Chapter 9 - schizophrenia.life

Fast Facts

Caring can be demanding. Supporting a loved one with both schizophrenia and substance use disorder involves managing unpredictable behaviors, relapses, and crises, often leading to chronic stress, guilt, and emotional exhaustion of caregivers.

Balancing caregiving responsibilities. Caregivers should adopt strategies that support both their loved one’s treatment needs and their own health and well-being.

Avoiding burnout. Recognizing early signs of burnout allows caregivers to take action before burnout leads to more serious mental or physical health complications.

Self-care is not a luxury – it’s a necessity. Prioritizing personal wellbeing, setting realistic boundaries, seeking social support, and practicing mindfulness can help caregivers manage burnout and sustain their ability to provide compassionate care.

Subchapter 1.

Managing the emotional and physical burdens

Subchapter 2.

Overcoming behavioral and communication challenges

Subchapter 3.

Overcoming social isolation and double stigma

Subchapter 4.

Seeking integrated treatment options

Subchapter 5.

Balancing caregiving and personal well-being

Subchapter 6.

How to avoid and manage caregiver burnout

References

Vadher S, Desai R, Panchal B, Vala A, Ratnani IJ, Rupani MP, et al. Burden of care in caregivers of patients with alcohol use disorder and schizophrenia and its association with anxiety, depression and quality of life. General Psychiatry [Internet]. 2020 Jun;33(4):e100215. Available from: https://pubmed.ncbi.nlm.nih.gov/32656497/

Neyra A, Parro-Torres C, Ros-Cucurull E, Carrera I, Echarri E, Torrens M. Management of schizophrenia and comorbid substance use disorders: expert review and guidance. Annals of General Psychiatry [Internet]. 2024 Oct 30;23(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11526640/

Du M, Wang X, Yin S, Shu W, Hao R, Zhao S, et al. De-escalation techniques for psychosis-induced aggression or agitation. Cochrane Database of Systematic Reviews [Internet]. 2017 Apr 3;4(4). Available from: http://www.cochrane.org/CD009922/SCHIZ_deescalation-techniques-psychosisinduced-aggression-or-agitation

Yule A, Kelly J. Integrating Treatment for Co-Occurring Mental Health Conditions. Alcohol Research: Current Reviews [Internet]. 2019;40(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6799972/

Chien WT, Clifton AV, Zhao S, Lui S. Peer support for people with schizophrenia or other serious mental illness. Cochrane Database of Systematic Reviews [Internet]. 2019 Apr 4;4(4). Available from: https://pubmed.ncbi.nlm.nih.gov/30946482/

Sampogna G, Brohan E, Luciano M, Chowdhary N, Fiorillo A. Psychosocial interventions for carers of people with severe mental and substance use disorders: A systematic review and metaanalysis. European Psychiatry [Internet]. 2023 Nov 24;66(1):1–75. Available from: https://pubmed.ncbi.nlm.nih.gov/37997647/

Hobern B, Carrotte ER, Rehm IC, Blanchard M, Groot C. Stigma Towards People Living with Co-occurring Schizophrenia Spectrum and Substance Use Disorders: A Scoping Review. International journal of mental health and addiction [Internet]. 2024 Jun 27; Available from: https://psycnet.apa.org/record/2025-00783-001

Joo JH, Bone L, Forte J, Kirley E, Lynch T, Aboumatar H. The Benefits and Challenges of Established Peer Support Programmes for patients, Informal caregivers, and Healthcare Providers. Family Practice [Internet]. 2022 Feb 1;39(5):903–12. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9508871/

Stuart H. Reducing the stigma of mental illness. Global Mental Health [Internet]. 2016 May 10;3(17). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314742/#ref8

Gaudreault K, Tremblay J, Bertrand K. The needs of carers who support people living with schizophrenia and a substance use disorder: a multiperspective evaluation. Advances in dual diagnosis [Internet]. 2024 Jan 2;17(1). Available from: https://www.emerald.com/add/article-abstract/17/1/14/1219100/Theneeds-of-carers-who-support-peopleliving- with?redirectedFrom=PDF

Siddiqui S, Mehta D, Coles A, Selby P, Solmi M, Castle D. Psychosocial Interventions for Individuals With Comorbid Psychosis and Substance Use Disorders: Systematic Review and Meta-analysis of Randomized Studies. Schizophrenia Bulletin [Internet]. 2024 Jun 28; Available from: https://pubmed.ncbi.nlm.nih.gov/38938221/

Tessier A, Roger K, Gregoire A, Desnavailles P, Misdrahi D. Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial. Frontiers in Psychiatry [Internet]. 2023 Jun 23;14. Available from: https://pubmed.ncbi.nlm.nih.gov/37426102/

Kokurcan, A, Yilmaz Özpolat AG, Göğüş AK. Burnout in caregivers of patients with schizophrenia. TURKISH JOURNAL OF MEDICAL SCIENCES [Internet]. 2015 [cited 2020 Nov 26];45(3):678–85. Available from: https://pubmed.ncbi.nlm.nih.gov/26281339/

Olindah Silaule, Daleen Casteleijn, Adams F, Nokuthula Nkosi. Strategies to alleviate the burden experienced by informal caregivers of persons with severe mental disorders in developing countries: a scoping review (Preprint). Interactive journal of medical research [Internet]. 2023 Apr 29;13. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10835589/