A common cause of relapse in schizophrenia is “difficulty managing high levels of stress,” according to Susan Gingerich, MSW, a psychotherapist who works with individuals with schizophrenia and their families.
Learning to manage stress isn’t just important for preventing relapse; it’s also important because stress is an inevitable part of facing new challenges and working to accomplish personal goals — “what recovery is all about,” write Gingerich and clinical psychologist Kim T. Mueser, Ph.D, in their book The Complete Family Guide to Schizophrenia.
Learning to navigate stress healthfully is key for family and friends, too. Having a loved one with schizophrenia can be stressful. Taking care of yourself enhances your well-being and daily functioning. And it means you’re in a better, healthier place to help your loved one.
In their comprehensive book, Mueser and Gingerich share excellent tips for helping your loved one and yourself cope with stress (along with valuable information on schizophrenia and how you can support your loved one).
Here are those suggestions and insights on managing and alleviating stress.
Recognizing Stress Signs
What one person finds enjoyable, another can find stressful. In the same way, how people respond to stress will differ. For instance, one person might exhibit changes in mood, such as becoming depressed and anxious, while another person will show physical signs, such as experiencing headaches and a heightened heart rate.
So it’s important to talk to your loved about their individual signs of stress. Talk about your personal signs, as well. Create separate lists for each of your reactions to stress.
Reducing Sources of Stress
The authors suggest thinking about what situations were stressful for your loved one in the past. Then try to avoid that situation or modify it. If your loved one had a tough time at Thanksgiving last year, it might help to shorten their stay or not go next year.
It’s also helpful to support your loved one in creating a stimulating environment with reasonable expectations. For instance, rather than attend a day program three times a week, one man preferred volunteering twice a week delivering meals to housebound seniors.
Plus, it’s important that you take care of yourself. Eat nutrient-rich foods, get enough sleep, participate in physical activities and engage in fun hobbies. Help your loved one identify what kinds of activities they’d like to do, too.
As the authors point out, because of the negative symptoms of schizophrenia, individuals can have a hard time thinking of enjoyable activities. Talk with them about the activities they’ve enjoyed in the past.
Be sure to give yourself and your loved one credit. (Being self-critical just spikes your stress.)
Mueser and Gingerich note how one father acknowledges the positive things that happen on a daily basis: “I’m proud of how persistent my daughter has been in pursuing her art career in spite of the many difficulties she’s encountered. We both have a lot to learn about coping with this illness, but we’ve also come a long way.”
Learning to Cope with Stress
Emphasize the importance of your loved one communicating with others when they’re feeling stressed, since “these feelings can be an early warning sign of relapse,” according to the authors. Make sure you, too, are able to turn to individuals who understand your situation.
Have family meetings to talk openly about the stressor and brainstorm potential solutions. Learn to use relaxation techniques, such as deep breathing, progressive muscle relaxation and visualization (such as imagining a serene beach scene).
Self-defeating thoughts only bolster stress for both of you. Try to practice positive self-talk and teach your loved one to do the same.
Mueser and Gingerich share the example of a father helping his daughter reframe her hospitalization, which made her feel like a failure: “I’m sorry you had to go through that, but I’m proud of you for getting help when you needed it and for being so strong in dealing with this illness. You’re a survivor.”
Don’t underestimate the power of humor. Try to find the lighter side of a stressful situation, according to the authors. It’s not always – or usually – easy, but it helps with stress. Plus, you and your loved one can enjoy a funny film or sitcom to lessen stress.
For some people, religious services and prayer can be very helpful. For others being in nature may feel like a spiritual experience and shrink stress.
Again, regular exercise — around three times a week — that you enjoy is important for both of you. Journaling can provide a great source of stress relief. “Many people with schizophrenia say that writing down what they experience, think, and feel is an important outlet.”
See if your loved one is interested in listening to music or making music themselves, such as singing or taking lessons; visiting art exhibits or creating their own art; playing games with family and friends; and pursuing other hobbies.
As the authors emphasize, people with schizophrenia are “more sensitive to the effects of stress because it can trigger symptom relapses and rehospitalizations.” Helping your loved one deal with stress in a healthy way helps them pursue their personal goals and improves their life.
Plus, working together to develop healthy coping strategies can strengthen your relationship and gives you plenty of opportunities for savoring quality time.