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When Schizophrenia Flares Up

Medically Reviewed by Smitha Bhandari, MD on February 26, 2021

If you or a loved one is living with schizophrenia, you know that the symptoms may worsen at times. While no one wants to think about being in crisis, it’s important to prepare for what you’ll do. Having a plan will let you quickly and safely get help.

Know the Signs

If your symptoms worsen, you could notice:

  • Depression
  • Anxiety
  • Short temper
  • Trouble sleeping
  • Lack of focus
  • No interest in friends or usual activities
  • A feeling that you can’t trust others
  • Strange speech patterns
  • Odd thoughts that won’t go away
  • Hallucinations -- seeing or hearing things that aren’t there

What to Do During an Episode

If you or a loved one feels a crisis is coming on, try to:

Distract yourself. You can watch TV, read, listen to music, video chat or text with someone you love, or do something active, like going for a bike ride. Everyone’s different, so you may need to try more than one thing before you find something that helps.

Get a reality check. When you have psychosis, it’s hard to figure out what’s real and what’s not. Find a person you trust who can be your “reality check.” As soon as you start to feel confused, reach out to them with your concerns.

Get space. You may feel more at ease in a peaceful, quiet setting. Some symptoms, like hallucinations, can get worse when you’re around a lot of people or noise.

Have a plan. When you’re feeling well, put together a list of ways you’d like support during a crisis. For instance, maybe you’d like a certain person to care for your children, your doctor to be called, or other steps to be taken so you can safely get through an episode.

Stay calm. While it can be hard to understand, realize that you won’t be able to reason or argue with someone who is in in crisis. Instead, let them know you support them. You might say something like, “I can only imagine how upset this must make you.” Be patient and keep your voice calm.

When to Get Help

Call your counselor or therapist as soon as you notice symptoms. If you don’t have one, make an urgent same-day appointment with your primary care doctor. Be honest about how you feel so you get the support that you need.

Many areas now have a local crisis line that lets you speak to counselors with special mental health training. Think about looking up this number in advance and adding it as a contact in your phone.

If you’re not sure who to call, the National Alliance on Mental Illness HelpLine (800-950-NAMI [6264]) provides free support to people living with mental health conditions and can connect you to nearby resources.

The National Suicide Prevention Lifeline (800-273-TALK [8255]) lets you speak to a trained crisis counselor 24 hours a day, 7 days a week.

If safety becomes a concern, you may need to call 911. Tell the operator it’s a mental health emergency and describe what’s going on. For instance, “My father hasn’t slept in 3 days and believes someone is talking to him through the TV.” Ask for police officers who are trained to assist with a crisis.

While some people choose to wear a medical bracelet or another form of ID, keep in mind that it may not be seen right away.

If schizophrenia makes it hard to maintain your home or manage day-to-day life, talk to your counselor or doctor about your options. You may find it helpful to live in a place that can support your needs.

WebMD Medical Reference

Sources

SOURCES:

Indian Journal of Psychiatry: “Early Intervention in Schizophrenia.”

Here to Help: “Dealing with Symptoms,” “Helping a Friend You’re Worried About.”

National Alliance on Mental Illness: “NAMI HelpLine,” “Navigating a Mental Health Crisis,” “Finding Stable Housing.”

British Columbia Schizophrenia Society: “Ulysses Agreement.”

Better Health Channel: “Housing and Accommodation Support for People with Mental Illness.”

Anaesthesia: “Medical identification or alert jewelry: an opportunity to save lives or an unreliable hindrance?”

Ken Duckworth, MD, chief medical officer, National Alliance on Mental Illness.

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