Reflect, Recover, Rebuild: Navigating Relationships after an Episode of Psychosis

A strong support circle can hugely help someone's recovery after a psychotic episode. Sadly, however, many people with schizophrenia report an increase in strained or broken relationships due to their symptoms.

Today, Lesley McCuaig explores how time, patience, and commitment can help relationships survive and thrive through psychosis. She also shares three steps for letting go of lost relationships when someone chooses not to reconcile.

Psychosis affects how people process information. It can cause people to see, believe, or hear things that aren't real.

One of the side effects of psychosis can be trouble with maintaining relationships. Yet, while schizophrenia (the condition I live with) obviously affects caregivers, friends, and family, some people can forget it also affects the person suffering from schizophrenia.

When symptoms of psychosis improve, some of our relationships can improve, too. But, sometimes, the strain of a psychotic episode proves too much for a relationship, which remains lost even after our symptoms lessen.

Losing our friends or loved ones is never pleasant. Though it can hurt, we must take time to grieve the loss of those relationships and try to move forward with our lives.

How psychosis has affected my relationships

I've lost several significant relationships due to psychosis. I've rebuilt some of them with time and effort, but others have remained lost.

Do I find it difficult not having those relationships in my life today? To be honest... yes, at times. I often consider what my relationships were like before and after my schizophrenia diagnosis.

However, I've noticed some warning signs in hindsight. Most of the relationships that broke down completely were showing weaknesses before my schizophrenia diagnosis. They weren't the most robust relationships in the first place.

When I experience psychosis, I'm consumed by "my" reality. A symptom of my psychosis includes hearing things that aren't there, known as auditory hallucinations. But, to me, the things I'm experiencing during a period of psychosis are genuine - are my reality - even if they're not real to someone on the outside. 

Sometimes, the lack of judgment or clarity with psychosis can cloud the ability to maintain healthy relationships. Other times, psychosis can cause you to behave in ways that look strange or erratic to the regular population, such as talking to people who aren't there. These symptoms and responses can make it difficult for me to interact with others in ways society considers appropriate.

Likewise, a lack of clarity, erratic behaviour, and being out of touch with reality can make it almost impossible to have healthy relationships - romantic or platonic - while in psychosis. It’s a very alienating experience for everyone.

Reconnect or relinquish? Accepting decisions and cherishing those who stayed

The good news is that with proper treatment, people can move forward from an episode of psychosis and begin to rebuild the things they've lost. Having a strong support circle is often integral to recovery.

Sometimes, however, loved ones may withdraw with or without saying anything. This could be due to:

Fear or lack of understanding of your condition

• General mental health stigma
• Difficulty differentiating between your true beliefs and character vs. any false beliefs or traits psychosis may have imposed on you
• Misreading something as a sign that you don’t want to reconcile
• Dealing with personal struggles that aren’t directly connected to you

I understand how and why this happens, but I congratulate and cherish those who haven't let my psychotic episodes define our relationship.

Nobody goes through a period of psychosis and comes out feeling great about themselves. Often, the aftermath is dealing with trauma, guilt and shame.

How to approach lost relationships after a psychotic episode 

As I mentioned before, some loved ones may choose to end their relationship with you during or shortly after a psychotic episode. Although hurtful and confusing, they may be unwilling to reconcile, even despite your best efforts and knowing you’re not to blame. 

It can be tempting to try to fight for the relationship or ask the other person for closure. However, it may be better to process your feelings, focus on your recovery, and accept that someone may not change their mind.

Here are three steps I use to speed up the healing process.

1. Take time to grieve

If or when psychosis leads to a relationship breakdown, the person in recovery needs to allow themselves to grieve.

Take some time for reflection and introspection. It also helps to talk things through with someone, such as another friend or a professional.

2. Make an active choice to move forward

After grieving, learn to move forward with those you love and respect. Grieving the loss of a friendship hurts, but facing these feelings allows you to move on with or without them.

3. Let go

Learning how to let go may be one of the biggest lessons I've learned since receiving my schizophrenia diagnosis. I want to let go of the life I once had and start setting new, realistic goals for the path forward.

Relationships can be complicated with or without schizophrenia, but mine were compounded and complicated by a decade of alcoholism. Sometimes, I think it's a wonder I have a friend left!

But with time, patience, effort, and commitment, relationships can survive and thrive through psychosis. You can learn to trust again, laugh again, and love again.

Moving on

Although psychosis can be disruptive and discouraging for people with schizophrenia, it doesn't have to define who we are.

Relationships ebb and flow. Although it can be disappointing and disheartening to watch a caregiver, friend, or family member walk away when you're at your sickest, this does not define all your relationships. With ongoing treatment adherence, one can live a very fulfilling life with relationships that matter.

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Date of preparation: October 2024
D: COB-GB-NP-00537 (V1.0) / T: COB-GB-NP-00539 (V1.0) / M: COB-GB-NP-00538 (V1.0)