Health

The best way to prevent relapse of schizophrenia is to stick with your treatment plan. There are many steps you can take to improve the quality of your life while living with this disease, including:

• Taking your medicines as prescribed. Never stop taking your medicines without the advice and supervision of your health professional.
• Attending your counseling sessions and classes even when you do not feel like it or when you think they are not helping you.
• Knowing your legal rights. People with schizophrenia have the same rights as other citizens. For example, they have the right to vote and to participate in legal agreements, such as marriage, divorce, or business ventures. Most states and many health care institutions have a bill of rights for people with serious mental illness. These rights include the right to privacy (or confidentiality) with respect to their illness and treatment plan and the right to treatment that places the fewest restrictions on their lifestyle.
• Joining a self-help or support group. These groups can be very helpful for some people with schizophrenia. Self-help and support groups are usually run by the members of the group (not health professionals).
• Developing a plan to take care of your personal affairs during times of relapse.

It is important for all family members and other people close to a person with schizophrenia to learn about the disease and how it affects their lives. Family members who learn the first signs of relapse and see that their loved one gets help early may prevent a long and difficult relapse.

• Help a person who is hallucinating by quietly calling the person by name, or by asking the person to tell you what he or she is experiencing and telling him or her that the voices are not real.
• Help a person who is paranoid by not arguing. Call for help if you fear the situation could become dangerous.
• Encourage a person to take medicines by talking about how the medicines keep them from hearing voices and by helping them monitor the medication side effects.

Sometimes people with schizophrenia are too sick to get treatment on their own. Depending on the severity of their symptoms, some people need to be held or treated against their will. Talk with your local law enforcement officials about the laws and procedures in your area for seeking treatment for an affected family member. Having this information before you need it will reduce your fears and concerns and enable family members to work together to get help for their loved one.

Some people with schizophrenia are likely to display aggressive or violent behavior.⁹ It is important to know the signs to watch for.

• Warning signs of suicide, such as talking about death or heavy use of drugs or alcohol
• Warning signs of violence towards others, such as talking about harming someone or unexpected and aggressive mood changes

Family members and other people involved in the care of a person with schizophrenia need to take care of themselves, such as seeking separate counseling, joining a support group, and maintaining their own interests.

Over 80% of people with schizophrenia smoke cigarettes.¹² Smoking increases the risk for other diseases, such as cancer and heart disease. For information on how to stop smoking, see the topic Quitting Tobacco Use.

• Think you cannot stop from harming yourself or someone else.
• Hear voices that are new or more upsetting than normal.
• Want to commit suicide, or you know someone who has mentioned wanting to commit suicide.

Warning signs of suicide include:

• Use of illegal drugs or drinking alcohol heavily.
• Talking, writing, or drawing about death, including writing suicide notes and speaking of items that can cause physical harm, such as pills, guns, or knives.
• Spending long periods of time alone.
• Giving away possessions.
• Acting aggressive or suddenly appearing calm.

Watchful Waiting

Watchful waiting may be enough if a mood episode has just started and you are taking proper medicines. If your mood episode has not improved within 2 weeks, call your doctor.

If you have a loved one who is experiencing a manic episode and is behaving irrationally, help the person seek treatment.

Who To See

Bipolar disorder is complex and hard to diagnose because it has many phases and symptoms. Sometimes it is misdiagnosed as only depression (unipolar depression) because people are more likely to seek treatment during a period of depression.

After you are diagnosed with bipolar disorder, it is important to keep a long-term relationship with your doctor or therapist to make sure that your treatment is consistent and that your medicines can be adjusted as needed.

Although other health professionals can diagnose bipolar disorder, you will probably be referred to a psychiatrist who specializes in treating such disorders and can prescribe medicines and provide counseling. Other health professionals who can diagnose bipolar disorder include:

• Have thoughts of suicide or are threatening suicide.
• Hear voices, especially if the voice tells you to hurt yourself or someone else, or to do something illegal such as destroy property or steal.

Call a health professional if you (or someone you know):

• Have a sudden change in behavior, such as refusing to eat because you think someone has poisoned your food.
• Have experiences you usually do not have (such as hearing someone calling your name when no one is there).
• Have difficulty taking care of yourself or become confused doing simple chores or tasks.
• Show warning signs of suicide, such as talking about death or spending long periods of time alone.
• Show signs of schizophrenia, such as seeming to talk to people who are not present or believing things that you know are false.
• Show the first signs of relapse, such as difficulty concentrating or withdrawing from other people.

Watchful Waiting

Sometimes people can have symptoms that appear similar to those of schizophrenia.

• Extreme stress can cause confusion and forgetfulness.
• Life-threatening situations, such as a serious accident or natural disaster, can cause extreme fear or heightened alertness.
• Grief after the loss of a loved one can cause a person to think he or she hears or sees the loved one.

If the unusual behavior lasts longer than 1 week, or if the experiences interfere with normal social function, talk with a health professional about your concerns.

Sometimes people have some of the positive symptoms of schizophrenia without having schizophrenia. These positive symptoms can occur after you take certain illegal drugs, as side effects of certain medicines, as complications of not sleeping or being overstimulated, or as symptoms of another medical condition. Positive symptoms of schizophrenia may also be symptoms in other illnesses such as severe depressionor bipolar disorder. If you have had symptoms of psychosis (such as hearing voices) or are concerned about changes in your thoughts or feelings, see a health professional for an evaluation.