During a psychotic episode or in the phase preceding such an episode, people have a different perception of their surroundings or show changes in their behavior that their family and friends cannot always comprehend. This can lead to feelings of uncertainty and helplessness or to conflicts, such that a psychotic episode constitutes a challenge not only for the patient, but also for family members, partners and friends.
- Stay in contact: Try to spend time with your loved one and motivate them to undertake enjoyable activities with you. Show them that they are important to you.
- Listen and empathise: Wenn a close friend or family member is suffering, one wants to come up with answers or solutions as quickly as possible. Although this is completely understandable, the affected person may have the impression of not being heard. Try to connect with the experience of your loved one on an emotional level by empathising with their experiences.
- Stay calm: When talking to an affected person, try not to take things personally and to keep feelings of frustration, fear and anger under control. This makes it more likely for the affected person to stay in contact with you.
- Set rules and limits: Clear, transparent and consistent rule-setting can promote feelings of security and self-responsibility of your loved one during crises. Ideally, try to involve the affected person when working out rules and limits.
- Motivate to a healthy life style: Motivate your loved one to eat healthy, sleep regularly, do sports and enjoyable activities, and abstain from alcohol and drugs. Instead of imposing a healthy life style onto them, try to set an example by your own behavior and possibly work out a list of ‘good intentions’ and a plan to achieve them together with your loved one.
- Don’t lose hope: It can take a while to stabilise a psychotic episode and deal with its consequences. Setbacks and small crises are to be expected on the path to recovery. Be patient and do not give up; in most cases, recovery is less like a sprint and more like a marathon.
- Take care of yourself: Do not neglect your own life. Try to eat healthy, get enough sleep, meet friends and keep pursuing your own interests and goals.
- Nobody is perfect: You cannot and will not do everything right. It is often in retrospect that we recognise that a certain reaction was not the best possible one. Try to learn from conflicts and setbacks instead of blaming yourself.
A psychotic phase may have an impact not only on the affected person, but also for their family and friends. Feelings of frustration and helplessness are normal, but you do not have to go through them alone. Talk to friends or seek help if the situation is too much for you. Your GP or early detection centers like BEATS in Basel can inform you about support options for relatives and friends.
It is possible to admit a mentally ill person to the hospital to be treated against their will. However, this infringes on their personal rights. Therefore, there are specific criteria for initiating such a procedure, which are strictly regulated by law:
- The person is a threat to him- or herself (e.g., suicidality, severe self-neglect) or to other people (e.g. in the case of violent behavior)
- Less restrictive measures such as outpatient treatment have been exhaustively tried
In case of emergency in Basel, you can contact emergency services and ask for an emergency psychiatric assessment at home. When there is imminent risk of self-harm or violence, you can also call the police. If a mental illness is suspected to be the cause of the crisis, the emergency services or the police will initiate further measures including an assessment for involuntary hospital admission.
However, the above strict criteria for involuntary admission are often not met in young people at the early stages of a psychotic disorders. If your loved one refuses a psychiatric evaluation, you can try the following:
- Propose an appointment with their GP, or arrange a home visit by the emergency psychiatric service
- If the person is neglecting their obligations (and thus risks, for example, being fired from work) or cannot take care of themselves adequately, you can contact the local child- and adult protection services (Kinder- und Erwachsenenschutzbehörde, KESB) and inquire about support possibilities.