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Schizophrenia: Treatment and Care Options


Unusual changes in your behavior, thoughts, or emotions are symptoms of schizophrenia. If you have noticed any of these differences, make an appointment to see your physician, who will perform a psychological and medical exam, or refer you to a psychiatrist who can determine whether an at-home or an inpatient setting is most appropriate.

A doctor will ask for the history of family members who may have similar symptoms or have been diagnosed with schizophrenia. Healthcare professionals will want to know if a family member has ever been hospitalized and details about recent behaviors. While a schizophrenia diagnosis may seem grim, many treatment options and resources are available.

Schizophrenia symptoms

The psychiatrist can give an official diagnosis of schizophrenia by looking at specific criteria. To be diagnosed with schizophrenia, a person must demonstrate the following symptoms persistently in the context of reduced functioning:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms

To be diagnosed with schizophrenia, someone must show at least 2 of the above symptoms for a month with some mental disturbance for over 6 months.

Schizophrenia is difficult to diagnose since there is no single physical or lab test for it. Your healthcare provider may perform a urine or blood test to rule out drug or alcohol abuse. A doctor will look at how an individual has functioned over the last 6 months to help with the assessment and to rule out other medical problems like a brain tumor or another psychiatric condition such as bipolar disorder.

When does schizophrenia occur?

The average onset age of schizophrenia tends to occur in the teen or early 20s for men and early 20s to 30s for women; however, it can develop at any age. It is rare in children under 12 and adults over 40. Teens' symptoms may present much differently than adults. Failing grades, sleep difficulties, withdrawal, unusual thoughts and suspicions, depression, trouble concentrating, and aggression may be present. This is called the “prodromal” period.

Treatment

It is important to identify schizophrenia as early as possible as it significantly improves recovery and management of the disease. Hospital admission occurs less frequently with early identification. Psychotherapy is essential early in treatment as it may help normalize thought patterns and teach coping skills for stress management. It may also assist in identifying warning signs of a potential relapse early on. Schizophrenia requires lifelong treatment.

There is no cure, but you can learn to manage your symptoms and have a purposeful and enjoyable life. Someone with schizophrenia will work with several trained professionals throughout their treatment, potentially including a:

  • Psychiatrist
  • Psychotherapist
  • Psychologist
  • Psychiatric nurse
  • Clinical social worker
  • Psychiatric occupational therapist
  • Case manager

Medication is essential to treating schizophrenia, and the goal is to achieve the lowest dosage necessary to control symptoms. A psychiatrist may try different medications and doses to achieve an effective result. It may take several weeks for the drugs to reach their maximum benefit. Because of drug side effects, there is a reluctance to take them, so consult your physician and avoid making any changes on your own.

Some first-generation antipsychotic medications include Chlorpromazine, Fluphenazine, Haloperidol, and Perphenazine. They may have neurological side effects such as tardive dyskinesia characterized by involuntary movements of the face or jaw (chewing movements, tongue darting, eye blinking) or the body (toe-tapping, arms flapping). Report such symptoms to your doctor. It may or may not be reversible; there are some medications to control it. The positive to these medications is that they may be less expensive than the more current second-generation antipsychotics.

Second-generation antipsychotic medications are preferred because they have fewer neurological side effects than first-generation. However, they generally cost more. Second-generation antipsychotics include Abilify, Rexulti, Vraylar, Clozaril, Latuda, Zyprexa, and Seroquel, to name a few.

Common side effects of second-generation medications include:

  • Weight gain
  • High cholesterol
  • High blood pressure
  • Hyperglycemia (high blood sugar)

How to take care of yourself

If you have schizophrenia, there are several steps you can take to help take care of yourself throughout your treatment process. These include:

  • Get involved in your treatment plan.
  • Take your medications. Do not discontinue them when you start to feel better and avoid making changes without first speaking to your team of doctors.
  • Educate yourself. Learn more about schizophrenia, and stay in contact with your treating physician and other team members.
  • Get involved in additional therapies. Consider psychotherapy, family therapy, and a support group where you can improve your interactions with others, manage your symptoms, and improve your participation in daily activities.
  • Use available resources to help prepare for your future. You may consider returning to work, or receiving vocational rehabilitation and supported employment training to prepare you for employment and finding and keeping a job.

Finding support

All of this will also help you develop a strong support system. But the first step is accepting your illness. Although being diagnosed with schizophrenia is very upsetting, it is the first step in recovery. It will enable you to take an active role in your treatment, which may include making healthy lifestyle changes, taking prescribed medications, and being vigilant about attending all your medical and mental health appointments. Follow your doctor's recommendations, and be upfront about any side effects, treatment concerns, and other issues you are experiencing.

Ignore the stigma of schizophrenia. Many people fear schizophrenia, and their fears are baseless. Only associate with people who accept you the way you are. Join the National Alliance on Mental Illness (NAMI), a national organization with local chapters devoted to the provision of educational and support groups and aims to destigmatize mental illnesses including schizophrenia.

Set meaningful life goals such as:

  • Work out at least 3 days a week, aiming for 150 minutes of weekly activity.
  • Relieve stress by participating in muscle relaxation techniques daily for 15 minutes.
  • Join and attend a local church one day a week.
  • Take up a new hobby like volunteering at an agency that helps animals or people, or an organization that has a cause you believe in.
  • Eat a healthy, well-balanced diet by decreasing sugar and refined carbohydrates and increasing your intake of omega-3 fatty acids from fatty fish, fish oil, walnuts, and flaxseed.
  • Live at home with supportive family members if possible, or look for an environment that makes you feel safe. Your living situation should provide stability and enable you to follow your treatment plan.
  • Attend a support group once a week.

There is no cure for schizophrenia, but it is successfully treatable. Life can be normal, and you may become symptom-free. Stick to your treatment plan. Don’t be afraid to be with others and rejoin the community.

References:

Healthy Barrington. Schizophrenia.

Very Well Health (2022). Early Signs and Symptoms of Schizophrenia.

WebMD. Schizophrenia Diagnosis & Tests: How Doctors Know If Someone Has It.

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