Tips On How To Talk To Someone With Schizophrenia

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated October 16, 2024by BetterHelp Editorial Team

Beyond affecting thoughts and behaviors, schizophrenia can also cause communication challenges. People with schizophrenia may struggle to express themselves clearly and appropriately. Other symptoms, like delusions, may also make their friends and loved ones have difficulties interacting with them. Practicing empathy, active listening, and patience when speaking to people with schizophrenia may be helpful. For further guidance in improving your communication skills, consider scheduling a session with a licensed therapist.

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What is schizophrenia?

Schizophrenia is a serious mental health condition that can cause people to lose track of reality. This is usually known as “psychosis.” When people with schizophrenia go through periods of psychosis (sometimes called “psychotic episodes”), they may experience problems in relationships and daily life. 

Schizophrenia symptoms can fall into three categories: positive, negative, and cognitive. Positive symptoms can be defined as thoughts and behaviors that are added to a person’s experience, such as the following:

  • Delusions (false beliefs that can’t be changed with facts or logic)
  • Hallucinations (seeing, hearing, tasting, smelling, or feeling stimuli that aren’t there)
  • Scattered, illogical, or unusual thoughts
  • Unusual stillness, repetitive actions, or other changes in movement 

Negative symptoms of schizophrenia are usually considered to be thoughts and behaviors that are taken away from a person’s experience, such as those listed below:

  • Loss of motivation to do tasks (like bathing or going to work)
  • Loss of the ability to experience pleasure
  • Loss of the ability to show emotion
  • Loss of interest in other people (also known as “social withdrawal” or “asociality”)

Cognitive symptoms of schizophrenia are generally changes in a person’s thinking. Researchers estimate that up to 98% of people with schizophrenia have trouble with the following mental abilities:

  • Thinking abstractly
  • Solving problems
  • Remembering information
  • Processing new information
  • Paying attention
  • Making plans

Schizophrenia often starts during young adulthood. Some people with schizophrenia may experience more subtle changes in their thoughts and behavior before their first psychotic episode. These may include self-isolation, unusual thoughts, and changes in mood. 

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How does schizophrenia affect communication? 

Another common symptom of schizophrenia is something called “disorganized speech.” This generally refers to changes in the ways people speak that reflect changes in the ways they think. 

Disorganized speech can look different depending on the person. That said, people with schizophrenia may commonly:

  • Express illogical thought processes (such as jumping between unrelated ideas)
  • Have trouble following conversations
  • Experience varying patterns of speech (such as changing the order of their words or making up new words)
  • Struggle to stay on topic
  • Echo the words and actions of other people
  • Stop responding to questions or respond with single-word answers
  • Speak in a way that’s hard for other people to understand

These sorts of behaviors can make it harder for people with schizophrenia to understand and communicate with others. 

How to talk to someone with schizophrenia

Communicating with someone who has schizophrenia can sometimes be challenging due to symptoms like disorganized thoughts and speech. However, various strategies may make it easier. The next time you’re talking to someone with schizophrenia, consider the following tips. 

Understand that you may not be able to change their beliefs

When someone with schizophrenia is experiencing a delusion, it’s usually not possible to “talk them out of it.” This may be true even if you have proof that the delusion is false. Pressing the issue may lead to distress—for both that person and you. 

Practice empathy

Being empathetic may enhance communication and improve relationships. Look for ways to see the situation from the affected person’s perspective, even if you recognize that what they’re believing or experiencing isn’t real. Do your best to validate their feelings with phrases like “I can understand why this must be upsetting,” or “I get that this must be tough. I’m here to support you.”

Practice active listening

Delusions and mood changes can sometimes cause people to have a guarded and closed attitude. However, you may still be able to gain insight into what they’re thinking and feeling by practicing active listening. Rather than just waiting for your turn to speak, try to actively pay attention to what they’re saying, ask questions, and observe their body language when possible. 

Be patient

People with schizophrenia often have difficulty paying attention. As we’ve discussed, they may also have trouble staying on topic or finding the right words to express themselves. Try to avoid making them feel rushed and give them time to think when needed.

Be mindful of the words you use

Avoid using words like “crazy” or “insane” to describe people with schizophrenia. These terms can add to the stigma that surrounds the disorder. Mental illness stigma may discourage people from seeking help and make it harder to recover

Recognize safety concerns

When talking to someone with schizophrenia, you may want to keep an eye out for psychotic symptoms and seek help if needed. In addition to delusions and hallucinations, signs of psychosis may also include inappropriate emotions, trouble thinking clearly, and a sudden decline in self-care

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Managing communication challenges with schizophrenia

Schizophrenia can create challenges for those living with the disorder and their loved ones. However, the condition can often be treated. If you or someone you know has recently been diagnosed with schizophrenia, consider talking to a mental health specialist. Various treatments may help people with schizophrenia improve their symptoms and daily functioning. 

Antipsychotic medications are often a first-line treatment for schizophrenia. These medications may reduce positive symptoms, including challenges with speech and communication. They must be prescribed by a psychiatrist or doctor, and you should always consult a licensed medical professional before starting, stopping, or changing the way you take medication.

Alongside medication, therapy is often a cornerstone of schizophrenia treatment. Working with a therapist may be a way to learn healthy coping skills and improve relationships with friends and family members. Some types of therapy focus specifically on improving communication. For example, social skills training may help people with schizophrenia hold conversations, make friends, and manage daily interactions

Having a therapist you trust may make it easier to stick to therapy if you’re living with schizophrenia. However, finding a counselor with whom you feel comfortable can sometimes take a few tries. Online therapy may make it easier to find the right fit by letting you change therapists at any time for no additional charge. 

Research has found that online treatments may be helpful for people with schizophrenia. In 2016, researchers used a telehealth monitoring program to support a group of 20 veterans living with schizophrenia. After three months, the majority of patients reported positive experiences and reduced thoughts of suicide. Please note that in-person care may be necessary for crisis situations and psychotic episodes.

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

Takeaway

Schizophrenia can cause symptoms like delusions and hallucinations. The condition can also affect the ways people communicate. People with schizophrenia may have trouble paying attention, finding the right words, and expressing their ideas clearly. Talking to someone with schizophrenia may be easier if you actively listen and exercise patience. Being mindful of your language, avoiding trying to change their beliefs, and seeking help if they show signs of psychosis may also be beneficial. Online therapy may be a helpful resource for those with schizophrenia and their loved ones.
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