Is Recovery from Schizophrenia Possible?

Schizophrenia is a neurodevelopmental disorder in which symptoms usually appear in late adolescence and early adulthood. Early warning signs include academic deterioration, reduced expression of emotion, and cognitive impairment. Eventually, some people with schizophrenia may lose touch with reality and experience hallucinations. A common question that families ask — is recovery from schizophrenia possible?

In the early 19^th century, Benedict Augustine Morel, a psychiatrist from France, introduced the term "schizophrenia" or premature dementia ("dementia praecox") — the disease was considered incurable. Persons with schizophrenia often come to the clinic with symptoms such as thought disorder, movement disorder, hallucinations, and delusions. They may also show symptoms such as a dull voice, loss of motivation, social withdrawal, and spending time in passive activities. Cognitive symptoms include difficulty learning new things due to inattention and poor memory.

Risk factors of schizophrenia include genetics and environmental causes, such as poverty and stressful surroundings. However, unlike in the 19^th century, today, patients with schizophrenia can manage their symptoms better to live meaningful lives. With a recovery-oriented approach, doctors and their care team can help patients support themselves. As a result, some people with schizophrenia can be gainfully employed and have fulfilling relationships.

Treatment options for schizophrenia

There are two types of treatments when it comes to schizophrenia. They include medications and psychosocial treatment.

Medications

Medical professionals prescribe medication to people with schizophrenia to help subdue and manage symptoms, such as delusional thoughts and hallucinations. The most commonly prescribed drugs are antipsychotics:

• First-generation antipsychotics. This group of drugs includes chlorpromazine, which acts non-selectively on D2 dopamine receptors in the brain. They relieve symptoms but can cause significant side effects such as increased prolactin and abnormal movements.
• Second-generation antipsychotics. These include clozapine, the drug of choice for treatment-resistant forms of schizophrenia.
• Third-generation antipsychotics. This next generation of medications includes drugs, such as aripiprazole, with minimal side effects. These are usually given as a subcutaneous injection, with their effect lasting up to four weeks.

Psychosocial treatments

In addition to pharmacological treatment, psychosocial treatment is needed to achieve the goals of recovery and adaptive adjustment. For increasing the social participation of individuals with schizophrenia, five different patient-centered approaches are recommended:

• Cognitive therapy. Includes therapies such as cognitive behavioral and cognitive remediation therapy.
• Family intervention. This intervention focuses on families only and excludes patients. It focuses on caregiving skills, stress reduction, and counseling.
• Psychoeducation. Families are provided support and education to help their loved one cope with the disease and achieve treatment compliance.
• Assertive community treatment. These treatments are specifically designed for individuals who may face multiple hospitalizations or homelessness.
• Social skills training. These approaches reduce the disease recurrence rates and help in managing symptoms in a better manner.

Can people with schizophrenia recover?

Researchers define recovery "as the complete absence of symptoms and a return to the pre-morbid level of personal, social, and occupational functioning." Most patients recover from acute episodes but may have relapses or recurrence of symptoms. Acute psychotic episodes in schizophrenia often require urgent medical intervention, including hospitalization or daycare. It aims to relieve psychiatric crises and restore the patient's normal function.

Once the patient is stabilized, a doctor may prescribe medication. However, because these medicines have side effects, many patients may skip them. Encourage your loved one with schizophrenia to take their medications regularly. Recovery from schizophrenia depends on several factors. For example, interpersonal factors include social support from peers and the community, whereas intrapersonal factors are aspects of self (e.g., intrinsic motivation or resilience). However, recent research noted that recovery treatment should focus on three areas: behavioral, cognitive, and social symptoms.

Behavioral treatment

Due to the lack of “clinical” insight, many patients with schizophrenia are unaware of their disease, which is linked to negative outcomes. When in denial of the disease, your loved one with schizophrenia may disregard medication. Family, or other cordial relationships, can help them adhere to their medication regimen. When patients with schizophrenia show compliance with medication and other treatments, gradual behavioral changes are more likely to occur.

Your loved one with schizophrenia can then set meaningful routines to improve self-care and develop social engagement when taking their medication as directed. Self-care includes activities of daily living, such as bathing and lifestyle changes. For example, while on antipsychotic drugs, doctors often recommend avoiding alcohol, nicotine, and drugs. Persons with schizophrenia also benefit from exercises that engage the mind and body (e.g., tai-chi or yoga).

Cognitive treatment

Cognitive impairment causes an interruption in problem-solving abilities, and people with schizophrenia feel dependent and victimized. A patient is said to be in cognitive recovery when developing feelings of autonomy, like being able to complete tasks independently. A common pitfall for family members is if persons with schizophrenia are treated like a child, then they may maintain behaviors like a child. A strong care team to design a cognitive plan that leads to autonomy is crucial for recovery.

Social treatment

When in social recovery, persons with schizophrenia have reduced stigma towards their illness and more insight. Some persons with schizophrenia join local support groups to develop social connections. As a result, they develop a sense of purpose, improve their current skill set, and maintain a vocation/career. These changes also help them build peer connections and engage in hobbies.

A comprehensive collaboration between psychiatrists, families, and individuals with schizophrenia is necessary to produce the most beneficial therapeutic approach and to treat schizophrenia effectively.

Supporting your loved one with schizophrenia

For persons with schizophrenia, their hallucinations are real to them. Your actions and reactions impact their behavior. Therefore, learning ways to conduct yourself to help eliminate conflict will help. Try incorporating the following techniques when dealing with your loved one with schizophrenia:

• Respond in a calm, honest, and reassuring manner.
• Help them to safety if they are trying to harm themselves or others.
• Staying in treatment may be difficult for some persons with schizophrenia, so encourage and help them to continue.
• Consider joining a local support group where you and your loved one with schizophrenia can seek information and emotional support.

By implementing a recovery-oriented approach, doctors and care teams can help persons with schizophrenia support themselves. Additionally, families play a crucial role in supporting persons with schizophrenia by promoting treatment and maintaining routines. Talk to your doctor about local or online support groups for yourself and your loved one with schizophrenia.