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Helpful things to do when someone you care about is experiencing psychosis.
"Who knew I'd have to learn to cope with living with someone with psychotic symptoms? I sure didn't. Gradually I've learned how to help my brother live with his symptoms, and to adjust to being around him successfully in the good times and the difficult ones."
Delusions & hallucinations
How a person might act:
Note: Unusual beliefs and behaviour may be part of a person's normal belief system or culture. If they are, they may have nothing to do with their mental illness.
Talking to voices that are not there
Talking about a strongly held false belief (delusion) or something they hear, see or feel that is not there (hallucination).
Behaving oddly because they have a false belief or are hearing, seeing or feeling something that is not really there. e.g.: avoiding water because the person thinks it is poisoned
Preaching because they believe they are Jesus Christ
Being distracted and unable to concentrate (see below as well).
Helpful things to do:
Avoid arguing with the person about their delusions. Delusions are extremely fixed and difficult to change
Connect with the emotion of the delusion or hallucination e.g. 'It must be frightening to believe that you are Jesus Christ'
Calm things down - reduce the number of people and noise around the person
Show compassion for the how the person feels about their false belief and do what you can to help where possible when the person is acutely unwell e.g.: turn off the TV if they think it is talking to them.
Being Paranoid (a delusion)
How the person might act:
Behaving as though they are being followed, tricked or spied on
Being overly sensitive and suspicious
Behaving in a way that is goes along with what their paranoid belief
Being irritable
Being aggressive – the person could be afraid because of the delusion and may act out of that fear.
Helpful things to do:
Avoid arguing with the person about their delusions
Let them know you can understand why they would feel afraid, given the things they are thinking.
Show them with your body language that you are on the same side. Sit beside rather than in front of the person
Stay calm
Consider the safety of you and the person.
Disordered Thinking & Behaviour
How the person might act:
They may talk in a disorganized way, and not make much sense.
They might not seem to cooperate or seem 'spacey' and 'not there'
Have a hard time doing regular things like as making meals and keeping themselves clean
Dressing inappropriately or strangely e.g. lots of clothes on a hot day.
Helpful things to do:
Speak to the person in a clear and simple way
If necessary, repeat things talking slowly and allowing plenty of time for the person to answer
Give step-by-step instructions.
Not showing a wide range of feelings (Affective flattening)
How the person might act:
The person's face may seem not to move or respond, or have no expression
The person may not meet your eye or look away
The person may not express much using their body.
Helpful things to do:
Be aware that this is a symptom of the illness; don't take it personally.
Try not to get frustrated or hurt that the person isn't showing their feelings much.
Be aware that just because the person is not showing their feelings very much, it does not mean that they are not feeling anything.
Being silent or not talking much
What the person might do:
Speak or communicate less
Give short and empty replies
Seem to have difficulty putting words together
The person appears to be thinking less.
Helpful things to do:
Speak simply and clearly to them and accept it when they speak simply in return
Keep talking to them no matter how they respond – don't assume the person cannot understand you, even if they don't respond much.
Having trouble starting and keeping going with activities or getting things done
What the person may do:
Sitting for a long time doing nothing
Not showing much interest in participating in any sort of activity
Not have much motivation.
Helpful things to do:
Understand and acknowledge that these are again symptoms of the illness. The person is not behaving this way on purpose.
Try not to become frustrated with how they are acting
Encourage them gently to participate in activities.
This information is adapted and reprinted with the permission of the Mental Illness Fellowship of Victoria (Australia).
