Living with - Schizophrenia

Most people with schizophrenia make a recovery. Many will have recurring symptoms from time to time. This is called a relapse.

With support and treatment, you may be able to manage your condition so it does not 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. 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 illness.

Signs 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 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 initial 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 another 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. Continuous medication can help prevent relapses.

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 community mental health team if you plan to take any over-the-counter remedies. For example, painkillers or nutritional supplements. These can sometimes interfere with your medicine.

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 regular physical activity, 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.

Your 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.

Your GP can help you to stop smoking. Talk to your GP or psychiatrist before you stop.

Get help to stop smoking

Avoid 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.

How alcohol affects your health and wellbeing

Drug information and support - drugs.ie

Who is available to help me?

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

Community mental health teams (CMHTs)

These teams provide local specialist mental health services. They can visit you at home.

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 your community mental health team.

Early intervention teams

Early intervention teams 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

This is an alternative to inpatient care in a hospital. 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 such as:

• helping you to find housing and work
• daily tasks like shopping and cooking

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

You should 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 community mental health team 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.

If you're unable to work as a result of your mental illness, you can get 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 can help individuals and families to:

• share experiences and coping strategies
• campaign for better services
• provide support for each other

Supporting people affected by mental health - shine.ie

Day centres

Even if you do not 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.

Day hospitals may only be available in some parts of the country.

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 a trained professional is available to support you. They can help you deal with day-to-day problems. Talk to your community mental health team to find out more.

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.

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 illness. Do not blame the person with schizophrenia or tell them to "pull themselves together".

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. Family therapy can help with information and support for you and your family.

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 a GP or community mental health team to arrange a mental health assessment for your relative. They will consider whether your relative should be kept in hospital.

You may also want to get support to cope with your own feelings. Several voluntary organisations provide 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 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:

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

Immediately report any suicidal thoughts to your GP or community mental health team.

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

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

Learn more about self-harm.

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 them know they're not alone and you care about them
• offer your support in finding other solutions to their problems

Supporting someone who might be suicidal

Organisations that provide mental health supports