You must be hospitalized immediately if you appear to be in imminent danger to yourself or others (e.g., if you display suicidal or homicidal tendencies). You should also be hospitalized if you cannot take care of yourself, or if you do not have an adequate support system. You might also be hospitalized for a careful evaluation of your first psychotic evaluation. Call your doctor immediately if you develop new or worsening symptoms, especially any thoughts of injuring yourself or others.
Continue to take your medication, even if your symptoms have improved. Due to the nature of the disease as well as the side effects of many medications used to treat schizophrenia, many people require supervision to ensure that they are taking their medications as prescribed.
Try to limit or quit smoking. Tobacco use is extremely common among patients with schizophrenia. Patients with schizophrenia tend to smoke heavily, and tend to choose cigarettes with a high nicotine content. Quitting is important for long-term heath; however, it may be particularly difficult for patients with schizophrenia to quit smoking, as nicotine may temporarily relieve symptoms associated with the disorder.
Drink alcohol only in moderation (one drink a day for women, up to two drinks a day for men), and avoid illicit drugs. Abusing certain drugs can create symptoms that mimic those of schizophrenia, and can also exacerbate symptoms of the disorder. Stimulant drugs (“speed”) including amphetamines, “crank”, and cocaine are probably the most likely to cause or worsen psychotic symptoms. Even milder drugs like marijuana may affect a person with schizophrenia much more potently than it might affect others. Therefore, you must avoid illicit drugs, and drink alcohol only in moderation to help your doctor make a clear diagnosis, and to help minimize your own symptoms.
Try to maintain a regular sleep schedule. Sleep disturbances, even relatively minor ones, can exacerbate psychotic symptoms. Alert your doctor or other healthcare professional if your sleep schedule changes substantially; especially if you are unable to sleep for more than an hour or two at a time over any 24-hour period.
Learn as much as you can about schizophrenia Table 03.
Table 3. Ten Important Facts about Schizophrenia
It is a major mental illness that affects the brain and results in loss of contact with reality. It afflicts about 1% of the population worldwide. It has a high economic cost in the United States. Ten percent of all hospital beds are occupied by patients with schizophrenia. Blaming the mother of a schizophrenic person is not helpful or valid. You cannot cause schizophrenia, but may help in your own recovery. Having a supportive and involved family can also help you live better. Medications only partially relieve symptoms. Schizophrenia symptoms such as self neglect, lack of interest, and social isolation are the most difficult to tolerate and to treat. Rehabilitation therapy such as vocational and social skill training really works. Just as in the rest of the population, only a very small minority of patients with schizophrenia exhibit violent behavior.
Pay close attention to your diet, and try to limit your intake of high-calorie beverages. Some medications used to treat schizophrenia can increase thirst and/or appetite. Weight gain is a common side effect of most antipsychotic medications. If you find yourself drinking a lot of beverages, try to drink low-calorie beverages—preferably water.
Your doctor is the best source of information on the drug treatment choices available to you.
Psychotherapy is an important part of treating schizophrenia. Individual as well as family therapy is beneficial for people with schizophrenia. Individual therapy should focus on helping you understand your illness and helping you deal with your symptoms. Therapy should not be aimed at “uncovering” hidden emotions or problems, or delving into early childhood experiences.
Family therapy is important because family members often take on a lot of responsibility for caring for a relative with schizophrenia. Family members need to learn how to interact with you and cope with the symptoms of the disease. They should also be as knowledgeable as possible about the medications you are taking and their potential side effects.
Drug treatment and counseling are essential if you abuse drugs, as many people with schizophrenia do. People with schizophrenia are more likely to use recreational drugs or alcohol in an effort to self-medicate the symptoms of the illness or the side effects from medications. However, the disadvantages of doing so far outweigh any immediate advantages.
Rehabilitation therapy such as training in vocational and social skills will better enable you to live successfully in society. Nearly one-third of all individuals with schizophrenia are homeless, and need social support for help with medical care, housing, and training.
Cognitive rehabilitation, similar to the strategies used for people recovering from brain injuries such as stroke, may also be useful, and are just beginning to become widely available.
If you are a woman with schizophrenia and wish to become pregnant, you should undergo special counseling regarding treatment plans before you conceive. Female patients who wish to become pregnant should discuss specialized treatment plans with their doctors before conception. In addition to the usual stresses associated with pregnancy and childbirth, there may be special risks for a woman with schizophrenia. The hormonal changes that accompany pregnancy, childbirth, and the period following childbirth may trigger a recurrence or worsening of symptoms. Also, the effects of medications used to treat schizophrenia on the fetus remain unclear, and your doctor may wish to discontinue or decrease the dose of medicine during pregnancy accordingly.
There is no known cure for schizophrenia. Prognosis depends on the severity of the symptoms and on how the patient responds to treatment. The course of schizophrenia varies over time from one individual to the next. Schizophrenia does not usually progressively worsen, but typically stabilizes after about 5 years. In general, the later the onset, the better the outcome. A favorable outcome is generally seen in patients whose signs and symptoms appeared suddenly, and who have mainly positive symptoms and less in the way of negative symptoms or cognitive deficits.
Many patients have severe and long-lasting effects from schizophrenia. Few return to the state they were in before the illness began, and many are unable to return to work or establish close personal relationships.
Schizophrenia is a life-shortening disease. The mortality rate of people with schizophrenia is double that of the general population. Part of this is related to the fact that people with schizophrenia have high rates of drug or alcohol abuse, tobacco consumption, and/or obesity. In addition, people with schizophrenia generally have poor access to medical care.
Many people with schizophrenia will attempt suicide, and approximately 10% end their lives by suicide.
Schizophrenia requires long-term follow-up care. The majority of people with schizophrenia will require lifelong maintenance drug therapy. However, at least 80% of all people with schizophrenia will fail to take ther medications as directed within two years after being discharged from the hospital. Therefore, long-term care is necessary to ensure that patients comply with treatment. Long-term care is also beneficial in determining whether a patient's current treatment is ineffective. In some patients with uncontrolled disease, long-term hospitalization may be required.
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