Schizophrenia is a chronic disease. The symptoms of schizophrenia affect many of your thoughts, feelings and behaviors. The severity of these symptoms can fluctuate, and even someone who is quite ill can sometimes feel and appear normal, even without medication. This remission of symptoms does not mean the illness has gone away.
Modern antipsychotic medications greatly reduce both the severity of your symptoms and the amount of time you spend experiencing active symptoms. Nevertheless, you should plan for times of remission and times of relapse. Even in remission, your residual symptoms (the symptoms you continue to have even when you’re relatively well) will effect all aspects of your life.
Your illness probably means that you’ll need more support than most people. It’s important for you, with the help of your doctor, social workers and loved ones, to figure out what kinds of supports you need, and then put those supports in place. Depending on the severity of your illness, you may have trouble with important skills, like:
- Focusing and maintaining attention
- Remembering appointments, meetings, or past conversations
- Having energy and motivation to do normal activities
- Feeling hopeful or optimistic to try or do new things
- Perceiving and interpreting social cues and facial expressions accurately
- Engaging in conversation in ways that other people expect
- Behaving socially in ways that other people expect
- Overcoming social shyness and fear of being rejected
It’s very important for you to plan ahead, when you feel relatively well, for times when you may start to become ill again. Schizophrenia makes it difficult for you to recognize signs of illness in yourself, so you’ll need to rely on feedback from other people that your behavior is changing. People you can ask to watch for changes include:
- People who live with you
- Doctors or social workers you see regularly
- People who work with you or go to school with you
- Family members
When you decide who can look out for you, give them your doctor’s phone number, and also give your doctor a list of the people who may call about you. Your doctor or social worker will not give anyone information about you (your rights to privacy are protected by strong federal laws), but they can listen to the information that these people provide.
Educate these people around what kinds of changes to look for. Because you may have trouble with some of these areas even when you’re relatively healthy, they should watch for changes in your behavior. For example, you may continue to hear voices even when well, but usually understand that they aren’t real; however, you want your helpers to call your doctor if they notice you begin to talk back to the voices or to be upset by them.
Important changes might include:
- Having a harder time getting up in the morning
- Being late to work or school
- Seeing more spacey or easily distracted than normal
- Seeming less happy, or less emotional in general
- Seeming more irritable or agitated
- Memory worse than usual, or having more difficulty with mental tasks like arithmetic
- Becoming more reactive to hallucinations
- Talking obsessively about a topic that seems strange or delusional
If you seek help from you doctor or social worker as soon as these changes occur, a temporary change in medication can prevent a full-blown relapse. Often, you’ll be able to go back to the previous dose after the crisis has passed, or your doctor may change your medications to something that will work better for you.