Schizophrenia

Schizophrenia is an illness that can affect your ability to think clearly, manage your emotions, and interact with others. It affects each person differently.

Most people who have schizophrenia:

• Hear and sometimes see things that aren't there (hallucinations).
• Often believe certain things that aren't true (delusions).
• May think that some people are trying to harm them (paranoia).

Some people with schizophrenia have paranoid thinking. This causes you to have frightening thoughts, to believe that people or forces are trying to harm you, and to hear voices.

The way other people react to schizophrenia can make a difference in how it affects you.

Living with schizophrenia can bring many challenges. It changes your life and the lives of your family. But you can live a full and meaningful life if you get professional help and are willing to work at helping yourself. It's also very helpful to have the support and understanding of your family.

There are some common signs that can suggest that someone with schizophrenia may become violent. The person may:

• Talk about violence. This is especially true when the talk is directed toward specific people, groups of people, or places.
• Talk, write, or draw about death and violence.
• Have unexplained mood changes or behave in an aggressive or violent way.
• Buy or talk about having weapons or other means that could hurt or kill people.
• Not take responsibility for his or her actions, or say that the actions are justified.
• Drink alcohol or use illegal drugs more often.
• Have increased fears of other people (paranoia).
• Say that he or she hears voices telling him or her to hurt or kill another person.

Most people with schizophrenia aren't violent. But if violence is likely, they need help. Getting help is a way to protect the person or those around him or her.

Your doctor will ask you questions about your health and about any symptoms you may have had, such as hearing voices or having confusing thoughts. You'll have a physical exam.

Your doctor also may suggest tests to rule out other conditions with similar symptoms or to diagnose other schizophrenia disorders. These tests may include blood tests and a CT scan or an MRI. The CT scan or MRI will check the size, structure, and function of your brain.

Medicines can help treat your symptoms. And counseling and therapy help you change how you think about things and deal with the illness.

Recovery usually is a lifelong process. In the recovery process, you learn to cope with your symptoms and challenges, find and meet your goals, and get the support you need.

The goals of treatment and recovery are to:

• Reduce or stop symptoms.
• Reduce the number of relapses.
• Make a personal plan for your recovery by setting and meeting goals for home, work, and relationships.

If medicine and therapy aren't helping you, your doctor may suggest electroconvulsive therapy (ECT). In this procedure, your doctor uses electricity to create a brief and mild seizure. This may change your brain chemistry and help your symptoms.

If you struggle with alcohol, drugs, or tobacco or have other mental health problems, such as depression, you will need to treat these problems too.

Take your medicine

• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• If you are having trouble taking your medicines or feel you don't need to take them, talk to your doctor. Your doctor may be able to change the medicine or the amount you take.

Ask about long-acting medicines

• Ask your doctor about long-acting medicines that are injected (shots). You get a shot every week or every few weeks. This may be a good choice because:
  • You have a set day and time to get the shot.
  • If you don't show up for your shot, your doctor knows right away.
  • The medicine stays in your body longer. If you are a little late for a shot, you have more time to get help before your symptoms return.
  • You are not reminded every day that you have a mental health problem.
  • You don't have to carry pills with you.

Have a routine

• Make a schedule for taking your medicines. Follow it every day.
• Identify things you do every day at the same time, such as brushing your teeth. Use these activities to help remind you to take your medicines.
• Set your watch alarm or a kitchen timer to remind you when to take your medicines. Or ask a family member to help you remember to take your medicines.

Use a pillbox

• Use a plastic pillbox with dividers for each day's medicines. It can have a few or many compartments. Some have timers you can program. Choose one that fits your needs.
• Put your pillbox in a place where it will remind you to take your medicines. For example, if you need to take medicine 3 times a day with meals, put those medicines in a pillbox near where you eat.
• Keep one pill in its original bottle. Then if you forget what a pill is for, you can find the bottle it came from.

Know how to get help

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

People who have schizophrenia sometimes have to spend time in the hospital. This can be because of severe symptoms or for other reasons.

You may have to go to the hospital if:

• You're having a psychotic episode. This means that you can't tell the difference between what is real and what isn't real.
• You talk about suicide or hurting yourself or others.
• You have severe medicine side effects, such as tardive dyskinesia.
• You need special tests.
• You need to change or adjust your medicines.
• You have problems with drugs or alcohol.
• You need a special medical procedure, such as electroconvulsive therapy (ECT).

Doctors will try to find the best way to get you back to your family and community as soon as possible.

For the caregiver

Sometimes people who have schizophrenia are too sick to seek treatment on their own. If the symptoms are severe, you may have to force the person to get treatment.

Talk with your health care providers and/or local law enforcement officials about the laws and procedures in your area for getting treatment in this situation. You'll need to think about your loved one's legal rights. States have laws that protect people who have mental health problems from being forced to go to a hospital or get treatment. These laws are different in each state. Having this information ahead of time can help ease your fears and concerns and may make it easier for you.

Working with a mental health care expert and putting your loved one into a hospital may not be an easy thing to do. But it might be the only thing you can do to prevent your loved one from harming himself or herself or others. In the hospital, your loved one will get treatment to help relieve symptoms and ease the danger.