What To Expect When You Are Dating Someone With Schizophrenia

The World Health Organization (WHO) estimates that 1 in 300 people worldwide experience schizophrenia. Despite the challenges and stigmas those with schizophrenia often face, they can have relationships that are just as fulfilling as individuals without the disorder. However, the partners of individuals with schizophrenia may benefit from learning about the struggles and impacts of this disorder, as well as potential coping methods. Speaking with a licensed therapist about how to best support your partner and maintain a healthy relationship can also be helpful.

How can schizophrenia symptoms impact a relationship? 

Schizophrenia can present with a variety of symptoms that may impact a romantic relationship. These symptoms are often divided into two primary categories: positive and negative. 

• Positive symptoms: The positive symptoms of schizophrenia may cause changes in thoughts and behaviors, often through hallucinations, delusions, and disordered thinking. 
• Negative symptoms: Negative schizophrenia symptoms may alter an individual's motivation, emotions, or the way they interact with others. 

Positive and negative symptoms may impair an individual’s ability to function socially, which could make dating difficult. Individuals experiencing schizophrenia may struggle to express their thoughts or emotions, which could put a strain on a romantic partnership. A person experiencing a schizophrenic episode may also misinterpret their partner’s actions due to delusional thought patterns or struggle to focus on a conversation as a result of disordered thinking.

Schizophrenia symptoms can also contribute to the stigmas that individuals with this disorder tend to face in the dating world. Research suggests that a large number of those living with schizophrenia may experience discrimination. In a 2020 phenomenological analysis, researchers found that 27% of respondents in a specific set of international studies encountered discrimination in romantic relationships, with a further 55% anticipating discrimination in the future. Further analysis involving a study of over 200 psychiatric patients with schizophrenia spectrum disorder found that 87% experienced interpersonal rejection and approximately 50% lost contact with someone close. In addition, two-thirds of respondents thought that others would not want a partner who had been diagnosed with schizophrenia. 

While stigmatization can have a variety of causes, one potential source may be popular media. Schizophrenia is often portrayed in movies and television shows as a violent disorder. In other cases, schizophrenia may be portrayed using the symptoms of other disorders, such as the “split personalities” of dissociative identity disorder. Stigmatization may instill a fear of rejection in those with schizophrenia, who may already struggle with social isolation, self-esteem, and difficulty maintaining a support system. 

Acknowledging and challenging these stigmas through education and compassion can be beneficial to those with schizophrenia and their loved ones. While the decision is yours as to you whether you want to date someone with schizophrenia, you may want to avoid making a decision based on prejudices and potentially inaccurate media portrayals of mental health conditions. If you do decide to date someone living with schizophrenia, learning how to help a partner experiencing this disorder can be helpful.

How to help a partner living with schizophrenia

While every case of schizophrenia can be unique, there may be a variety of ways for a person to help their partner with schizophrenia. Finding out as much as you can about schizophrenia can be an effective first step to providing support to a partner with this disorder. This may mean learning the signs of acute schizophrenia, which may be referred to as a schizophrenic episode. Acute schizophrenia is often the second of three potential phases of schizophrenia. However, some phases may no longer be recognized by the Diagnostic and Statistical Manual (DSM-V). Still, understanding these phases may have some benefits. Schizophrenia phases usually include the following:

• Prodromal: The prodromal phase often involves subtle changes in behavior and thinking that may be difficult to recognize. These mild symptoms can signal the development of an acute episode of schizophrenia. Understanding when this phase begins and ends may be challenging until more acute symptoms manifest. 
• Acute: Sometimes referred to as the active phase, acute schizophrenia is typically easier to recognize than other phases. Individuals experiencing acute schizophrenia may show both positive and negative symptoms. These may include hallucinations, delusions, disordered thoughts, a lack of motivation, and difficulty communicating. 
• Residual: During the residual or recovery phase of schizophrenia, some symptoms (often positive symptoms) may be alleviated while others (usually negative symptoms) could persist. Individuals may struggle with reduced energy and motivation, which could contribute to difficulty functioning in social situations. 

Understanding the possible phases of schizophrenia can be just one way to help your partner with the condition. Supporting a partner who is experiencing schizophrenia symptoms can be stressful and challenging. While every situation is unique, several tips may be beneficial.

• Understand that communication may be difficult. A person experiencing schizophrenia or psychosis may switch rapidly between topics, be easily distracted, use words that may not make sense, discuss subjects that may not follow logic, or struggle with facial expressions. Try to remain patient and talk clearly with your partner.
• While delusions may lead an individual to hold beliefs that are unrealistic or illogical, try to remain empathetic. Listen to your partner, avoid judgment, and let them know you understand. Arguing, challenging their beliefs, or trying to talk if they do not wish to do so can all be detrimental. Overall, try to remain respectful and mindful that your partner may be uneasy or fearful when experiencing symptoms.
• If your partner is struggling with schizophrenia symptoms, you might need to reach out to their care team. This may involve contacting their primary care doctor, mental health provider, or any other professional who is currently administering their treatment.

In addition to understanding the disorder, taking relationships slow when dating a person with schizophrenia may be beneficial. Stress may exacerbate schizophrenia symptoms, so placing pressure on a partner to advance a relationship or go on dates that are outside their comfort zone may be harmful. Certain medications used to treat schizophrenia, such as antipsychotics, may also have sexual side effects. You can discuss these potential effects with your partner and move at a pace with which they are comfortable.

How to cope when your partner is experiencing schizophrenia symptoms

While caring for your partner may seem like a priority, it can also be beneficial to care for yourself. While there may be a variety of ways to do so, two potential coping methods involve engaging in self-care and talking with a mental health professional.

Self-care

Self-care typically involves taking care of one's physical, mental, and emotional health through a variety of activities. 

• Exercise: According to the Centers for Disease Control and Prevention (CDC), exercise can have a variety of benefits, including improving brain health, strengthening bones and muscles, and reducing the risk of certain diseases. Exercise may lower the likelihood of heart disease, stroke, type 2 diabetes, infectious diseases, and several common cancers. In addition, exercise may reduce the levels of adrenaline and cortisol in the body, which are sometimes referred to as “stress hormones.” Lower levels of these hormones may decrease stress in individuals who may be experiencing challenges in their relationships (or other parts of their lives). 
• Sleep: According to the National Institutes of Health (NIH), sleep can be beneficial to a person's health and well-being. Like exercise, proper sleep can lower the risk of high blood pressure, stroke, and coronary heart disease. Poor quality sleep may also decrease a person’s ability to respond to insulin and regulate levels of leptin and ghrelin, which typically regulate hunger and fullness cues. In addition, improper sleep may increase the likelihood of getting colds and infections while also impacting someone's ability to learn and form long-term memories. 

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While self-care can have several benefits, other care options may also be beneficial. Seeking the support and perspective of an outside party, such as a mental health professional, can round out your care for yourself or your partner.

Talk with a mental health professional 

While an individual living with schizophrenia may benefit from therapy, their partner may also benefit from seeking the support of a mental health professional. Partners of those with schizophrenia may discuss the challenges they face with a therapist. They might talk about their experiences in caring for their partner, ways to recognize symptoms, and their feelings concerning their partner’s disorder. In addition, a therapist may be able to share techniques that could help their partner or discuss coping methods to reduce stress.

However, in-person therapy may not be available for everyone. In some cases, an individual may not have time to commute to face-to-face sessions, or they may lack reliable transportation. Some may also live in an area without a sufficient number of providers, which could make scheduling sessions difficult. Others may want to use alternative formats, such as texting, calling, or video chatting. In these situations, potential alternatives may be beneficial, such as online therapy.

Research suggests that online therapy may have similar levels of effectiveness to in-person therapy. In one meta-analysis of 12 randomized controlled trials and 931 patients, researchers compared the efficacy of cognitive behavioral and family therapies delivered via telehealth to those delivered in person. They found no significant differences between the capacity for online and in-person therapy to treat certain mental health disorders in a variety of categories, including symptom severity after treatment, overall improvement, function, working alliance, and client satisfaction.