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Schizophrenia and marriage: from a psychiatric and social perspective

Schizophrenia is a chronic and severe mental disorder characterized by changes in thinking, perception, emotions and behavior. A person with schizophrenia often suffers from a continuous pattern of delusions, hallucinations, disordered thinking and speech, decreased motivation, and impaired social and occupational functioning. This mental illness is serious, long-term and debilitating and can severely affect the lives of patients and their spouses and put a lot of pressure on the marital relationship.

In many traditional and family-oriented societies, the responsibility of caring for the patient is placed on the shoulders of the family, especially the spouse. Caring for a spouse with schizophrenia is a very difficult and tiring job, because it requires a lot of energy, time, and money, and it brings a lot of mental and physical stress. This pressure affects different aspects of life and causes social, emotional and financial problems for the family. Read more: symptoms of catatonic schizophrenia

Psychological and behavioral symptoms of schizophrenia directly affect intimacy and daily functioning in married life. Research shows that the pressure of symptoms such as delusions, hallucinations such as hearing voices, scattered thoughts, social withdrawal, not expressing feelings and emotions along with problems related to basic care such as personal hygiene has increased the divorce rate among people with schizophrenia. In general, the marriage rate for people with schizophrenia is lower than the rest of society. However, some people, especially women, have a better chance of starting and maintaining a romantic relationship because their disease may have a later onset or better social functioning. For this reason, it is necessary to raise awareness about schizophrenia and marriage so that social misconceptions are reduced and people with schizophrenia have a more stable and healthy relationship. The main challenges of living together with schizophrenia

In living together with a person with schizophrenia, the main challenge is on the shoulders of the healthy spouse, who often takes on the role of caregiver. Caring for a schizophrenic spouse is exhausting and challenging, and in addition to mental and physical pressure, it requires considerable energy, time, and money. The pressure of living with a schizophrenic spouse can cause numerous social, emotional, and financial problems. Spouses of people with schizophrenia are involved in a lot of stress and mental pressure. This mental pressure can reduce their quality of life and prepare the ground for anxiety and depression. In particular, women who have spouses with schizophrenia face more problems in various aspects such as physical, psychological, social and environmental. These problems have a direct negative effect on the marital relationship.

Scientific research shows that the spouses of people with schizophrenia usually endure heavy pressure, isolation and psychological stress and have a low quality of life. Spouses of schizophrenic patients have shown sexual, social and emotional adjustment, and their impaired marital relationships have had a negative effect on the physical and mental health of these people.

What is the result?

These challenges have caused the divorce and separation rates to be higher than usual in marriages where one spouse has schizophrenia. Schizophrenia symptoms create many barriers to maintain intimacy and cohabitation and limit relationship abilities. In addition, the fluctuations of the disease and its debilitating consequences can cause chaos in the usual process and routine of life.

People who resist schizophrenia treatment are more prone to auditory hallucinations, irregular thoughts, abnormal behavior and instability. Other symptoms such as indifference, social withdrawal, inattention and self-care problems, which are sometimes confused with depression, can also destroy the intimacy between the couple.

Decreasing cognitive abilities such as concentration, decision-making and memory problems affect the relationship. These conditions create additional pressure on the caregiver (healthy spouse) in terms of dividing family tasks and redefining joint life plans. In addition, some antipsychotic drugs cause lethargy, weight gain, and decreased emotional expression, which has a direct effect on marital relationships.

Management of schizophrenia symptoms in Home

The delusions and hallucinations of a person with schizophrenia are not seen in healthy people. For example, a person with schizophrenia, especially if they are on the extreme paranoia and pessimism spectrum, may think that someone is plotting against them and intending to hurt them. Also, a schizophrenic patient may have many sensory experiences that have no basis in reality, such as hearing voices talking to them. These symptoms can put a lot of strain on the marital life and the home environment.

Since the hallucinations and delusions seem very real to the person with schizophrenia, the best way to manage peace at home is to not discuss with the sufferer whether or not the delusions are real. Trying to convince the person that their imaginations are imaginary may make things worse. Don't forget that when the symptoms of schizophrenia recur, you are dealing with a disease and not with the sick person.

If the symptoms recur, talk to the sick person with respect and calmness. Don't confirm the content of the person's delusions and hallucinations, but don't argue with them either. What your patient needs is listening and attention without trying to solve the problem. If symptoms become severe, consulting a mental health professional can be of great help in managing the situation. In this regard, Dr.Doctor's online visit feature helps you access an experienced specialist at any place and time.

How to deal with the denial of schizophrenia by your spouse

One of the biggest challenges for a healthy spouse is that a spouse with schizophrenia often does not accept his illness or escapes from treatment. The thought of treatment may even fuel a person's paranoid beliefs and cause the patient to react against the therapist. Sometimes a person may think that he is better and no longer needs medicine due to a romantic and intimate relationship with his wife. Discontinuing medications can change a person's personality and behavior and increase the pressure on the relationship. Therefore, the most important principle in facing the denial of illness by a person with schizophrenia is to maintain patience and composure. The healthy spouse should be careful not to pressure or directly threaten the sick spouse to accept treatment. It is possible to explain the importance of treatment in improving the quality of life and reducing symptoms with a gentle and supportive approach.

Counseling sessions and couple therapy can help the patient and his wife to return to the feeling of security in the family environment and make it easier for the patient to accept the treatment. For a better follow-up of counseling sessions and couple therapy, a healthy wife can present the reasons for visiting a psychologist and psychiatrist as a general and treatable problem such as insomnia, not her husband's psychosis. Meanwhile, a healthy wife should not forget to take care of herself. A healthy spouse must have social support, self-care, and boundaries to maintain peace and balance so that he or she can withstand and manage the psychological pressure caused by the spouse's denial of schizophrenia.

Key recommendations for the spouse of a person with schizophrenia

If you are the spouse of a person with schizophrenia and you have assumed the role of caregiver, you should know that This responsibility can be challenging and sometimes overwhelming. Awareness of the illness, patience, effective communication skills, and self-care are the main pillars of supporting a spouse struggling with schizophrenia. In the following, we list some key suggestions and recommendations for spouses of people with schizophrenia:

• Have a structured care plan and encourage the patient to comply with treatment and take medication regularly.
• Monitor the acute symptoms of schizophrenia and prioritize the safety of yourself and your family.
• Use reminder tools such as a calendar or an application to take medications regularly. Discontinuing medication is one of the most common reasons for the relapse of schizophrenia.
• Record the patient's behaviors and mental states every day and present them to the doctor.
• If you encounter the person's hallucinations and delusions, do not try to convince him and maintain respect and positive communication.
• Do not confirm the person's hallucinations and delusions, but listen to his words and be by his side so that the atmosphere is calmer.
• For better self-care, use a support system if possible and become a member of support groups.
• Get help from proper nutrition, adequate rest, regular exercise, and meeting with family and friends to manage the mental pressure and stress caused by caregiving.
• Remember that your problem is schizophrenia, not the person himself. This issue can increase your flexibility and resilience.

To keep calm and manage the symptoms of psychosis at home, we suggest that you consider these points:

• If you are faced with acute episodes of psychosis with a sudden return of paranoia, confusion or aggression, limit visual and audio stimuli and keep the environment calm.
• If the patient If he intends to harm himself or others, call the patient's doctor, the police, or the social emergency number 123.
• Before a crisis occurs, have information such as the contact number of the treatment team and the destination of the psychiatric hospital ready.
• If you have a child at home, be sure to consider a safe place such as a trusted neighbor's house so that the children are protected from harm in the event of a serious crisis.

Is having children dangerous for couples with schizophrenia?

In general, yes. The decision to have a child for a couple with schizophrenia is complex, sensitive and risky and should be done with the full knowledge and responsibility of the parties. According to experts, having children creates important concerns such as security, stability and health of the whole family. The parenting ability of a schizophrenic person, along with the heavy burdens that this disease places on the family, makes it difficult for a healthy spouse to manage finances and household chores.

The next point is the possibility of harming the children in case of a recurrence of the disease. Possibilities such as verbal or emotional abuse, destruction of household property, or endangering the life of a healthy spouse and children should be considered. In addition to the direct effect of a schizophrenic parent on the child, there is a possibility of the child inheriting the disease. Also, if a woman with schizophrenia experiences pregnancy and childbirth, she may have severe fluctuations in her mental state. Therefore, one of the most important topics regarding schizophrenia and marriage is the discussion about sexual relations and possible methods of preventing pregnancy. However, some research shows that having children has a positive effect on the long-term maintenance of marriage. Having said that, if a couple decides to have a child for any reason, they should consciously and responsibly plan for it. Also, the couple needs to evaluate the genetic and psychological risks and consider strategies to prevent the recurrence of the disease during pregnancy. It goes without saying that the creation of a strong support system for mother and child care is a priority.

Doctor's final words

Living with a person with schizophrenia is challenging and complex and requires awareness, patience and preparation to manage symptoms. In a marriage with a person with schizophrenia, the healthy spouse may have a heavy burden and need support and care. If you or one of your loved ones lives with a person suffering from schizophrenia, it is enough to contact one of the professional and experienced specialists of the Dr.Doctor team through the online visit option so that you can benefit from the most accurate instructions for managing the symptoms of the disease and maintaining the mental health of yourself and your loved ones.

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