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    When Schizophrenia Appears

    Experts offer guidance for newly diagnosed patients and their families

    Find a Qualified Therapist

    "Medication is always emphasized, but it's only one piece of the puzzle," Jewell says. It’s important to find a therapist who specializes in schizophrenia, especially when someone doesn’t want treatment.

    "Patients don't understand that they've been sick or what has to be done about it. This makes it hard to keep them motivated to stay in treatment. Counseling can help."

    Effective therapy teaches patients and families about the illness -- "what can make it worse, what can make it better, and how to deal with hallucinations,” Jewell says.

    For example, therapy can help patients learn to ignore voices they hear. Counseling should also address substance abuse and social withdrawal, which are common problems for people with schizophrenia.

    Train the Brain

    Antipsychotic medications are effective at reducing hallucinations and delusions. But they do little to improve concentration and memory.

    Researchers are still looking for the right medications to fight these symptoms, Harvey says. In the meantime, cognitive remediation therapy or "brain training” may help.

    "These are exercises that are designed to train your brain -- to force you to use skills you might not be using,” Harvey says. They expand working memory and improve processing speed. "These interventions actually do work."

    In one study, people with schizophrenia got cognitive therapy, life skills training, or a combination of the two. Those who received both improved the most in functioning at home and at work. They learned money management skills, how to use public transportation, and social skills.

    Help Prevent a Relapse

    Three keys are:

    1. Stick with therapy.
    2. Keep stress levels low. "The tools most of us use on a daily basis to manage stress are just as relevant for someone with schizophrenia," Jewell says.
    3. Don’t skip medications. Stay on the exact dose prescribed by the doctor, which is usually the lowest needed to control symptoms.

    Sometimes, people with schizophrenia feel like they have recovered from the illness or do not want medicine. Stopping medication is a major reason their symptoms start back up.

    In cases like these, Harvey suggests using long-acting, injectable medications that the patient gets every 2-4 weeks. "These have a very low relapse rate," he says.

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