7 Tips to Keep Your Relationship Strong
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Every relationship has its ups and downs, but when one person is diagnosed with schizophrenia, it’s possible for partnerships to become strained or end altogether.
One prior study estimated that 12 percent of marriages end in divorce among nursing home residents with schizophrenia, for example. Another study showed that 35 percent of veterans with schizophrenia experienced divorce compared with 28 percent among those without schizophrenia.
“Schizophrenia can make it hard for some people to form close bonds,” says Dost Öngür, MD, director of the Schizophrenia and Bipolar Disorder Research Program at McLean Hospital in Belmont, Massachusetts.
One small study, published in October 2020 in Frontiers in Psychology, found that some people with schizophrenia report feeling that they face internal obstacles to love relationships as a result of their condition, including a change in emotions and decreased trust toward others, as well as deficits in emotional, social, and cognitive skills, which some participants described as feeling like they were “losing a part of themselves.”
For some people whose partner was diagnosed after the relationship began, the onset of schizophrenia can come as a shock, according to BrightQuest Treatment Centers, a network of inpatient mental health treatment centers. The condition can change a person’s behavior and personality, and partners may not immediately know how to respond to these symptoms.
According to the aforementioned Frontiers in Psychology study, some people with schizophrenia felt that the onset of their condition put a particular strain on their relationships, including love relationships. For some, it marked a turning point in their relationship and challenged the identities they had before their diagnosis.
It’s common for partners to become caregivers for their loved ones with schizophrenia, and caring for a loved one who has schizophrenia can be especially challenging compared with other conditions. Caregivers of people with schizophrenia tend to report poorer mental or physical health than other caregivers, according to research published in August 2022 in Frontiers in Psychiatry.
Although schizophrenia can pose challenges to relationships, it doesn’t mean a relationship is doomed, especially if the individual and their family members get professional help, according to BrightQuest Treatment Centers. There are ways to help both partners feel like their needs are met and to maintain a strong relationship.
These seven tips can help if you or your partner is living with schizophrenia.
1. Help Your Partner With Schizophrenia Seek (and Stick to) Treatment
Your partner with schizophrenia may need help finding treatment, if they haven’t done so already. Getting professional help for your loved one is one of the best ways to support them and help them manage their symptoms, which in turn can help keep your relationship strong, according to BrightQuest Treatment Centers.
The most common and effective treatments for schizophrenia include antipsychotic medication, individual and family psychotherapy, family and social support, and education or work support.
It can be helpful to help your loved one set up a coordinated specialty care (CSC) team. CSCs are a team-based approach to treating schizophrenia. They can be very effective in helping people with the condition stick to their treatment in the long run, manage their symptoms, and live well.
Be sure to involve your loved one as much as possible in decisions related to their treatment, as this can help them stay engaged with treatment in the long run, states the National Institute of Mental Health.
2. Know That Partners Without Schizophrenia Need Support, Too
As mentioned earlier, it’s common for romantic partners to become a caregiver for their partner diagnosed with schizophrenia. In addition to caring for your partner’s health needs, it’s important to care for your own mental health, too.
Caregivers to people who have schizophrenia tend to experience relatively high levels of distress, sometimes known as “caregiver burden,” according to the aforementioned research published in Frontiers in Psychiatry. This study also found that caregivers who get support feel less burdened by caregiving and less likely to express negative emotions that can exacerbate their partners’ symptoms.
That’s why it’s important for caregivers to have access to mental health support, such as a counselor or therapist. Support groups for caregivers can also be helpful, as they allow you to meet and talk to people who understand what you’re going through, according to Mayo Clinic. Friends and family can also provide a listening ear or even just meet up for a walk or cup of coffee, per Mayo Clinic.
3. Work Together on Communication
Open and clear communication can help people who have schizophrenia find the support they need, as well as help both partners understand what’s expected from each of them in the relationship.
“Helping to maintain open lines of communication can help to prevent concerns from festering,” says Jacob Ballon, MD, a psychiatry professor and co-director of the Inspire Clinic at Stanford University in California, which treats people experiencing psychosis.
If your partner has schizophrenia, there are some key dos and don’ts for good communication with them, especially when it comes to helping manage their symptoms, according to Banyan Mental Health, a network of inpatient mental health treatment centers.
“It helps to create a dynamic where partners can express concerns about escalation of symptoms without making either partner feel like they are walking on eggshells,” adds Dr. Ballon.
Per Banyan Mental Health, be sure to:
- Avoid using medical terms to describe things your partner says or does, as this can come across as insensitive or dismissive of their feelings.
- Listen more than you speak when it comes to figuring out what they need, and don’t make big decisions without their input.
- Keep your voice calm, because using an aggressive tone can make your partner feel backed into a corner.
- Use simple and direct language, because someone experiencing an episode may have difficulty understanding more complex comments or recommendations.
Couples or family therapy are good ways to practice skills like these and can help both partners cope with the effects of schizophrenia on the relationship, per Mayo Clinic. A couples therapist can also help both partners learn how to resolve conflicts and navigate challenges related to schizophrenia.
4. Talk Openly With Your Partner About Sex
There are many reasons sex and intimacy can be difficult for some couples when one partner has schizophrenia. Although many people with schizophrenia remain interested in sex, some may find they have diminished interest in sex or experience sexual dysfunction as a result of taking antipsychotics to manage their condition, according to research.
Stigma and trust issues can also negatively impact sexual relationships for people with schizophrenia. One study published in 2019 in Psychiatric Services noted that nearly half of people with schizophrenia and other psychotic disorders desired intimacy but 70 percent of them found their symptoms made it hard to maintain intimate relationships.
Relationship counseling that includes frank and open conversations about intimacy and sexual interest and functioning can help both partners develop a sex life that works for them, this study also found. For people with schizophrenia in particular, this could help improve quality of life and medication adherence and lead to fewer relapses, per the study.
5. Set Clear Expectations About Each Partner’s Household Responsibilities
Dividing up household responsibilities can be stressful in any relationship, but when someone has schizophrenia — which can impact their motivation, their emotions, their organization, and their ability to pick up social cues — this can get even trickier.
It’s important to have open communication about responsibilities in the household, including how new or worsening symptoms may require some adjustment of responsibilities. Counseling can help caregivers learn how to set clear expectations in a supportive and positive way and to specifically define each partner’s responsibilities around the house, says Dr. Öngür.
In general, dividing up household responsibilities in a way that feels equitable to both partners can lead to stronger and more satisfying relationships, according to the Council on Contemporary Families.
6. Stay Connected With Extended Family or Other Support Systems
It’s also important to keep up relationships with extended family members if possible, even when the main focus is on caring for the person with schizophrenia, according to BrightQuest Treatment Centers.
When you’re caring for a partner with schizophrenia, maintaining those relationships is key to your own support system, as well as your loved one’s support system, because social withdrawal can be a common symptom among people with schizophrenia.
You may also find that relatives could express willingness to help support you and your loved one and pitch in with day-to-day caregiving tasks, such as driving your loved one to and from medical appointments or helping you with errands, per BrightQuest Treatment Centers.
Other forms of social support that could help include friends, support groups, or other community groups (such as religious groups), according to Mayo Clinic.
7. Consider Your Finances
Medications for schizophrenia can be expensive, and frequent copays can add up. Schizophrenia is one of the most costly of all mental health conditions, prior research shows. Let your doctors know about your financial situation as well, because some clinics charge on a sliding scale, according to the Substance Abuse and Mental Health Services Administration.
Although some people who have schizophrenia can work, not all are always able to work, even after their symptoms are stabilized, research shows.
If this is the case, applying for Social Security disability benefits can help. And know you’re not alone if this happens to you. In 2020, nearly 1 in 5 people receiving disability benefits in the United States received these payments due to depression, bipolar disorder, or a psychotic disorder like schizophrenia, according to a report from the White House published in May 2022.
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