Advice to family and friends

What is the best way to help a friend or relative?

1. Try to understand the person and his/her disease

Patients with sensitive paranoia sometimes seriously disturb their family and friends. Their rapid changes of opinion, their inconsistencies, their continuously repeated ruminations, their aggressiveness can make them unbearable for the people around them, who sometimes do not realise that these features are the symptoms of a disease.

When faced with this type of situation, you must gradually realise that all of these disorders are not your friend’s or relative’s fault, but are due to his/her disease, as he/she is unable to control these changes: irritability, periods of depression at night, sometimes with improvement in the afternoon and evening, mood swings, etc.

2. Obtain more information

You can only help this person and protect yourself with a good knowledge of these disorders. Try to find reliable and practical information. Our references page recommends a number of books. Internet can help you to find many information sources and we are here to answer your questions.

This new vision of the situation will allow you to take a more objective view, making your relationship more beneficial.

3. Participate in treatment without being authoritarian

We have seen that adequate drug treatment is generally effective on sensitive paranoia, but it must be prescribed very carefully and often requires many trials that can last many months before achieving the most appropriate treatment.

Your knowledge of your friend or relative prior to emergence of the disorders, the quality of your relationship, your closeness which allows you to know his/her feelings and reactions constitute valuable information that you can share with the nursing team. You should therefore cooperate with healthcare professionals and respect their working methods.

Patients with sensitive paranoia are often distrustful and often refuse to acknowledge that they are mentally ill. Consequently, they frequently do not tell the truth to the doctors looking after them. It is often very useful to correct the information provided by your friend or relative.

For example, you can provide information on:

– the real and regular use of medications

– the short-term and medium-term effects produced by a new treatment

– warning signs of a new delusional episode

– the suicidal thoughts expressed by the patient, etc.

If your friend or relative does not take treatment regularly, you are one of the best people to convince him/her to do so. Several rules should be followed to ensure the best chances of success :

  • Choose an appropriate time and place to talk about the problem

    Choose a time when both you and your friend or relative are available and able to listen to each other. A particularly favourable time to talk about the problem of medication is immediately following resolution of a delusional episode, as the patient clearly remembers what he/she has just experienced and the fact that medication was able to restore his/her former self.

  • Talk on a one-to-one basis with mutual respect

  • Recognize the other person’s experience

    You and your friend or relative each have your own experiences:, you perceive things differently and you must identify your differences.

  • Avoid judgements and reproaches

    Talk by using “I” and not “You”. “I” does not accuse anybody and allows you to share what you feel or think. Expressions such as “I believe that…” or “I feel” do not engage the other person’s feelings.

These general rules should be used as often as possible.

Do not make the patient feel guilty, but encourage him/her

The approach to a patient with sensitive paranoia requires great care: excessive solicitude can hurt the person’s self-esteem. You need to be present without being a burden. However, you must help the patient to accept his/her disease, by choosing a time at which the patient requests your help and is therefore more receptive.

Remain confident

Even after several years without any progress, it is still possible to find a treatment that can allow stabilization. Do not lose hope and do not hesitate to change doctors if, after a long period, no improvement has been made.