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."
Jewell says 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.”
For example, therapy can help patients learn to ignore the voices they may be hearing, Jewell says. Counseling should also address substance abuse and social withdrawal, which are common problems for people with schizophrenia.
Train the Brain
Antipsychotic medications are very effective at reducing hallucinations and delusions but do little to improve concentration and memory. Researchers are still looking for the right medications to fight these symptoms, Harvey says. In the meantime, patients may benefit from cognitive remediation therapy or "brain training."
"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 a 2012 study published in The American Journal of Psychiatry, people with schizophrenia got cognitive therapy, life skills training, or a combination of the two. Those who received both showed the greatest improvements in real-world functioning at home and at work. They learned money management skills, how to use public transportation, and social skills.
Reduce the Odds of Relapse
Relapses can be stressful for patients and family members. There are proactive ways to reduce relapse.
- Stick with therapy.
- 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.
- Don’t skip medications; stay on the exact dose prescribed by the doctor (usually the lowest needed to control symptoms).
Sometimes people with schizophrenia feel like they are recovered from the illness or do not want medicine. Stopping medication is a major cause of relapse. In cases like these, Harvey suggests using long-acting, injectable medications that are given once every 2-4 weeks. "These have a very low relapse rate," he says. While doctors or family members may not know right away if a patient stops taking pills, they can respond immediately if a patient doesn't show up for an injection.
If a loved one shows signs of a relapse, Jewell recommends handling the situation carefully. "You can't argue [patients] out of a delusion -- telling them they're wrong will just create tension," he warns. "But you shouldn't tell them they're right, either. You find a way to offer support" and get them back into treatment as quickly as possible.