Most people with schizophrenia make a recovery. Many will have symptoms that return from time to time. This is called a relapse.
With support and treatment, you may be able to manage schizophrenia so it does not have a big impact on your life.
Caring for your own health can also make treating schizophrenia easier. It can also help reduce anxiety, depression and fatigue. This 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 illnesses 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 psychotic episode
If you have schizophrenia and are experiencing a relapse, this is usually in the form of an acute psychotic episode.
You can learn to recognise the signs that you're becoming unwell. This can help you manage your episodes.
Signs can include:
- feeling anxious or stressed
- having disturbed sleep
You may also notice some other symptoms developing, such as:
- feeling suspicious or fearful
- worrying about people's motives
- hearing voices that are not there
- 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 early signs of an acute psychotic episode can be useful. It may be prevented through the use of antipsychotic medicines and extra support.
If you have an acute psychotic episode, follow your care 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 medicines
It's important to take your medicines as prescribed, even if you start to feel better. You can help prevent relapses by staying on your medicines.
If you have any concerns about your medicines or side effects, talk to your GP or community mental health team (CMHT).
Read the information leaflet that comes with the medicines. This will have information about interactions with other drugs or supplements.
Check with your CMHT if you plan to take any remedies you buy without a prescription. For example, painkillers or nutritional supplements. These can sometimes interfere with your medicine.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Healthy living
Your healthcare team and GP will monitor your mental and physical health.
It's important to have a balanced diet with lots of fruits and vegetables, and regular physical activity. This 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.
Your GP may:
- record your weight
- check your blood pressure
- do blood tests
Get help to quit smoking
If you're a smoker, you have a higher risk of developing cancer, heart disease and stroke.
Stopping smoking has clear physical health benefits.
Your GP can help you to stop smoking. Talk to your GP or psychiatrist before you stop.
Avoid drugs and alcohol
Alcohol and drugs may give you 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. 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 GP or CMHT for help.
How alcohol affects your health and wellbeing
Drug information and support - drugs.ie
Getting help
During your treatment, you'll visit many different mental health services.
Community mental health teams (CMHTs)
These teams provide local specialist mental health services.
They offer:
- assessment
- treatment
- social care
Trained peer support
Peer support is available if you have had schizophrenia and are now stable. You can get it through some CMHTs, or refer yourself.
Early intervention teams
Early intervention teams provide assessment and treatment if you have the first symptoms of schizophrenia. Your GP may be able to refer you directly to an early intervention team.
Acute day hospitals
Instead of staying in hospital (as an inpatient) there are day hospitals you go to during the day. You can go there every day or as often as you need.
Assertive outreach teams
These teams deliver intensive treatment and rehabilitation in your local area. They will work with you if you have a severe mental health difficulty. They provide rapid help in a crisis situation.
Staff often visit people at home and act as advocates (speak for you with your permission). They work with other services, such as your GP or social services.
They can also help with practical difficulties such as:
- helping you to find housing and work
- daily tasks like shopping and cooking
Assertive outreach services may only be available in certain regions.
Advocates
These are trained workers who help you communicate your needs and views to other people, such as your family or social services. They can also help you get impartial (unbiased) information about your situation.
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
It's important to avoid too much stress. This includes work-related stress.
If you're employed, you may be able to work shorter hours or in a more flexible way. Several organisations give support, training and advice if you wish to continue working.
Your CMHT is a good first point of contact. They can tell you what services and support are available. They can also help you contact local employment support services.
Pay and benefits
If you have a job but cannot work because you have schizophrenia, you may be entitled to sick pay from your employer.
Sick leave and sick pay - citizensinformation.ie
You may be entitled to benefits if you:
- do not have a job
- cannot work because of your schizophrenia
Benefits for people who are sick or have a disability - citizensinformation.ie
Health, disability and illness supports - mywelfare.ie
Occupational therapy
If you are getting treatment for schizophrenia you may be referred to an occupational therapist (OT).
Your OT will help you participate in meaningful activities of everyday life.
They will work with you to improve your day-to-day life in your workplace, school or home.
Talking to other people with schizophrenia
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.
Shine
Shine specialises in supporting people who experience psychosis and schizophrenia.
They offer supports that can help individuals and families to:
- share experiences and coping strategies
- campaign for better services
- provide support for each other
Getting help from family, friends and partners
Friends, relatives and partners have a big role in helping people recover. They can help make a relapse less likely.
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 medicine and attend medical appointments
Tips for family, friends and partners
Stay positive and supportive when dealing with a friend or loved one's mental health difficulties. Do not blame the person with schizophrenia or tell them to "pull themselves together".
Friends and family should try to understand what schizophrenia is and how it affects people. You can give emotional and practical support by encouraging treatment and support.
Family support may be part of treatment. This can help with information and support for you and your family.
You may also want to get support to cope with your own feelings. Find out about help and support for carers.
What to say to someone who is going through a tough time
Depression and suicide
Many people with schizophrenia experience periods of depression. Do not ignore these symptoms. If depression is not treated, it can worsen and lead to thoughts of suicide.
Studies have shown people with schizophrenia have at an increased risk of suicide.
Talk to your GP for advice and treatment if you:
- feel depressed
- have been feeling particularly low or down over the last month
- no longer take pleasure in the things you used to enjoy
Immediately report any thoughts of suicide to your GP or CMHT.
Warning signs of suicide
There 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".
It may also be an indirect phrase such as "Wouldn't it be nice to go to sleep and never wake up?"
Self-harm
Self-harm is when somebody damages or injures their body intentionally (on purpose). It's a way of coping with or expressing emotional distress.
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 you should:
- get professional help from mental health services
- let the person know they're not alone and you care about them
- offer your support in finding other solutions to their difficulties
Urgent advice: Phone 112 or 999 if:
- you or someone you know is at immediate risk of harming themselves, or another person
Stay with them or have someone else stay with them.
Remove any items or medicines around the person that they may use to harm themselves.
Content supplied by the NHS and adapted for Ireland by the HSE