My grandmother died and I stayed stable

This is a composite story, drawn from common experiences shared in the schizophrenia community. It does not depict a real individual.

I am 36, a woman, and I live in Atlanta. My grandmother died in February of pancreatic cancer at the age of 84. She had raised me from the time I was nine years old, after my mother could not. I have had schizophrenia since I was 22. The grief of losing her is its own subject. What I want to write about is something narrower: how I stayed stable through her three-month decline, her death, and the funeral, and what that quiet fact has meant to me.

What I was afraid of

Grief is a known relapse trigger for people with our diagnosis. Sleep gets disrupted. Routines collapse. Appetite goes. The kind of nights you sit awake replaying the last conversation are exactly the kinds of nights my brain has historically used to start producing voices again. My last hospitalization was nine years ago, and the years since had been built on a careful set of structures. I was afraid grief was going to dismantle them.

My psychiatrist and I had the first conversation about my grandmother's prognosis in November, the day after her diagnosis. She did not minimize the risk. She said: "We are going to plan for this carefully. You will grieve, and you will stay stable. Both can be true."

The plan we built

Don't change the medication during the crisis

I was on lurasidone (Latuda) and had been for four years. We agreed not to change it. Adding new variables during a known stressor is risky. The exception was that we built in the option to add a short course of a sleep aid if I needed it. I did, in January, for about three weeks.

Sleep as the highest priority

I told my family that I was going to need to sleep, even when I did not feel like it. My aunt, who was the primary caregiver in the final weeks, agreed to text me updates rather than call after 9 p.m. I went to bed at 10. I woke at 6. I missed two nights — the night my grandmother went on hospice and the night she died — and on those nights I called my psychiatrist's after-hours line for guidance. She told me to take a single dose of the prescribed sleep aid and to schedule an appointment for the next day. I did both.

One person who knew everything

My therapist became the single point of integration. She knew the medical picture, the family picture, the early warning signs my brain produces, and the grief work I needed to do. We moved from biweekly to weekly through November and weekly through April. Having one person who could see the whole thing meant I did not have to explain myself ten times to ten different people.

Visiting in small doses

I lived an hour from my grandmother. The temptation was to spend every weekend at her bedside. My therapist and I made a different rule: two-day visits, never more, always with a clear return home. The longer visits were the ones that had historically wrecked my sleep. Two days felt almost too short. They were the right length. Quality of presence mattered more than quantity.

A clear yellow zone

My psychiatrist and I had updated my relapse prevention plan in November. The yellow zone — early warning — included: two consecutive nights of less than six hours of sleep, return of any voice, ruminating thoughts I could not redirect, or skipped medication. The plan if any of these happened: call my psychiatrist within 24 hours and pull back from the household around my grandmother. I did not have to use it. The fact that it existed made me less afraid.

The day she died

She died on a Monday morning. I was at her bedside with my aunt and my cousin. I had been there since Friday. The weekend had been hard but quiet — the slowing breath, the long pauses, the light coming through the window in the way she had loved. When she went, I cried in the way you cry when someone you love dies.

I drove home that evening. My therapist had a session set up for me at 11 a.m. the next day. I went. I cried more in her office. I went home and slept.

The funeral

The funeral was the following Saturday. I had been worried about the funeral the way someone with my diagnosis can be worried — not about the social part but about the sensory and emotional density of it. I built a small set of supports. I asked my husband to drive. I did not give a eulogy; I read a short passage instead, which I had practiced. I sat in the front row with my family. I left the reception after an hour.

The day was hard and ordinary. I was sad. I was not symptomatic. I was a granddaughter at a grandmother's funeral.

What this has meant

In the weeks since, I have noticed something I did not expect. The grief is large, but the grief feels separable from my illness in a way it might not have been ten years ago. I am sad because someone I loved died. The sadness is not a symptom. The voices have stayed quiet. The structures held.

For most of my twenties, every difficult emotion felt like the leading edge of a relapse. I treated my own feelings with suspicion. Staying stable through this loss is the first time I have proved to myself, in a serious test, that grief and stability can coexist. I trust my brain more this week than I did three months ago. That trust will outlast this particular grief.

What I would say to someone facing a similar loss

• Tell your treatment team early. Anticipated grief deserves an anticipated plan.
• Do not change medications in the middle of the crisis if you can avoid it.
• Treat sleep as medical equipment. Build the structures that protect it.
• Visit in doses. Quality of presence matters more than quantity.
• Have one person — a therapist, a case manager, a trusted family member — who knows everything.
• Update your relapse prevention plan with grief-specific yellow-zone signs.
• Allow grief to be itself. Sadness is not a symptom.

For more, see when my cat died and I stayed stable and NAMI's family resources. The SAMHSA Disaster Distress Helpline can also be a resource for acute grief support.

This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a qualified mental health professional. If you or someone you know is in crisis, call or text 988 in the US, or your local emergency number.