Schizophrenia and Avoiding The Pitfalls That Lead Back To a Relapse


It’s difficult to overcome an affliction, whether physical or mental. The ups and downs of any condition can cause frustration, anxiety and fear for everyone involved in the struggle, whether family, mental health professionals, physicians, support groups or friends.

With schizophrenia, medications sometimes have to be adjusted and new coping mechanisms must be learned before the long, hard road to feeling better finally comes to fruition. How can you maintain this stability and who will stand by and support you with your struggle to avoid the pitfalls leading back to a relapse? Who will be your support group and why are these resources so invaluable?

Schizophrenia has been described as a psychosis – a severe, chronic and generally disabling brain and behavior disorder that affects how people think, feel and act. There are a number of subsets to this disorder: Paranoid schizophrenia, disorganized schizophrenia, catatonic schizophrenia, residual schizophrenia and schizoaffective disorder. People suffering from schizophrenia may hear voices others don’t hear or may believe that others are out to get them, to control their thoughts or harm them.

This can cause violent outbursts or those affected may simply stop speaking. They may begin to withdraw, to lose motivation in achieving goals and may lose interest in friends and family. Their memory and attention span may become affected, leading to the loss of ability to plan and organize. Day-to-day living may seem frightening and overwhelming to them, making leading a normal life a daunting task because this terror can make them unresponsive, agitated or withdrawn. Symptoms may be constant or intermittent, and those who do not understand the disease may perceive them as having “split” or multiple personalities. 

While schizophrenia is a chronic disorder, it can be treated with medication, psychological and social treatments, substantially improving the lives of people with the condition. Relapse and remission cycles often occur; a person can get better, worse and better again repeatedly over time, making stability and continued support a major concern.

Most mental health professionals agree that early diagnosis of schizophrenia may be key to successful therapy. Schizophrenia affects women and men equally, in all ethnic groups throughout the world. Symptoms such as hallucinations and delusions usually begin between the ages of 16 and 30. While men’s symptoms may start earlier than women’s, most people do not get this disorder after the age of 45. Children seldom manifest the symptoms, but awareness of childhood onset schizophrenia is increasing. Diagnosis in teens is difficult. The first signs can include behaviors that are not unusual in that age group: changing friendships, a drop in grades, problems with sleeping and irritability.

Different factors can predict schizophrenia in about 80 percent of youth who are at high risk of developing this illness. Symptoms include isolating oneself and withdrawal from others, unusual thoughts and suspicions and a family history of psychosis. A diagnosis is reached by observing the symptoms for six months. Two or more symptoms (hallucinations, delusions, disorganized speech, catatonic or grossly disorganized behavior) must last for at least one month, but bizarre delusions or consistent hallucinations can be another clear indicator. Drug screening will be done, to determine that this is not the cause, as will screening for other psychological disturbances (such as depressions) and family history will also be examined. Abnormal brain scans or blood chemical imbalances are now being researched to further understand genetic and environmental causes, in the hopes that better early diagnosis and intervention can decrease damage done to brains by recurring psychotic episodes. 

 It’s been observed that early signs in children may be difficult to detect because this disease is not as usual in young children as in adolescents. Affected children may not be able to distinguish dreams or television from reality, have invisible friends and may seem shy as they withdraw into their own little world, away from those who used to be their friends. Teachers are often the first people to notice these symptoms. Treatment of children combines medicine, individual and family therapy and specialized programs (e.g at school) to help them cope. Psychiatric medication may also help when monitored by a child and adolescent psychiatrist. 

The caregiver is key to the health of a person living with schizophrenia. Their care, support and stability are essential, along with medicine, therapy and interventions. A plan of care can be established involving work or school and relationship goals. Caregivers go to the doctor with their charges, keeping in contact with healthcare professionals and maintaining a daily routine at home. They help with daily activities, make sure the person is taking their medicine, watch carefully for worsening symptoms, discuss how to support the treatment plan and ensure a healthy lifestyle. With their help and by sticking to the treatment, schizophrenics can lead happy, fulfilling lives.

Support groups can also be invaluable for the caregiver and for those suffering from the disease. The National Alliance on Mental Illness (NAMI) hosts a Hearts and Minds program to offer support to families, recognizing their crucial benefit to recovery. Family-to-Family groups may be found in most states, in multiple languages. Part of rehabilitation involves making and achieving goals through psychiatric rehabilitation, to recover meaning and value through work, education, socialization and autonomy, eventually helping individuals live in independent housing and pursue education while getting training in relationships and social interaction. This is also where programs such as the Program for Assertive Community Treatment (PACT) may be of most benefit, if offered in your state.

If an individual shows signs of the threat of a relapse, a mental  health specialist who best knows the person can adjust medication, discuss coping strategies or suggest a change in the support system. Schizophrenia may be chronic, and there may not yet be a cure, but research, early diagnosis and treatment plus support and stability can be the best way to combat this condition.