How to Communicate With Someone With Schizophrenia 
Health ConditionsMental Health ConditionsSchizophrenia

How to Communicate With Someone Who Has Schizophrenia

How to Communicate With Someone Who Has Schizophrenia
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Published on April 7, 2025
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If you have a friend or family member with schizophrenia, it’s important to take that into account when you talk to them. Symptoms of this chronic mental health condition include episodes of hallucinations, delusions, disorganized thinking, and social withdrawal, all of which can make communication difficult.

When your loved one is having an episode, you’ll want to support them while also knowing that some of the things they say may not be true. They’re likely to be scared and may have trouble following what you’re saying. It can be a tricky balance, trying to validate your loved one’s feelings without worsening them.

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Mitul Desai
Mitul Desai
Caring for a brother with schizophrenia
Founder of The Care Hack
"Maintaining that familial relationship, while also trying to be a caregiver, is so important."
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“A person with schizophrenia has a lot going on under the surface that you don’t know about or may just have a small indication of,” says Diane Solomon, PhD, a psychotherapist based in Portland, Oregon. “During an episode, they may be hearing voices and having delusions. They may think they or someone else is someone that they aren’t, or like someone is coming to get them.”

Dealing with this can be challenging. But with the right tools, you can support your loved one. Here’s how.

What Not to Say to Someone With Schizophrenia

First, it can be good to know what you shouldn’t say to a loved one with schizophrenia who is having an episode. Steer clear of phrases that come off as:

  • Denying: “No, that’s not true,” or “You’re just imagining things.”
  • Criticizing: “Why are you acting this way?” or “You’re acting crazy.”
  • Debating: “Are you sure that’s really what happened?”
  • Interrupting: “I’ve heard enough.”
  • Joking or sarcasm: “Oh sure, that sounds real.”
  • Pressuring: “What’s going on with you?”

Caring for Your Loved One Living With Schizophrenia

Caring for Your Loved One Living With Schizophrenia

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Best Ways to Communicate With and Support Someone With Schizophrenia

Offering a sense of comfort and safety can greatly help your loved one when they are experiencing delusions. Start with these tips:

  • Speak in a calm, quiet voice. Shouting will just upset and startle your loved one, making them feel even more unsafe. Speak calmly, even if you aren’t feeling that way in the moment.
  • Use simple, clear language. To avoid confusion when your loved one already feels overwhelmed, use simple phrases, such as, “Let’s sit and talk.”
  • Let your loved one speak. Give them space to talk without interruption. Cutting them off will likely agitate them more.
  • Express understanding. When your loved one is saying something that isn’t true, you can simply nod your head or say, “I’m hearing you.”
  • Validate their emotions. Try to figure out what the person is feeling under the surface of their delusions. For example, if they seem to be experiencing fear, you could say, “That sounds really scary.”
  • Surround your loved one with comfort items. When someone with schizophrenia is having delusions, they may not eat or drink and may feel panicked. “Make food that you know they like, or put on music that they like,” Dr. Solomon says.
  • Guide them to treatment. If your loved one is experiencing new or worsening symptoms, try suggesting that it may be time to revisit their schizophrenia management plan: “Maybe you should talk to your counselor about this.”
  • Check in regularly. Call, text, or visit your loved one in person to see how they are doing. If you’re not able to do this, remind them that they can always call, text, or chat with 988 or a local crisis intervention program if they need to talk to a trained counselor.
  • Explain your actions. A person who is having delusions may feel afraid of sudden movements or actions. Say what you’re going to do before you do it, such as, “I’m going to pull up this chair, so I can sit next to you.” Also, talk to your loved one about how often you will check in with them, so they don’t feel suspicious about why you are calling or visiting. For example, you can say, “I’m going to call or text you three or four times a day. That’s just what I’m going to do, so don’t be surprised,” says Solomon.

Other Ways to Support Your Loved One Who Lives With Schizophrenia

If you notice your loved one is going through a stressful time, plan to help them stay steady, whether they have an episode or not. You can do that by encouraging them to stick to their treatment plan. The mainstays of schizophrenia management include taking antipsychotic medications and seeing a therapist. Experts also recommend that people with schizophrenia practice interpersonal and social rhythm therapy, which involves finding ways to manage symptoms by regulating their daily routines and social interactions.

But don’t assume that just because your loved one is managing their condition, they won’t have an episode that requires your support. Even when your loved one is in therapy and taking medication as prescribed, it’s still possible for them to experience episodes of delusions or hallucinations. “Medication is not a fail-safe. It can really help, but sometimes a person may need a different dose or a different medication,” Solomon notes. It’s also possible for someone to be triggered by lifestyle factors, such as stress or a lack of sleep.

Do your best to make sure your loved one is taking care of themselves by keeping up with their treatment, sleeping, eating healthy, and staying active. “You can’t make another adult do something, but you can be a partner and help set up a schedule if they’re willing. Or have meals with them at certain times,” says Solomon.

The Takeaway

  • If your loved one has schizophrenia, do use clear, simple language, maintain a calm tone, and validate their feelings.
  • Don’ts use confrontational, critical, or dismissive language, especially when your loved one is experiencing delusions or hallucinations, as this reaction from you can make the situation worse.
  • Call your loved one’s provider if you are afraid for your safety or your loved one’s during an episode. You can also call, text, or chat with 988 for immediate support.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Schizophrenia. National Institute of Mental Health.
  2. Haynes PL et al. Social Rhythm Therapies for Mood Disorders: An Update. Current Psychiatry Reports. August 2016.
Additional Sources
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Angela-Harper-bio

Angela D. Harper, MD

Medical Reviewer
Castle Connolly Top Doctor

Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.  

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

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Erica Patino

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Erica Patino is a freelance writer and editor, content strategist, and usability specialist who has worked for a variety of online health outlets, including Healthline, Sharecare, and Twill Care. She was previously a senior editor at Everyday Health. She is also the founder and editor-in-chief of Hear 2 Tell, a website that covers advances in hearing loss treatment. Patino lives in Portland, Oregon, with her husband and twin sons.
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