Caring for Someone with Psychosis: A Guide for Families

When someone in your family develops psychotic symptoms as a result of a mood disorder, psychotic disorder, or substance use disorder, it can be incredibly challenging for the whole family. The confusion of their psychosis can transfer to their relationships and the family system dynamics too. The best approach when caring for someone with psychosis is an empathetic, compassionate, strong, and grounded one. With help, your family can develop that successful recovery approach.

Now that her daughter is experiencing psychotic episodes as a result of major depression, Suzanne has been dealing with overwhelming grief over losing the daughter she used to know. The level of care her daughter needs is increasing, and normal, predictable days are fewer and further between. But Suzanne is grateful that she is able to spend considerable time caring for her daughter directly, especially as she learns more about the do’s and don’t’s of caring for someone with psychosis and she can recognize the progress being made.

Caregivers and family members like Suzanne must balance out their own needs with those of the person with psychosis. They need to be willing to manage their own stress, exhaustion, depression, grief, sleep, and isolation—due to the demands on their time for care or their own shifts in attitude and priorities in light of their loved one’s disorder. In this way, care can progress, relationships can be rebuilt, and families can find sustainable solutions for long-term recovery. Ultimately, someone with psychosis has a better chance of recovery success when family members remain involved.

What Are the Challenges of Psychotic Symptoms in a Family Member?


Psychosis refers to symptoms that can stem from various psychotic and mood disorders, as well as from substance use. When someone experiences psychosis, their perceptions are confused, so they may not be sure what is real. Delusions and hallucinations (visual or auditory) can further complicate their thoughts and their understanding of what is real around them. Their speech and behaviors might not make sense, and they can develop anxiety, depression, isolation, insomnia, and difficulty functioning in the context of everyday life. Psychotic disorders and features come in many types, and each family’s plan for care management will be unique.

Within the family, psychotic symptoms can introduce a confusing shuffle between independence and dependence. Someone with psychosis may be experiencing their own identity through convoluted perceptions, and they may begin to lose a grip on their relationships and regular responsibilities in life. Family members may be called to give increasing time and attention to that person’s daily care. But it’s important for you to remember that your son or daughter or brother or sister or partner is still there and in need of compassionate understanding. Know, too, that you don’t need to endeavor through these challenges alone.

Professional support is critical for proper diagnosis at the source of someone’s psychotic symptoms, as well as for medication and therapy management and mitigation of the risks that increase with psychosis: substance use disorders, suicidal ideation and attempts, trauma, unemployment, and mortality. It’s easy for stigmatization to occur, even within the home, as a family member’s thoughts and behaviors become more unfamiliar and unpredictable, and they may act out aggression or isolate. The strain on relationships can be extreme if appropriate support is not reached. Quality of life may get progressively worse for someone with psychosis and their family members if they are not aware of how to effectively manage these symptoms and life along the way.

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Tips for Caring for Someone with Psychosis


Caring for someone with psychosis can often feel like an uphill battle. This is especially true if they resist your support due to suspicions and doubts about your motives. It’s important to facilitate the most trusting, comfortable, and cooperative relationship for recovery success. Experienced advice and support for supporting someone with a severe mental illness can be invaluable.

Do

Don’t

  • Ignore the symptoms and deleterious effects of psychosis
  • Extend compassionate understanding for someone who is overwhelmed by misperceptions they cannot control
  • Apply inappropriate pressure on someone with psychotic symptoms to perceive things accurately
  • When psychotic episodes are mild, gently redirect conversations away from harmful thoughts and perceptions
  • Tell the person they are wrong or feed into their psychotic experience by playing along with their mistaken impressions
  • Call for emergency assistance if you are concerned that the person experiencing psychosis may hurt themselves or another
  • Attempt to handle a situation on your own that feels out of control or dangerously unpredictable
  • Treat the person in your care as a valued member of the family, emphasizing the connections you share
  • Talk about your family member’s psychotic condition in a way that might provoke shame or guilt

Family members can serve as important advocates for their loved one with psychosis: you can help by discovering the best treatment options, communicating to healthcare professionals the details of the person’s symptoms, and providing ongoing compassion and social support along the recovery journey. Ideal treatment programs will integrate family participation as a primary long-term recovery strategy. Since you are such an important part of your family member’s life with psychosis, it’s critical that you feel included and informed during their treatment.

Even better, family members should have access to educational and counseling programs that address their needs directly and specifically—not just as a vague extension of the client’s care and counseling. Opportunities for family members include peer support groups to learn from others’ experiences with their loved ones’ mental health recovery journeys; practice with healthy, effective communication; practice developing boundaries to strengthen the whole family system; and supports and resources that are accessible even after a long-term treatment program is complete. Even if the day itself feels daunting—let alone your family member’s long-range recovery—there are compassionate professionals and programs ready to support you all along the way.

BrightQuest offers comprehensive residential treatment for people struggling with mental health disorders as well as co-occurring substance abuse and eating disorders. Contact us to learn more about our renowned program, and how we can help you or your loved one start on the path to lasting wellness.