A very close friends of mine has just been released from a psychiatric ward. As of two days now I am his full time care giver and feel, in all honesty, over my head. He’s very passive and displays little interest in anything. I know I need to push him out of his comfort zone and slowly rejoin society, but I don’t want to do it in such a way that he feels unsafe with. He is quite heavily medicated at the moment, which I know does have an effect on these feelings if complacency. The question I have is, does anyone have similar experiences? What is the best approach to the readjustment process, without causing feelings of anxiety ? I assume its the sort if thing that varies from person to person, but any and all general suggestions would be greatly appreciated.
Hi, first of all thank you for taking care of your friend, that’s wonderful of you.
Second, I think you need to give him time to heal. When I first got out of the hospital took me one year to get my life back on track and it’s still a challenge sometimes to do stuff and to get out “of my comfort zone”.
Psychosis and hospitalizations can be traumatic events, and we need to adjust to medication and to the fact that we’re mentally ill.
When I first got out of the hospital my mom and psychiatrists immediately wanted for me to do something and “rejoin society” but I wasn’t able to, led me to a bunch of bad decisions that I’m now trying to solve that weren’t good to my mental health.
Psychosis also kind of shatters confidence, we become affraid of being crazy, and that takes time to heal also.
My advice is give him time, let him rest and then slowly help him regain his confidence and abilities.
But maybe other people have other advices.
Also, @geeknoid just posted this on another thread, it’s very good for stepping into recovery: https://www.reddit.com/r/getdisciplined/comments/40ccgs/advice_a_nine_step_plan_for_recovery_from_mental/
Also, give him this forum, it can also help him with his worries about the illness.
Not to steal @notmoses thunder but these are very good books:
Caregivers need to be very observant and watchful, as well as communicating with the patient, to see, hear and feel how ready the patient is for “prodding.” Too much too soon can be very counterproductive.
@Minnii is right about those books. I would definitely get and read them.
Also, here’s a rundown of “best practice” items you can look into right now to greatly increase your skills base:
- Get properly diagnosed by a board-certified psychopharmacologist who specializes in the psychotic disorders. One can find them at…
- Work with that “psychiatrist” (or “p-doc”) to develop a medication formula that stabilizes their symptoms sufficiently so that they can tackle the psychotherapy that will disentangle their thinking.
- The best of the psychotherapies for that currently include…
DBT – http://behavioraltech.org/resources/whatisdbt.cfm
MBSR – http://www.mindfullivingprograms.com/whatMBSR.php
MBCT - http://www.ncbi.nlm.nih.gov/pubmed/22340145
ACT – https://contextualscience.org/act
10 StEP – http://pairadocks.blogspot.com/2015/04/the-10-steps-of-emotion-processing.html
- the even newer somatic psychotherapies like…
MBBT – https://www.newharbinger.com/blog/introduction-mind-body-bridging-i-system
SEPT – https://en.wikipedia.org/wiki/Somatic_Experiencing
SMPT – https://en.wikipedia.org/wiki/Sensorimotor_psychotherapy
- or standard CBTs, like…
REBT – https://en.wikipedia.org/wiki/Rational_emotive_behavior_therapy
Schematherapy – https://en.wikipedia.org/wiki/Schema_Therapy
Learned Optimism – https://en.wikipedia.org/wiki/Learned_optimism
Standard CBT – https://www.nami.org/Learn-More/Treatment/Psychotherapy & scroll down
- If you/she/he needs a professional intervention to get through treatment resistance, tell me where you live, and I will get back to you with leads to those services.
- Look into the RAISE Project at https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=raise%20program%20schizophrenia.
- Look for mental illness clubhouses in your area (which can be hugely helpful… but may also pose risks). Dig through the many articles at https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=mental%20illness%20clubhouse%20model to locate and investigate them.
It’s great you are helping your friend. If he had a psychotic break, it can take a year or two to stabilize and begin recovery.
There is no need to push. Rejoining society can mean taking a walk in a neighborhood, going out for coffee, grocery store shopping, any healthy activity you both enjoy. When he seems up for it (however long this takes), start inviting him to do things, maybe one activity a couple times a week at first. If he says no, okay.
As far as rebuilding activities of daily living like meeting basic needs and hygiene, hopefully he is working with a doctor and counselor to do this at a pace that is healthy for him.
Remember to take care of yourself. Err on the side of kindness to yourself and your friend; it seems preferable to be in a comforting place while healing.
Also, since you feel you are in over your head, maybe you can help him find somewhere suitable to stay and visit him or take him places a few times a week once he is ready.
You just have to give him time and it can be slow. Gradually and with proper meds, he’ll be able to do more by don’t rush recovery. It is up to them and they have to learn how to cope and adjust. It truly is a hero’s journey. As hard as it is for the caregiver, it is equally hard for them. We don’t always see this but think of how they avoid people just because they might not trust their mind or actions. It’s easier to just retreat. Search LEAP on this site for a wonderful video from Dr. Armador on negative symptoms.