Maybe it started with a crisis in the middle of the night, a call from campus security, or a loved one who suddenly seemed like a different person.
You found yourself in an emergency room or a hospital unit, listening as a doctor said words like “schizophrenia” or “bipolar disorder.”
In that moment, it can feel like the floor is gone.
Families often describe shock, fear, guilt, and grief all tangled together. You might be asking yourself:
- What does this diagnosis really mean for the person I love?
- Will they ever have a good life?
- What are we supposed to do next?
Schizophrenia and bipolar disorder are serious mental illnesses. They affect how a person thinks, feels, and functions in daily life.
Schizophrenia often begins in late adolescence or young adulthood and can involve psychosis, such as hearing voices or having fixed false beliefs. Bipolar disorder involves cycles of extreme “highs” (mania or hypomania) and “lows” (depression) that go far beyond typical mood swings and interfere with school, work, and relationships.
At the same time, there is real reason for hope. Many people with these diagnoses build meaningful lives when they have access to treatment, stability, and family support. You do not have to figure this out alone. In Eastern Virginia, your local Community Services Board (CSB) can partner with you in family education, ongoing care, and crisis planning.
This article offers a grounded look at what these diagnoses mean, how families can respond in the first months, and why planning ahead for crises can protect everyone involved.
Understanding what schizophrenia and bipolar disorder mean
Serious mental illness is often portrayed in extreme or frightening ways in movies and news. That can make a new diagnosis feel even more terrifying. Taking time to understand the basics can help you move from panic toward a clearer next step.
Schizophrenia is a mental illness that affects how a person thinks, feels, and behaves. People may hear or see things that are not there, hold beliefs that are not based in reality, or speak and act in ways that seem very disorganized. The World Health Organization estimates that schizophrenia affects about 23 million people worldwide, with onset most often in late adolescence and the twenties.
Bipolar disorder is also a serious mental illness. People with bipolar disorder experience periods of unusually elevated or irritable mood, high energy, and decreased need for sleep, as well as periods of deep depression. These episodes can be chronic or come and go. In the United States, an estimated 4.4 percent of adults experience bipolar disorder at some point in their lives.
Both conditions are associated with risks like difficulty maintaining employment or school, higher rates of other health problems, and increased suicide risk if they are not treated. Yet decades of research also show that with treatment, many people experience fewer symptoms, fewer hospitalizations, and better quality of life. That treatment often includes medication, therapy, support with housing or employment, and structured help for families.
A diagnosis is not a verdict about who your loved one is or what they can become. It is a description of patterns in thinking and mood that need ongoing support.
The first weeks: shock, questions, and finding your footing
When a serious diagnosis enters the family, it is common for everyone to be in survival mode. You may be trying to keep track of new medications, insurance forms, and follow-up appointments while you are still reeling emotionally.
Families often ask: “How much do we push?” “How much do we step in?” “What do we tell extended relatives or employers?” There is no single right script, but there are a few themes that help many families through these early weeks.
First, it is normal to have mixed feelings. You might feel relieved to finally have a name for what you have been seeing, and at the same time deeply sad or angry that this is part of your loved one’s story. Those reactions do not make you less supportive. They mean you are human.
Second, you do not have to understand everything at once. It is completely appropriate to ask providers to slow down, repeat information, and put things in writing. You can keep a notebook or digital file where you jot down questions, medication names, and contact numbers. Bringing another trusted person to appointments can help you remember details and feel less alone.
Third, this is a good time to connect with your local CSB and ask about ongoing services. In Virginia, CSBs are local public agencies responsible for community-based behavioral health care, including services for people with serious mental illness and their families. Staff can explain what assessments, outpatient services, case management, and crisis supports are available in your area. You can learn more about that here.
Why family education changes outcomes
When someone develops schizophrenia or bipolar disorder, the person is not the only one affected. Family members often become the main source of housing, transportation, emotional support, and day-to-day care. That is a heavy role to step into without a map.
Family education is one way to change that. “Psychoeducation” simply means structured information and support about a mental health condition, tailored to families. Research over several decades has found that family psychoeducation reduces relapse and rehospitalization in schizophrenia and improves treatment adherence. (source) Programs like NAMI’s Family-to-Family, which is recognized as an evidence-based intervention, have been shown to increase coping and problem-solving skills for relatives of people with mental illness.
Family education typically covers topics like:
- What symptoms look like in real life and how to recognize early warning signs
- How medications work and what common side effects might be
- Communication strategies that reduce conflict and shame
- Ways to respond to symptoms without getting pulled into endless arguments
- Community resources and legal or financial considerations
The goal is not to turn you into a therapist or a nurse. It is to give you enough understanding that you can respond to your loved one with more confidence and less fear. Your local CSB or organizations like NAMI Virginia can help you locate family education classes or groups that fit your situation.
Shifting out of blame: seeing symptoms for what they are
Schizophrenia and bipolar disorder change how a person’s brain processes information. That can show up as difficulty concentrating, slower thinking, low motivation, or trouble following through on tasks. These are not lazy choices. They are often part of the illness itself.
It can help to imagine that your loved one has a serious physical illness that affects energy and thinking. On a “good” day, they might be able to do more. On a “bad” day, they might need more help and more rest.
That does not mean you accept unsafe behavior. Violence, threats, and ongoing substance abuse are real concerns that require clear boundaries and professional help. But when you understand that many difficult behaviors are connected to symptoms, it becomes easier to respond with firm compassion rather than constant criticism.
Instead of “You are just being difficult,” you might say, “I can see getting out of bed is really hard right now. Let’s talk with your provider about how you have been feeling and whether your treatment needs adjusting.”
This shift does not fix everything. It does lower the emotional temperature in the home and makes it more likely that your loved one will accept help rather than withdraw.
Planning for crisis before you are in crisis
People with schizophrenia or bipolar disorder are at higher risk for mental health crises, especially in the years right after diagnosis or when treatment is changing. A crisis might involve severe depression, suicidal thoughts, intense agitation, or psychosis that makes the person unsafe or unable to care for themselves.
One of the most protective steps a family can take is to build a crisis plan before a crisis happens. National guidelines from the Substance Abuse and Mental Health Services Administration (SAMHSA) emphasize prevention and planning as essential elements of crisis care.
A crisis or safety plan is usually created together with your loved one, a clinician, and often family members. It typically includes:
- How your loved one knows when they are starting to struggle: their own early warning signs and triggers
- Strategies they can try at home to stay safe and grounded
- People they trust whom they are willing to contact
- Professional supports such as therapists, psychiatrists, and case managers, with up-to-date phone numbers
- Local and national crisis resources, including 988
- Clear guidance on when to call emergency services or go to the emergency department
SAMHSA offers simple safety plan templates based on the Stanley-Brown model, which is a brief intervention developed specifically for people at risk of suicide or self-harm.
Your local CSB can help you adapt these tools to your situation, including what to do if your loved one refuses care or becomes aggressive. Having those decisions on paper before emotions are running high can spare everyone from unnecessary fear and conflict later.
Caring for yourself while you care for someone else
When a serious diagnosis enters the family, many relatives immediately shift into crisis-solving mode. They attend every appointment, manage medications, take phone calls from schools or employers, and quietly rearrange their own lives.
Over time, this level of caregiving can lead to burnout, anxiety, or depression in family members. Studies have found that relatives of people with schizophrenia often experience high levels of stress and that psychoeducation and support can significantly improve their well-being.
Caring for yourself is not a selfish luxury. It is part of caring for your loved one. That might look like:
- Going to your own therapy or support group to process what you are feeling
- Keeping your own medical and mental health appointments
- Making time for small moments of rest, exercise, or spiritual practices
- Setting limits on what you can and cannot do, especially if you are the primary caregiver
Many CSBs and community organizations offer support groups for family members, where you can hear from others who are walking a similar path. NAMI Virginia and its local affiliates also provide free support and education programs for families and caregivers.
You do not have to carry this alone.
How your local CSB can partner with your family
In Eastern Virginia, Community Services Boards are the front door for public mental health services. They were created under Virginia law to ensure that every city or county has access to community-based services for people with mental health and substance use conditions and developmental disabilities.
If your family has just received a serious diagnosis like schizophrenia or bipolar disorder, your local CSB can help you:
- Arrange an intake or assessment for your loved one
- Explore ongoing services such as outpatient therapy, psychiatry, case management, or psychosocial rehabilitation
- Access family education about serious mental illness and how to respond at home
- Create or update crisis and safety plans
- Connect with community resources, including housing, employment supports, and peer support
You do not need to wait for another crisis to reach out. When you call, you can say something as simple as, “A loved one was recently diagnosed with schizophrenia [or bipolar disorder]. We are trying to understand what supports are available for them and for our family.” Staff can talk with you about next steps, eligibility, and financial questions.
If you or your loved one is in immediate crisis, you can contact the local crisis line at 988 to reach the 988 Suicide & Crisis Lifeline. These services are available 24 hours a day.
You are not alone in this
A diagnosis of schizophrenia or bipolar disorder can feel like a line between “before” and “after” for a family. It is true that life may look different than you imagined. It is also true that there are many pathways toward stability, meaning, and connection.
With time, education, and the right supports, families often learn to recognize early warning signs, respond to symptoms more effectively, and plan for crises instead of living in constant fear of them.
If a serious diagnosis has entered your family, you do not have to become an expert overnight. Your next step can be as simple as this:
Reach out to your local CSB and ask about family education and crisis planning.
From there, you, your loved one, and your care team can begin building a plan that centers safety, dignity, and hope – not just for the person with the diagnosis, but for everyone who loves them.
