How To Calm Someone With Schizophrenia: Gentle Approaches for Difficult Moments

If your loved one has schizophrenia, your knowledge of their mental health condition and support for them is vital to their health, well-being, and quality of life. In fact, researchers have found that having supportive family members can boost brain activity, influence adherence to treatment plans, and improve social skills for people with schizophrenia.

The key is learning how to support them using a nonconfrontational approach, especially when they’re experiencing a challenging or difficult moment. A nonconfrontational approach not only helps improve their safety and yours but also honors their dignity as a person. Here’s how to be gentle and calming during trying times.

What Difficult Moments Can Look Like

When you care about someone who has a mental health condition like schizophrenia, it can be challenging to navigate the difficult moments. Aside from the primary symptoms of schizophrenia, like hallucinations, delusions, and disorganized speech, your loved one may also display agitation, fear, withdrawal, and paranoia.

Much of their fear, agitation, and paranoia comes from not being able to tell what’s real and what isn’t real. This can make it difficult for people with schizophrenia to trust whether someone’s intentions are good. They may also feel like people are trying to harm them in some way. When this happens, the fear and anxiety they experience can lead to social withdrawal or conflict with others, including you.

People with schizophrenia may also become overly agitated and experience anosognosia (also referred to as a lack of insight). Anosognosia can cause people with schizophrenia to be in denial about their condition. Other common symptoms include making strange movements that may not fit the social situation or refusing to respond to people altogether. These symptoms can be confusing and concerning, but providing your support can help your loved one manage their symptoms.

How Loved Ones Can Help De-Escalate Distress

If your loved one is experiencing a difficult moment, there are certain things you can say and do to help. Here are a few strategies to try.

Tailor Your Approach to Their Behavior

When you identify a sign that your loved one may be in distress, figure out what you can do to make them feel safe and supported in that moment. First, you can try implementing strategies that mirror their needs. In other words, if they’re avoiding eye contact, try not to get in their face, crowd them, or demand they look at you. Instead, give them space and speak to them calmly, without being judgmental or controlling.

What To Say — and What To Avoid

When talking to your loved one during a difficult moment, focus on treating them with respect, being patient, and empathizing with how they’re feeling. Resist the urge to criticize or argue. Even though you know their perception of reality is affected, their experiences feel very real to them.

You can try asking a direct question and waiting for a response. Allow them space to talk about what’s frightening them or making them feel agitated. If they open up about how they’re feeling, you can respond with validating statements like: “I understand why you might feel that way,” or “That sounds scary.” You should also avoid using sarcasm or making jokes.

You can also reassure them that you’re there to help. You might ask, “What can I do that would help you feel safe?” Be respectful of their boundaries, and don’t push them to communicate with you if they don’t want to.

Create a Calm Environment

Creating a calm home environment that feels predictable and safe can also help your loved one through difficult moments. If there are known triggers or noises that frustrate or agitate your loved one, try to limit or remove them. For instance, you can reduce background noise by turning off devices or encouraging them to use noise-cancelling headphones.

It can be helpful to have a private, dedicated space within the home where your loved one feels safe. Having a peaceful environment for them to go when they feel angry, agitated, or stressed can help calm their emotions. This environment also provides a space for self-soothing when you’re not at home to help them through a difficult time.

To create a calm environment, it may be helpful to:

• Choose an area with comfortable seating or a space that has pillows and blankets
• Turn on music that they find comforting
• Encourage coping skills like counting objects, reading aloud, or humming
• Suggest relaxation techniques that don’t involve imagery, such as breathing exercises or stretching

When suggesting these ideas, respect their autonomy by asking permission first, such as saying: “I have an idea — do you mind if I share it?”

Supporting Someone Who Is Hearing Voices or Feeling Paranoid

If your loved one is hearing voices or feeling paranoid, focus on being calm, talking in simple sentences, and practicing patience. This will help you navigate the situation — and provide your loved one with the reassurance they need.

Remain Calm and Patient

While it might feel frightening or even frustrating if you’re unsure what your loved one’s experiencing, it’s key to be patient with them. Saying their name and asking about what they’re feeling can provide comfort and support. Speak slowly and gently, keeping your voice neutral.

Validate Experiences Without Affirming False Beliefs

Accept that your loved one’s experience is very real to them, even if it doesn’t make sense to you. Try not to be judgmental, critical, or argumentative. This doesn’t mean you have to agree with their false beliefs. Instead, be curious about what they’re going through. Ask them questions and let them know you’re there to support them.

Be Present

Let your loved one know they’re not alone and that you love and support them, even during this trying time. It’s easy for people with schizophrenia to feel alone or isolated, especially when hearing voices or experiencing paranoia. Even if they’re unable to acknowledge your support, it’s helpful to hear that you still care about them.

You may feel the urge to want to fix your loved one’s situation, but that may not be helpful or possible at the moment. Instead, focus on being supportive, acknowledging how they feel, and offering assistance. You can ask them: “What would help you most right now?” You can also try redirecting them toward activities they find soothing. The key is to work toward de-escalating the situation.

When To Get Immediate Help

If your loved one’s difficult moment turns into an emergency situation or severe psychosis, call 911. Your loved one may be experiencing severe psychosis, if they’re:

• Being aggressive
• Showing severe agitation
• Threatening harm to themselves or others
• Exhibiting extreme paranoia

Once the 911 operator is on the line, let them know that your loved one is experiencing a mental health crisis and that they need medical attention. Stress that you’re not looking for an arrest and that you plan to meet emergency personnel outside when they arrive. You can provide details about the situation and effective ways to calm your loved one down.

Don’t let embarrassment keep you from reaching out, especially if this is their first episode of psychosis. According to mental health experts, treatment following the first episode of psychosis can reduce a chance of recurrence or future episodes by up to 50 percent.

Also, remember that your loved one may be at an increased risk for suicide. In fact, people with schizophrenia attempt suicide more frequently than any other group of people. You or your loved one can call or text 988 or chat online at 988lifeline.org with a crisis counselor any time.

Caring for Yourself While Supporting Someone Else

Being a caregiver for someone with schizophrenia can be physically and emotionally draining, leaving you feeling burned out, angry, and frustrated. That’s why it’s so important to make self-care a priority. This means keeping appointments with your healthcare providers, seeing a mental health professional when needed, and taking time for yourself every day.

It may also be helpful to get plenty of physical activity, eat a nutritious diet, and prioritize your sleep. Consider joining a support group with people who understand what you’re going through. In a support group, you can share your feelings and challenges and gain insight from others on how they navigate life caring for a family member with a mental health condition.

Join the Conversation

On MySchizophreniaTeam, people share their experiences with schizophrenia, get advice, and find support from others who understand.

If you have a loved one with schizophrenia, what have you done to help them through difficult moments? Let others know in the comments below.