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Below are some suggestions for things that might be helpful for you to do, or not do, to help your friend or relative to get better. When people experience psychosis, they often go first through a psychosis phase and then through a recovery phase (see the section on what is psychosis). Listening and trying to understand is especially important when someone is experiencing psychosis, and promoting independence is more important when someone is recovering, but other things like keeping calm and taking time out for yourself are important all the time.

Do:

Listen and try to understand what your friend or relative is trying to tell you and why they think the way they do. This may be hard as they may be telling you some things that sound quite unusual, unbelievable or distressing BUT the more you listen the more you will understand and also for your relative or friend having someone who they can talk to will help them to make sense of what’s going on and may even make them start to question it.

Encourage your friend or relative to get back to the things that they have previously enjoyed in life, or to take up new hobbies, social activities, college courses or job opportunities. You might remind them of their skills and strengths, and the things they’re good at, but then let them decide how much they are able to do and how quickly. Tell them how well they’re doing when they make even small steps to recovery. This will encourage them to keep going.

Think positively and be optimistic  about the things that your friend or relative might want to do in life. Help them to think about the future and the things that they may want to get back to. Psychosis often begins when people are young so it’s easy for it to interrupt college, university, work and friendship groups. Low mood, lack of energy  and negative thinking about psychosis (self-stigma) can make it harder to get back to these things, but the more hopeful you are for your friend or family member, the more you think with them about their goals and how to get there, the more likely they will achieve things, in their own time.

Promote you friend or relative’s independence . It might be tempting to ‘look after’ or ‘protect’ your friend or relative. This may especially be true, if they have their lost confidence and you or they are worried about the psychosis coming back. Worry about psychosis coming back is normal but it can hold young people back. It’s important that they rebuild their hope, confidence, independence and social life, but perhaps just being a little bit aware of ‘triggers’ or ‘signs of relapse’. If you are worried, it might help to discuss a ‘wellness or relapse plan’ in general or in relation to your friend or relative, with your local EIP service.

Have realistic expectations. It can be tempting to push your friend or relative to get back to their old life as soon as possible after psychosis. This may be because you want to be reassured that they’re better again, because you think it will help, or because you miss the old them or need them to do the things they used to do. Your friend or relative may find it hard to get back to things they used to do or start new things (see the section about the recovery stage). Pushing people to do too much at this stage can cause more stress and if they cant do things, can make them feel even more of a failure. Do encourage your friend or relative, but do let them recover at their own pace.   

Keep calm and make time for yourself. Having a relative or friend with psychosis can be upsetting and stressful for you too. You may find it hard to understand what they’re going through, how to talk to them and how to help them. You may miss your friend or relatives input or company, their help around the house, their contribution to money. There may be mental health professionals, other friends and family and the young person themselves telling you different things or saying things that you don’t agree with. It’s important that you keep calm, take time for yourself, and get the support that you need, that way you will have the strength and energy you need to help your friend or relative. See the section below for more ideas on how to help yourself.

Remember you have lots of experience to draw on from being there with your friend or relative in other difficult situations in the past. Mental health is no different from other problems, like relationship break-ups, problems at school, work and home. Use your experience from dealing with problems in the past, to help you approach the new situations that you face together as a result of mental health problems. Keep trying different approaches to solving problems until you find something that works. 

Support your friend or relative to choose and use the interventions that are on offer. You could talk to them about their options, linking this to what’s important to them and what they want to achieve. You could even come with them to a session where they discuss treatments and goals. There are a number of recommended interventions for psychosis. These include

 

  • Medications that help with unusual and distressing experiences, medications that help with moods like depression and anxiety, and medications that help with keeping your mood stable.
  • There are also talking therapies such as Cognitive Behaviour Therapy (CBT) which can help young people to understand their experiences, thoughts and behaviours so that they can improve things for themselves, and;
  • Family interventions (FI) which help the whole family to understand what’s been happening, to solve problems, deal with difficult emotions and reduce stress and tension so that the whole family can support each other and reduce the risk of relapse for the young person. 
  • Vocational or Occupational support which can help young people to get back to work or education.
  • Cognitive remediation therapy is a new therapy that helps people to cope and get on with life with on-going planning and memory problems.
  • There are also lots of other therapies and approaches that may also be helpful with stress, general well-being and physical health, like exercise, yoga, art, drama, music and relaxation

Ask if you can input to and have information about your friend or relative’s care plan. You may have useful information which will help to understand your friend or relative’s difficulties, how they cope and early signs that they are struggling. Your friend or relative may not be very good at understanding and recognising their problems themselves. Also, if you have more information you will be better able to support your friend or relative.You can find out more about treatments in our information booklet on ‘treatment choices’. 

Have a crisis plan in place.When your friend or relative is well, you can discuss with them, the sorts of things that may be helpful for them if they become less well again. This can include things that they, you and mental health services can do to support them in a way that works best for them. 

Don’t:

Don’t keep telling your friend or relative that they’ve got it wrong and that what they’re concerned about isn’t happening. Sometimes, if your friend or relative is already questioning things then telling them you don’t think they’re right can be helpful and reassuring. Often though, when people are experiencing psychosis they are completely certain that they’re right. They may be absolutely sure that they are hearing someone talking to them or that someone is out to get them, or even that they or you are someone they’re not and so telling them they’re wrong can alienate them and make them even more defensive, angry or upset.

Young people with psychosis have often said that the worst thing is people telling them they’re wrong and that what they’re experiencing isn’t happening. 

Don’t force or pressurise your friend or relative to do things that they don’t want or aren’t ready to do. When people are experiencing psychosis, they can feel very scared or anxious, and they may struggle to concentrate, it can be extremely difficult to do the things they used to do. Even when the psychosis experiences have gone, young people may have lost a lot of confidence and may continue to feel anxious, depressed or lacking energy and motivation. Different people recover at different speeds. For some, it may take a long time, and involve very small and gradual steps. Pushing your friend or relative too much when they’re not ready can make them feel like a failure, which will make them feel even less able to do things.

Don’t devalue or ignore your friend or relative’s progress, try to have realistic expectations. It can be hard to understand why it takes so long for your friend or relative to recover, and it can seem like they’re being lazy, not trying or not getting anywhere. Remember, your friend or relative will take time to recover. Your support and encouragement for their efforts, however small, will be really helpful to them. 

Don’t try to protect your friend or relative. It’s tempting, especially if you’re worried, to keep a close eye on your friend or relative, to go with them when they go out, to check up on them or to discourage them from doing anything that might cause stress, like living alone, getting a new job or starting a new relationship. But, taking risks and experiencing stress is a part of life. A better approach would be to encourage your friend or relative to find better ways of coping with stress.     

Don’t be critical, blaming, pessimistic, angry or upset with your friend or relative. It’s hard to be positive all the time but negative and critical comments will undermine your friend or relative’s efforts to change. Remember, psychosis is no-one’s fault. If you’re feeling negative, and are tempted to criticise or blame your friend or relative. Try doing something for yourself instead to help you to relax and to feel more positive.      

The EYE Project is a research project supported by:

Sussex Partnership NHS Foundation Trust, Swandean, Arundel Road, Worthing, West Sussex, BN13 3EP