How to Minimize Symptoms of Schizophrenia

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1Getting Proper Diagnosis

2Finding the Right Medication

3Getting Support

4Making Healthy Lifestyle Choices

5Treating Schizophrenia Using Therapy

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Schizophrenia is a chronic brain disorder characterized by the presence and absence of particular symptoms. Positive symptoms present in schizophrenia include cognitive issues/disorganized thinking, and the experience of delusions or hallucinations. Negative symptoms include the apparent absence of emotional expression. A combination of medication, support services and therapy is the most effective way to minimize schizophrenia symptoms.

Steps

Method 1

Method 1 of 5:

Getting Proper Diagnosis

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   See a medical professional. Proper diagnosis of schizophrenia is essential to treating its symptoms. Schizophrenia is difficult to properly diagnose, because it shares qualities with a number of other mental health conditions. Ask your primary care physician for a referral to a psychiatrist, psychologist or other specialist who may be able to provide proper diagnosis.

   • Average age of onset for schizophrenia is late teens to the early 20s for men, and late 20s to early 30s for women. Schizophrenia is rarely diagnosed in children younger than 12, or in adults over the age of 40.
   • It's difficult to diagnosis schizophrenia in teenagers. This is because the first signs of the illness include behaviors common among teens – avoiding friends, showing less interest in schoolwork, sleep problems and irritability.
   • Schizophrenia is a highly genetic condition. If you have a relative with schizophrenia, your chances of being diagnosed with the disorder are higher than for the typical population.
   • African-Americans and Hispanic people may be more likely to be misdiagnosed. Try to find a health care provider who understands the way schizophrenia affects minority communities to ensure best treatment options.
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   Learn the symptoms of schizophrenia. To be diagnosed with schizophrenia, a person doesn't need to have all of its symptoms. He must demonstrate at least two of these symptoms over a period of time. The symptoms must have a noticeable impact on the person's ability to function, and not be better explained by another cause, such as drug use.

   • Delusions or hallucinations are the symptom most commonly associated with schizophrenia. Hallucinations can be either auditory or visual. These symptoms are often associated with psychotic episodes.
   • Disorganized speech is a function of a person's cognitive disorganization. The person may be difficult to understand, not be able to stay on a topic, or respond in ways that are confusing and irrational. He may use imaginary words, or speak in an entirely made-up language.
   • Disorganized behavior reflects the person's temporary loss of cognitive functioning due to schizophrenia. He may have difficulty completing a task, or persevere on a task beyond ordinary expectations.
   • Catatonic behavior can also be a symptom of schizophrenia. The person may sit for hours without speaking. He may appear unaware of his surroundings.
   • Negative symptoms of schizophrenia are often mistaken for depression. They include a lack of emotional expression, lack of pleasure in everyday activities, and/or talking less.
   • Many times, the person with schizophrenia is not troubled by these symptoms, resulting in resistance to treatment.
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   Recognize that you might not be the best judge of your symptoms. One of the most challenging characteristics of schizophrenia is the difficulty in recognizing delusional thinking. Your thoughts, ideas, and perceptions may seem perfectly normal to you, while appearing delusional to others. This is often the source of a great deal of tension between the person with schizophrenia and his family and community.

   • Almost half of all people diagnosed with schizophrenia have difficulty recognizing their delusional thinking. Therapy should address this lack of insight.
   • Learning to ask for help handling troubling or worrisome perceptions and other symptoms is central to living well with schizophrenia.
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Method 2

Method 2 of 5:

Finding the Right Medication

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   Ask your doctor about antipsychotic medication. Antipsychotic medication has been used in treating the symptoms of schizophrenia since the mid-1950s. Older antipsychotics, sometimes called typical antipsychotics or 1st generation antipsychotics, work by blocking a specific subtype of dopamine receptor in the brain. Newer antipsychotics, also called atypical antipsychotics, block the receptor as well as a specific serotonin receptor.

   • 1st generation antipsychotics include such medication as chlorpromazine, haloperidol, trifluoperazine, perphenazine and fluphenazine.
   • 2nd generation antipsychotics include clozapine, risperidone, olanzapine, quetiapine, paliperidone and ziprasidone.
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   Watch for undesirable side effects. Antipsychotic medications often have significant side effects. Many side effects will go away after a few days. Side effects include blurred vision, drowsiness, sensitivity to the sun, skin rashes, and weight gain. Women may experience menstrual problems.

   • It may take a while to find the medication that works best for you. Your doctor may want to try different doses, and combinations, of medication. No two people respond in exactly the same way to medication.
   • Clozapine (Clozaril) can result in a condition called agranulocytosis, which is a loss of the white blood cells. If your doctor prescribes clozapine, you will need to get your blood checked every week or two.
   • Weight gain from antipsychotic medication may result in diabetes and/or high cholesterol.
   • Long-term use of 1st generation antipsychotics may result in a condition known as tardive dyskinesia (TD). TD causes involuntary muscle spasms, usually around the mouth.
   • Other side effects from antipsychotic medication include rigidity, tremors, muscle spasms and restlessness. Talk to your doctor if you are experiencing these side effects.
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   Remember that medication is only one treatment for your symptoms. Despite the importance of taking medication to treat the symptoms of schizophrenia, medication by itself does not cure schizophrenia. It is only one tool used to help minimize the symptoms. Psychosocial interventions such as individual therapy, social skills training, vocational rehabilitation, supported employment, and therapy for your family can also help to manage your condition.

   • Be proactive in seeking additional information about treatment options that may work together with medication to minimize your symptoms.
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   Be patient. Medications may take days, weeks, or even longer to become truly effective. While most people may see good results after taking medication for six weeks, others may not see good results for several months.

   • If you don't start seeing improvement after six weeks, check with your doctor. You may benefit from a higher or lower dosage, or a different medication.
   • Never stop taking antipsychotic medication abruptly. If you choose to discontinue taking medication, do so under a doctor's guidance.
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Method 3

Method 3 of 5:

Getting Support

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   Talk to your doctor honestly. Having a strong support system is one of the primary factors for successful treatment of schizophrenia. A good support team may consist of mental health professionals, family members, and personal friends and peers who share the diagnosis.

   • Talk to trusted friends and family members about your symptoms. They may help you navigate mental health care systems to get the treatment you need.
   • Many times, maintaining stable, consistent housing is difficult for people with schizophrenia. If staying with your family is an option during stressful times, consider allowing your family to care for you until your symptoms improve.
   • Housing options, such as group homes or supported living apartments, support people with schizophrenia. The availability of such homes varies widely from state to state. Check with your local National Alliance for Mental Health (NAMI) chapter or other mental health professionals to learn more about these services.
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   Communicate with your doctor or treatment provider. Having good, honest communication with a mental health professional will allow you to receive the best level of treatment they can provide. Being honest with your doctor about your symptoms will ensure that you're getting the right dosage of medication, neither too much nor too little.

   • You can always seek out a second opinion, if you feel that your doctor isn't responsive to your needs. Never discontinue medical treatment without having a back-up plan.
   • Check in with your doctor regarding any questions you may have regarding treatment issues, medication side-effects, persistent symptoms, or other concerns.
   • Your participation is essential towards most effective treatment of your symptoms. Treatment works best when you're working together with your treatment team.
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   Attend a support group. The stigma from schizophrenia can be more uncomfortable than the symptoms. In a peer support group, your experience is shared by other members. Attending a group for support has been shown to be one of the most effective ways to minimize the difficulties of living with schizophrenia and other mental illnesses.

   • Peer support groups are offered through local mental health organizations, Schizophrenics Anonymous (SA) and NAMI throughout the United States. For more information, do an online search for groups in your area.
   • Peer support groups are also offered online. SA offers conference call support groups as well. Find a support group option that works for you.
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Method 4

Method 4 of 5:

Making Healthy Lifestyle Choices

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   Eat a healthy diet. Studies suggest that people with schizophrenia tend to have more unhealthy diets than non-schizophrenic people. Lack of exercise and smoking are also common among people with schizophrenia. Research suggests that a diet low in saturated fat, high in polyunsaturated fatty acids, and low in sugar might be beneficial also in alleviating the symptoms of schizophrenia.

   • Brain-Derived Neurotrophic Factor (BDNF) is a protein that is active in the parts of the brain associated with learning, memory, and higher thinking. While the evidence is as yet unclear, a possible hypothesis is that a high-fat, high-sugar diet leads to exacerbation of symptoms in schizophrenia.
   • Unhealthy diets can lead to secondary medical problems, such as cancer, diabetes, or obesity.
   • Eat more probiotics. Probiotics contain beneficial bacteria which improve the quality of the gut. Many people seeking a health-conscious treatment for the symptoms of schizophrenia may want to include balanced diet which contains probiotics. Sauerkraut and miso soup are good sources of probiotics. Probiotics are sometimes added to foods and are available as a dietary supplement.
   • Avoid products with casein. A small percentage of people with schizophrenia have negative reactions to casein, which is found in milk products.
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   Quit smoking. Smoking cigarettes is more common among people with schizophrenia than the average population. One study estimated that over 75% of adults diagnosed with schizophrenia also reported smoking cigarettes.

   • Nicotine can lead to temporary improvement in thinking, which may be why many people with schizophrenia choose to smoke. However, this is a short-term improvement. It does not counterbalance the long-term negative consequences of smoking.
   • Most smokers started smoking before the psychotic features of schizophrenia appeared. Research is unclear on whether cigarette smoke may result in vulnerability to schizophrenia manifestation, or whether the higher rates of smoking are a side effect of antipsychotic medication.
3. 
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   Try a gluten-free diet. Gluten is the general name for the proteins found in most grains. Many people with schizophrenia also have gluten sensitivities. They may have a co-existing condition called Celiac Disease, which causes negative reactions to gluten.

   • Celiac Disease is three times more common among people with schizophrenia. In general, people with gluten-sensitivities are more likely to experience mental health problems. This has resulted in a hypothetical connection between mental health concerns and gluten intake.
   • Research is inconclusive regarding positive benefits resulting from gluten-free diets.
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   Try a ketogenic diet. A ketogenic diet is high in fat and low in carbohydrates, while providing adequate protein. Originally used as a treatment for seizure disorders, the diet has been adapted for a variety of mental health concerns. In the ketogenic diet, the body begins to burn fat rather than sugar, avoiding the extra production of insulin.

   • There is insufficient data to suggest that use of this diet eliminates symptoms of schizophrenia, but some people may wish to try this diet if their symptoms are otherwise resistant to treatment.
   • The ketogenic diet is also known as the Adkins diet, or the Paleo diet.
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   Include more Omega-3 Fatty Acids in your diet. Studies suggest that a diet high in Omega-3 fatty acids helps treat the symptoms of schizophrenia. Benefits from Omega-3 increase if your diet contains antioxidants. Antioxidants may play a role in the development of schizophrenic symptoms.

   • Fish oil capsules are a good source for Omega-3. Eating cold-water fish such as salmon or cod raises Omega-3 levels as well. Other high Omega-3 foods include walnuts, avocados, flax seeds and other nuts.
   • Take 2-4 grams of Omega-3 per day.
   • Foods that are high in antioxidants, including vitamins E and C, and melatonin, have been suggested to help minimize the symptoms of schizophrenia.
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Method 5

Method 5 of 5:

Treating Schizophrenia Using Therapy

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   Try Cognitive Behavioral Therapy (CBT). Individual cognitive therapy has been shown to help people change maladaptive behaviors and beliefs. While CBT appears to have little direct impact on the symptoms of schizophrenia, it helps many patients stick to their treatment program, and has a positive impact on their overall quality of life. Group therapy can also be effective.

   • CBT sessions should be scheduled once per week for 12-15 weeks for best results. These sessions can be repeated as needed.
   • In some countries, such as the UK, CBT is the most widely-prescribed treatment for schizophrenia other than antipsychotic medication. In other countries, CBT may be difficult to access.
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   Receive psychoeducational therapy. This is a form of therapy that primarily serves to better educate you about your symptoms and the way they affect your life. Research suggests that learning about the symptoms of schizophrenia will help you develop better understanding of the way these symptoms affect you, and empower you to manage them better.

   • One of the characteristics of schizophrenia is lack of insight, impulsivity and poor planning. Learning about your diagnosis may help you make better choices regarding situations that negatively impact your life.
   • Education is a gradual process, not a short-term goal. This form of therapy should be an ongoing part of your work with a therapist, and may easily be combined with other forms of therapy such as CBT.
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   Consider electroconvulsive therapy (ECT). Research suggests that ECT may have certain benefits for patients with schizophrenia. It is generally prescribed for people suffering from chronic depression. This is a treatment more commonly practiced in the European Union, and there is little research to support its use to treat people with schizophrenia. However, there are case studies in which people whose symptoms have been resistant to other treatments have responded favorably to ECT.

   • ECT is usually given three times a week. A patient may require as few as three or four treatments or as many as 12 to 15. Modern ECT methods are painless, unlike the versions practiced decades ago in the early days of ECT.
   • Memory loss is the primary negative side effect of ECT. Issues with memory usually improve within a couple months after the last treatment.
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   Use repetitive transcranial-magnetic stimulation (TMS) to treat symptoms. This is an experimental treatment that has shown some promising results in several studies. Data on this treatment is still limited, however. This treatment may be specifically used to treat auditory hallucinations.

   • Studies show most promise for people with severe, persistent auditory hallucinations, or "voices."
   • The treatment consists of application of TMS for 16 minutes per day for four consecutive days.
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Expert Q&A

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• Question

  What are signs of a schizophrenia relapse?

  

  Noel Hunter, Psy.D
  Clinical Psychologist

  Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.

  

  Noel Hunter, Psy.D

  Clinical Psychologist

  Expert Answer

  There's usually a period where you're sort of half-in and half-out of reality, and that's where you'd see your signs before it becomes full-blown psychosis. One big precipitating factor is increased stress, anxiety, and fear. You might also have strange sensations or ideas in your head or start acting erratically. Also, other people might start to express concern about your behavior or what you're saying.

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