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Schizophrenia and the Family: Getting the Diagnosis

What you need to know about the early stages of schizophrenia.

Key points

  • Hallucinations and delusions are not the first signs of schizophrenia.
  • Schizophrenia can have a profound effect on families. Educating oneself about the disorder can help mitigate misunderstandings.
  • Learning more effective ways to communicate with a loved one with schizophrenia can help decrease frustration and anger.
Irina Polonina/Shutterstock
Source: Irina Polonina/Shutterstock

Your adolescent has been acting differently lately and you are concerned. You have noticed that he has not been sleeping well and his appetite is poor. He has been more isolative and seems to have lost interest in the things he used to enjoy. At first, you might be concerned that he is depressed or think this is just how adolescents are. So you decide to just ride it out until he gets older and then things will go back to normal. You also begin to notice that his hygiene is not as good as it used to be. He used to shower every day and now you have to remind him to bathe. He is also having difficulty concentrating and thinking clearly. His grades have gone down. Perhaps you might think he may be experimenting with drugs or that he has an attention deficit disorder. You think maybe he should have some type of evaluation but really are at a loss as to what to do.

Years may go by before he begins to talk about seeing and hearing things that no one else can. He may believe that people are out to hurt him and become suspicious of everyone's motives. While you still may not know the nature of his problem, you know that he needs to be seen by a doctor for an evaluation. Sometimes you might need to see multiple providers before you receive an accurate diagnosis. The process is not an easy one. Finally, an evaluation with a psychiatrist indicates that your son is schizophrenic. All the symptoms he has been experiencing are considered to be a part of the prodromal or early stage of the disease that can sometimes take years to progress into full psychosis.[1]

Schizophrenia's impact on families

Like most people, you probably do not know much about schizophrenia. While you know your child has struggles ahead, you find yourself trying to handle a serious mental disorder that you know nothing about. Research[2] and experience have shown that when a child is diagnosed with schizophrenia, the entire family is impacted.

Having the diagnosis is really just the beginning. What tends to follow is a roller coaster of emotions for the family trying to understand what all this means. Accepting the diagnosis is difficult for everyone involved. Denial can linger and cause problems in effectively managing the disorder and preserving family relationships. It is not unusual for parents to feel confusion, overwhelm, guilt, anger, shame, disbelief, and grief. Everyone must adapt to the new situation and their shifting roles. The situation for all involved can be stressful, frustrating, as well as traumatic.

A big question for parents is, “How did this happen to my child?” Schizophrenia is a combination of brain chemistry, environmental factors, and genetics. Indeed, one of the best indicators that the diagnosis may be schizophrenia is in the family history.[3] The family member may not have had a formal diagnosis of schizophrenia but exhibited some of the same behaviors as your child and was said to be “strange” or “weird.”

Schizophrenia education for families

Once the diagnosis is made and confirmed, one of the most important things you can do initially is to begin to educate yourself about what schizophrenia is, how it is treated, and what to expect. You are likely to have many questions that you should share when you accompany your loved one to the doctor. The more you understand what you are dealing with, the better you will be able to take care of your loved one as well as yourself.

Often, the patients and families say that they are not given enough information about the diagnosis and available resources. If this were to happen, contact your local National Alliance on Mental Illness (NAMI) chapter to begin the process of educating yourself. In addition to providing general information about mental illness, they will be able to address your specific concerns about schizophrenia. Support groups and classes are also available.

How to talk to someone who has schizophrenia

Often, by the time a diagnosis is given, your relationship and communication with your child have become difficult and even adversarial at times. Torrey[3] suggests some of the basics to remember when talking with someone who has schizophrenia. Below are four of them:

  1. Trying to talk him out of his delusions and hallucinations is futile. You will be unsuccessful and create anger and frustration by trying to “reason” with him.
  2. Conversations should be brief and to the point. Try not to overload him with multiple requests and information.
  3. Try not to be alarmed if he spends a good deal of time alone in his room. This is often a coping mechanism to keep him from becoming overstimulated. He needs his solitude.
  4. Torrey states that the best way to manage a schizophrenic at home is to stay calm (which at times can seem impossible) and provide structure to his day, i.e. set times to wake, go to sleep, and have meals.

If you can incorporate these four suggestions in your day-to-day interactions with your loved one, communication and life in general will be easier and more productive.


1) Manju George, Schreemit Maheshwari, Suhas Chandran, J. Shivananda and T.S. Sathyanarayana Rao. (2017) Understanding the schizophrenia prodrome. Indian Journal of Psychiatry, 59(4):505-509.

2) Caqueo-Uryar, Alejandra (2017). Schizophrenia: Impact on family dynamics. Current Psychiatry Reports 19,2.

3) Torrey, E. Fuller (2019) Surviving Schizophrenia, Seventh Edition. A Family Manual First Harper Perennial Edition.

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