Family and Caregiver Schizophrenia Discussion Forum

What is the correct thing to say to about the voices they hear?

What do tell when they tell you about the voices. How they are telling them there are people
That are gonna kill them. Do you go along with it. Or tell them it’s not real ?
My roommate has adhd bipolar just last month out of the blue he started hearing voices. He thinks there’s sometype of implant in him that the voices can track him. We had to take him to the ER for an x Ray to prove there was no tracking device inside him. He is on Invega for about 2 weeks now. Not seeing a big change yet. Are there better drugs put there. ?

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Welcome @Patricktyler good questions! There are a couple of different types of Invega, there is a monthly injection I think and there are the pills. Most meds take 2 to 4 weeks to see any results give or take. Improvements are often gradual. The meds have to be taken as prescribed and they have to be at a therapeutic level. Some medicines take a month to even get to a therapeutic level because you have to increase the dosages very slowly for safety. For those meds it could be 6-8 weeks before results are seen. Many patients have to try more than one medication before they find the right one.

There is a thread on this website where we discussed how to talk to someone with delusions: Here is a contribution that I made on the topic, you might find it helpful. (see pdf link below)

Usually it is advised to not argue or reason with the person having the delusions. Better to empathize (even though you know they are wrong). Like with your room mate believing he “had an implant”. Saying something like, “that sounds very upsetting” “I wouldn’t like that” I understand that could be concerning" (<—I’m just making these up but you get my drift) anyway this article I found explains better.

Also in response to your last question: Yes there are many different drugs and depending on the patient, some better, some worse. Every patient is different. He needs a dedicated psychiatrist that will work closely with him to get him stabilized on the right medication and that takes time. Reducing stress also helps.

Does your room mate have family support??

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@Patricktyler, to add to @Catherine excellent response from a diagnosed perspective, here’s a few more things to think about:

There is no “correct thing to say”, just some responses that are better than others. Realize that what they hear is important or concerning to them, and they are taking a risk telling you about it. I’d advise keeping it in confidence, lest they distrust you should they learn you divulged the information without consent. Realize if you discount or dismiss what they say they may start to withdraw or stop talking about their concerns, but if you feel uncomfortable or exhausted when about talking about certain subjects at length, I think it’s okay to say so, and ask them if they can find someone else to talk to without suggesting therapy directly. In general open-ended, vague, feeling acknowledging and “brainstormy” discussion is better.

Intuitively they may get a sense when it is and isn’t safe to talk about such things, but if they don’t learn this coping skill events can escalate badly. For example my brother said the wrong thing to police, and it ended badly for him and my family. If you get a chance, rent or stream the 2008 film version of Horton Hears a Who (it’s “free” on Hulu if you have it) which demonstrates how things can escalate when voices or delusions (even if based in fact) are revealed without circumspection. Seth Rohan’s character Morton models a good friend to someone apparently hallucinating and delusional even if Horton doesn’t always follow his advice.

Another thing I’ll mention comes out of Dr. Amador’s work. When you get things “wrong” or upset your friend somehow or lose his trust, it’s okay to apologize. I’m adding a TEDx video of him which includes an illustration of these sorts of methods. I probably overuse it, but I think it does a good job of modeling the frame of mind of the delusional or hallucinating person, and some enhanced ways of communicating with them. A demonstration of anasognosia (lack of insight) starts at 8:44

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Thank you thank you so much for all this advice !!!

Thank you so much. He basically has me and his mom for support. But it’s so draining at times

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It can be very draining for sure. There is another good resource you can check out if you want to if they have a group in your town. They offer resources and free classes to educate you more on the illnesses and often you can find other people there going through the same thing you are. I took the Family to Family class and I learned so much and made some life long friends as well. Invaluable.

I also would advise that if you are in it for the long haul to support your friend and stay in his corner through the thick and thin of it , it’s not a bad idea to look into counseling or talk therapy for yourself. I say that because I have taken care and supported my younger son since his diagnoses at the age of 21 with schizophrenia and we still live together and he is 36 (and doing much better) -and not only did I find personal counseling for myself really helpful when trying to figure out my next move with my son but also I discovered the more calm and stable and grounded I approached him the better our interactions were.

Your friend is very lucky to have you and I’m glad to hear he has his mom too. Sounds like a good team. Here is the NAMI link. https://nami.org/Support-Education/NAMI-Programs/NAMI-Family-Friends

@Patricktyler, you stated “just last month out of the blue he started hearing voices”. Since your roommate is “new” to hearing voices, this is the best time to try to support him in any way so he stays on medication and hopefully tells his doctor about the voices. Often a person with bipolar or schizophrenia won’t admit their voices to anyone.

As @Maggotbrane said, “Realize that what they hear is important or concerning to them, and they are taking a risk telling you about it.”

Oftentimes the voices are their friends, or special beings that watch over them, or give them special powers, or they could be very negative, causing much stress… My adult daughter talked to her voices for almost 3 years before I could get her forced onto medication which stopped the voices (hallucinations) and strange beliefs (delusions). The unmedicated years or wrongly medicated years were full of her staying up all night screaming at (to) her voices until she could hardly speak, and even then she still tried to scream at them or with them when almost completely hoarse. Those people were REAL to her, and when the medication stopped the voices, she just thought her special beings had left the city.

It is very hard on you to have to deal with psychosis, but your roommate probably needs your support. It is great that you came to this site, read and comment and educate yourself. Knowledge gives power to help battle the psychosis.

The best thing to do is never to scold them, or belittle them, or put them down for their hallucinations or delusions. If you read that book “I’m not Sick, I don’t Need Help”, and put bits and pieces into use to help you cope with your roommate’s voices and odd beliefs, it can bring improvements.