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Schizophrenia - Living with

Most people with schizophrenia make a recovery. Many will experience a return of symptoms from time to time. This is called a relapse. 

With support and treatment, you may be able to manage your condition so it doesn't have a big impact on your life.

Caring for your own health can also make treating your condition easier. It can also help reduce anxiety, depression and fatigue. It can help you have a better quality of life and be more active and independent.

Self-care includes:

  • maintaining good physical and mental health
  • preventing illness or accidents
  • dealing with minor ailments and long-term conditions

You'll be in regular contact with your healthcare team. You can discuss your symptoms and concerns with them. The more they know, the more they can help you.

Spotting the signs of an acute schizophrenic episode

Learn to recognise the signs that you're becoming unwell. This can help you manage your illness.

These can include

  • losing your appetite
  • feeling anxious or stressed
  • having disturbed sleep.

You may also notice some milder symptoms developing, such as:

  • feeling suspicious or fearful
  • worrying about people's motives
  • hearing quiet voices now and again
  • finding it difficult to concentrate

You may also want to ask someone you trust to tell you if they notice your behaviour changing.

Recognising the initial signs of an acute schizophrenic episode can be useful. It may be prevented through the use of antipsychotic medicines and extra support.

If you have another acute episode of schizophrenia, follow your care plan. Particularly any advance statement or crisis plan.

Your care plan will include the likely signs of a developing relapse and the steps to take. It will include emergency contact numbers.

Taking your medication

It's important to take your medication as prescribed, even if you start to feel better. Continuous medication can help prevent relapses.

If you have any concerns about your medication or side effects, talk to your GP or care coordinator.

Read the information leaflet that comes with the medication. This will have information about interactions with other drugs or supplements.

Check with your healthcare team if you plan to take any over-the-counter remedies. For example, painkillers or nutritional supplements. These can sometimes interfere with your medication.

Healthy living

Keep healthy

Your healthcare team and GP will monitor your mental and physical health.

A balanced diet with lots of fruits and vegetables, and taking regular exercise, is good for you. It can reduce your risk of developing cardiovascular disease or diabetes. You should also try to avoid stress and get enough sleep.

Have a check-up with your GP at least once a year. This will monitor your risk of developing cardiovascular disease or diabetes.

The GP will:

  • record your weight
  • check your blood pressure
  • take any necessary blood tests

Stop smoking

If you're a smoker, you're at a higher risk of developing cancer, heart disease and stroke.

Stopping smoking has clear physical health benefits. It also improves the mental health of people with schizophrenia.

You're up to 4 times more likely to quit smoking if you use support, as well as stop smoking medicines. For example, patches, gum or inhalators.

Ask your GP about this or go to QUIT.ie for more support. You should talk to your GP or psychiatrist before you stop.

Avoiding drugs and alcohol

Alcohol and drugs may provide short-term relief from your symptoms. But they're likely to make your symptoms worse in the long run.

Alcohol can cause depression and psychosis. Illegal drugs may make your schizophrenia worse. Drugs and alcohol can also react badly with antipsychotic medicines.

If you're currently using drugs or alcohol and finding it hard to stop, ask your care coordinator or GP for help.

Visit askaboutalcohol.ie

Who is available to help me?

During your treatment, you'll be involved with many different services. You will need a referral from your GP for some and your local authority for others.

Community mental health teams (CMHTs)

These provide the main part of local specialist mental health services.

They offer:

  • assessment
  • treatment
  • social care

Trained peer support

This involves support if you have had schizophrenia and are now stable. It may be available through your community mental health team.

Early intervention teams

They provide early identification and treatment if you have the first symptoms of psychosis. Your GP may be able to refer you directly to an early intervention team.

Acute day hospitals

An alternative to inpatient care in a hospital, where you can visit every day or as often as necessary

Assertive outreach teams

These teams deliver intensive treatment and rehabilitation in the community. They will work with you if you have a severe mental health problem. They provide rapid help in a crisis situation.

Staff often visit people at home and act as advocates. They work with other services, such as your GP or social services.

They can also help with practical problems. For example, helping to find housing and work and daily tasks like shopping and cooking.

Advocates

Trained and experienced workers who:

  • help people communicate their needs or wishes
  • get impartial information
  • represent their views to other people

Advocates can be based in your hospital or mental health support groups. You can also find an independent advocate to act on your behalf.

Employment and financial support

Avoid too much stress, including work-related stress. If you're employed, you may be able to work shorter hours or in a more flexible way. Several organisations provide support, training and advice if you wish to continue working.

Your community mental health team is a good first point of contact. They can help you to find out what services and support are available for you.

If you're unable to work as a result of your mental illness, you're entitled to financial support. For example, disability allowance.

Talk to others

You may find it helpful to meet other people with the same experiences. This can be for mutual support and to share ideas. It's also an important reminder that you're not alone.

Charities and support groups allow individuals and families to:

share experiences and coping strategies
campaign for better services
provide support

Shine - supporting people affected by mental health 

Day centres

Even if you don't have a job or are unable to work, it's still important to go out and do things. This gives a structure to your week.

Many people regularly go to a day hospital, day centre or community mental health centre. These offer a range of activities that allow you to get active again and spend time in the company of others.

Work projects

These provide training to help you develop your work skills and support you back into work. They often have contacts with local employers.

Supported accommodation

This could be a bedsit or flat where there's someone around who is trained to support you. They can help you deal with day-to-day problems.

Peer support

You may get the chance to meet regularly with a trained peer support worker. They may have recovered from psychosis or schizophrenia themselves.

What can family, friends and partners do to help?

Friends, relatives and partners have a big role in helping people recover. They may make a relapse less likely.

Don't blame the person with schizophrenia or tell them to "pull themselves together". Stay positive and supportive when dealing with a friend or loved one's mental illness.

You may also want to get support to cope with your own feelings. Several voluntary organisations provide help and support for carers.

Friends and family should try to understand what schizophrenia is. They should learn how it affects people. You can provide emotional and practical support by encouraging treatment and support.

Family therapy may be part of treatment. This involves information and support for you and your family.

Friends and family can play a major role by:

  • monitoring the person's mental state
  • watching out for any signs of relapse
  • encouraging them to take their medication and attend medical appointments.

If you're the nearest relative of a person who has schizophrenia, you have certain rights. These can be used to protect the patient's interests.

You can ask social services to request a mental health assessment for your relative. They will consider whether your relative should be detained in hospital. 

Depression and suicide

Many people with schizophrenia experience periods of depression. Don't ignore these symptoms. If depression isn't treated, it can worsen and lead to suicidal thoughts.

Studies have shown people with schizophrenia are at an increased risk of suicide.

Speak to your GP for advice and treatment if you:

  • have been feeling particularly down over the last month
  • no longer take pleasure in the things you used to enjoy
  • feel depressed

Immediately report any suicidal thoughts to your GP or care coordinator.

The warning signs of suicide

The are a number of warning signs that someone may be considering suicide.

Making final arrangements

Giving away possessions, making a will or saying goodbye to friends.

Talking about death or suicide

This may be a direct statement such as "I wish I was dead".

There may be indirect phrases such as "Wouldn't it be nice to go to sleep and never wake up?"

Self-harm

Cutting their arms or legs, or burning themselves with cigarettes.

Sudden lifting of mood

This could mean a person has decided to try to end their life and feels better because of their decision.

Helping a suicidal friend or relative

If you see any of these warning signs:

  • get professional help - a crisis resolution team or the duty psychiatrist at your local ED
  • let them know they're not alone and you care about them
  • offer your support in finding other solutions to their problems

If there's an immediate danger, stay with them or have someone else stay with them. Remove all available means of suicide, such as sharp objects and medication.

Content supplied by the NHS and adapted for Ireland by the HSE.

page last reviewed: 15/03/2019
next review due: 15/03/2022

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