• Schizophrenia may lead to challenges in communication that affect speech, motivation, and cognitive function.
  • Acknowledge what your loved one is experiencing, and actively listen to them, especially if their symptoms are changing.
  • It’s important to understand the reasons why schizophrenia affects your loved one’s ability to communicate with others, so you can be more empathetic and effective in your own efforts to reach out.

Affecting an estimated 1 percent of people in the United States, schizophrenia is a complex mental health condition that can also cause communication difficulties.

Read on to learn the best practices for improving communication with your loved one throughout all stages of this condition.

While hallucinations and delusions are commonly associated with schizophrenia, this neurological disorder also impacts communication skills.

Some symptoms include:

  • disorganized speech
  • troubles relaying thoughts
  • thinking difficulties

Schizophrenia is also known to cause a lack of motivation. Your loved one might not seem like they’re interested in or enjoy the activities they normally do. Small, everyday tasks may also be challenging to complete.

Effective communication with someone with schizophrenia relies heavily on education, compassion, and empathy.

Rather than trying to “fix” this mental health condition, it’s important to meet your loved one where they are today and assure them you’re there for them no matter what challenges they might face.

Here are some ways you can get started:

  • Acknowledge what your loved one may be feeling.
  • Actively listen to what they express they’re feeling, sensing, or hearing, regardless of whether it makes sense to you.
  • Ask them what you can do to help them right now — encouragement can help increase motivation.
  • Let your loved one know you’re there for them whenever they’re ready to talk with you.
  • Have patience, and allow extra time for your loved one to gather their thoughts if they wish to speak with you.

Knowing what to say during symptom changes can foster better communication. But it’s also important to know what not to say to someone with schizophrenia.

For example, you should never:

  • blame your loved one for not “trying to fix” their condition
  • tell them their symptoms are “all in their head”
  • demand your loved one talk with you, so they’ll “feel better”
  • express pessimism about your loved one’s condition or current challenges

It’s also important to understand some of the misconceptions that may be associated with this condition. For example, people with schizophrenia do not have “split personalities,” so you shouldn’t treat your loved one as such.

Like other mental health conditions, symptoms of schizophrenia may come and go. You can start by familiarizing yourself with some of the most common symptoms of schizophrenia, along with the possible challenges they pose for communication.

Psychosis refers to a state where someone might lose sense of reality and experience hallucinations, delusions, or disorganized behavior.

In schizophrenia, psychosis may also entail a loss of interest in daily activities, an inability to express emotions, and decreased interpersonal communication.

Here’s how you can respond more effectively to your loved one during these symptoms.

Positive symptoms

Positive symptoms are the symptoms that people diagnosed with schizophrenia may experience that most of the population does not experience — including hallucinations and disorganized thoughts.

If you see positive symptoms in your loved one, you might start by asking them about their current treatment plan and if they need help making an appointment with their doctor.

Encourage your loved one to stay on top of their therapies or treatments.


Hallucinations occur when someone may see, feel, or hear something that isn’t really there. This phenomenon can also affect sense of taste and smell. Auditory hallucinations are the most common type in schizophrenia.

While hallucinations can be confusing as a bystander, it’s important to keep in mind that these phenomena are real to your loved one. Try asking what’s going on, and if your loved one needs your help.

You might suggest other activities as a distraction, but don’t force your loved one to change environments if they’re not comfortable doing so.


Delusional thinking is based on a fixation with false beliefs despite “reasonable” evidence that proves such thoughts to be incorrect.

If you tell your loved one they’re wrong, you may risk a communication barrier.

Instead, acknowledge their beliefs and fears and ask questions. This may help encourage your loved one to come to reason on their own.

Negative symptoms

Negative symptoms describe the actions that those with schizophrenia may struggle to do in comparison to others — including expressing emotions, communicating, and completing everyday tasks.

Affective flattening

Affective flattening means that someone is unable to express emotions with others. A person experiencing affective flattening may come across as blunt or “unfeeling.”

While affective flattening might come across as apathy, it could instead be related to a lack of social and environmental stimuli.

You should never force your loved one to socialize or to try new activities. Instead, try occasionally offering your loved one the opportunity to accompany you in such situations without sounding forceful.


Alogia refers to a lack of speech. In schizophrenia, this may be caused by the inability to put thoughts together, and not necessarily a lack of desire to talk with someone.

If you notice increased difficulties with speech, it’s important not to point them out, as you might risk embarrassment and resentment.

Instead, focus on the conversation, allowing your loved one time to respond. Avoid distractions, like smartphones or televisions.


Avolition is an extreme lack of motivation, which can make it difficult to complete everyday tasks — and also start them.

In schizophrenia, avolition can also affect everyday communication skills. Your loved one might avoid eye contact or have difficulty with phone calls.

Another issue may be managing personal hygiene. Those experiencing avolition might have a hard time with tasks like showering, dressing in clean clothing, or other forms of daily personal care.

To help a loved one experiencing avolition with schizophrenia, try encouraging small steps and offering help, if they need it.

Seemingly “simple” tasks can be overwhelming for your loved one right now, so accomplishing one step at a time can increase motivation to help them do more.

Schizophrenia is considered a chronic mental health condition, so long-term treatment is essential to controlling symptoms.

This condition can also cycle between “active” stages, where you may notice symptoms, like hallucinations and communication difficulties, are more prominent.

There are many treatment options available for schizophrenia, including psychotherapy and antipsychotic medications. Your loved one should talk with a doctor if their current treatment plan isn’t sufficiently helping their symptoms.

Also, as a loved one of someone with schizophrenia, you may find it helpful to seek therapy. Individual, family, and group therapy sessions can help you bolster communication skills and learn to set reasonable boundaries with your loved one surrounding their symptoms.

Schizophrenia can impact your loved one’s communication skills in various ways. Some of these impacts may be more obvious during more active stages of this chronic mental health condition, but others may occur throughout the course of this illness.

It’s important to understand the reasons why schizophrenia affects your loved one’s ability to communicate with others, so you can be more empathetic and effective in your own efforts. As a friend or family member, your support is crucial to your loved one’s treatment.