I am a gardener planting a lily. Gently covering it in soil and lovingly watering the seed, and then getting to experience the joy and pleasant serenity in watching this flower grow and bloom. Its an interesting thought because it doesn’t matter how much I water that seedling, it still has to break through all the dirt and pull itself up. Teamwork. I can’t just will that flower to grow, there has to be work on both ends. While the journey may be different for the flower than the gardener, they need each other. Because without the determined lily, the gardener’s flowerbed wouldn’t be the same, would it?

To all the lilies out there, Keep breaking through that soil so us gardeners can enjoy watching you thrive.

Tools for Caregivers

Many people talk about coping tools for those who have a mental illness. These are very important to know, but what is also important is what kind of coping tools are available to caregivers? Being on the flipside of the coin, caregiving shares many tools of self-care and also has several unique to the situation. Fear not for there are coping skills for all!

The first one, and for me at one point my least favorite, take care of yourself too. This doesn’t mean to just dump your child, spouse, parent, or other loved one at somebody else’s place and fly to Tahiti for a month. For myself it means to not lose myself in the role of caregiver. It means to make sure that I still enjoy a decent quality of life so that I can continue to be a good caregiver. For example, maybe I’m awake early and my wife is still asleep, what a good opportunity to read a book I’m into (or a mighty article? Lol). The point is that while we may be striving to be the best, we are only human and therefore can burnout. By taking care of ourselves AND our loved one we can hopefully avoid burnout and continue to be there for the ones we love.

Secondly, don’t lose your shit. This one is twofold. Say your loved one is having a rough day and says something you may find strange or rude. Don’t get hysterical over it. For instance, I’ve experienced a loved one saying some things that others could find disturbing, I just keep my cool, accept it as a part of their illness, and talk it out calmly. Also, sometimes people have a bad day, we are all entitled to them once in a while. Maybe your loved one snaps at you. Again, keep your cool. You can still be firm but be careful not to come across as confrontational or looking for a scrap.

Thirdly, Stay organized. I’ve found that one of the most beneficial things that I’ve done is to keep records of anything mental illness related. I’ve got a great big binder with several sections. Keep a record of anything that may be useful for reference down the road, appointments, questions and answers with doctors, and medications, that sort of stuff. Keeping a record of everything will make it so you don’t have to have everything stored in your memory all the time. Trust me when I say this one is critical.

Fourth, think about making a crisis plan. The crisis plan in our house consists of important phone numbers, medications and their doses, where to go, what to make note of, and some readings for people who may want to know more on how to approach a crisis. If you’re giving a copy to someone who may be spending any amount of time with your loved one, make sure they go over it BEFORE not when a crisis appears.

Fifth, I decided to buy a laptop bag for the big binder mentioned earlier. It works as a “survival bag” as well as a way of easily carrying the binder around. This also had the positive outcome of putting all the essentials for an emergency department visit in one bag. I highly recommend getting a setup where you can leave in a hurry and know you’re as prepared as possible.

Finally, Never, ever, EVER lose hope. Hope is the foundation of just about everything we cherish in this world. Plus, hope is contagious. So, in a nutshell, hope for the best and prepare for the worst.

While this is only my personal and limited experience, I do hope it is of some benefit to anybody who finds this article.