Despite the widespread misconception that people with schizophrenia have no chance of recovery or improvement, the reality is much more hopeful. Think of schizophrenia as similar to a chronic medical condition like diabetes: although currently there is no cure, it can be treated and managed with medication and supportive therapies.
A diagnosis of schizophrenia is not a life-sentence of ever-worsening symptoms and hospitalizations. Recovery is possible. In fact, the majority of people with schizophrenia get better over time, not worse. According to the UK’s Royal College of Psychiatrists, for every five people who develop schizophrenia:
- 1 in 5 will get better within five years of their first episode of schizophrenia.
- 3 in 5 will get better, but will still have some symptoms. They will have times when their symptoms get worse.
- 1 in 5 will continue to have troublesome symptoms.
What does recovery mean?
Recovery from schizophrenia is a lifelong process. It doesn’t mean you won’t experience any more challenges from the illness or that you’ll always be symptom-free. What it does mean is that you are continuing to work toward your goals, learning to manage your symptoms, developing the support you need, and creating a satisfying, purpose-driven life.
Successful treatment for schizophrenia aims to relieve current symptoms, prevent future psychotic episodes, and restore your ability to function and enjoy a meaningful life. A treatment plan that combines medication with supportive services and therapy is the most effective approach.
Encouraging facts about schizophrenia
- Schizophrenia is treatable. Currently, there is no cure for schizophrenia, but the illness can be successfully treated and managed. The key is to have a strong support system in place and get the right treatment for your needs.
- You can enjoy a fulfilling, meaningful life. When treated properly, most people with schizophrenia are able to have satisfying relationships, work or pursue other meaningful activities, be part of the community, and enjoy life.
- Just because you have schizophrenia doesn’t mean you’ll have to be hospitalized. If you’re getting the right treatment and sticking to it, you are much less likely to experience a crisis situation that requires hospitalization to keep you safe.
- Most people with schizophrenia get better over time, not worse. People with schizophrenia can regain normal functioning and even become symptom free. No matter what challenges you presently face, there is always hope.
Getting a diagnosis
The first step to schizophrenia treatment is getting a correct diagnosis. This isn't always easy, since the symptoms of schizophrenia can resemble those caused by other mental and physical health problems. Furthermore, people with schizophrenia may believe nothing is wrong with them and resist going to the doctor.
Because of these issues, it is best to see a psychiatrist with experience identifying and treating schizophrenia, rather than a family doctor. To learn more, see Helpguide's Getting a Diagnosis (PDF).
If you suspect that you or someone you know is suffering from schizophrenia, seek help right away. The earlier you catch schizophrenia and begin treating it, the better your chances of getting and staying well. An experienced mental health professional can make sure your symptoms are caused by schizophrenia and get you the treatment you need.
Successful treatment of schizophrenia depends on a combination of factors. Medication alone is not enough. In order to get the most out of treatment, it's important to educate yourself about the illness, communicate with your doctors and therapists, have a strong support system, make healthy lifestyle choices, and stick to your treatment plan.
Treatment must be individualized to your needs, but no matter your situation, you’ll do best if you’re an active participant in your own treatment and recovery. You should always have a voice in the treatment process and your needs and concerns should be respected. Treatment works best when you, your family, and your doctors and therapists are all working together.
Your attitude towards treatment matters
- Don’t buy into the stigma of schizophrenia. Many fears about schizophrenia are not based on reality. It’s important to take your illness seriously, but don’t buy into the myth that you can’t get better. Associate with people who see beyond your diagnosis, to the person you really are.
- Communicate with your doctor. Make sure you’re getting the right dose of medication—not too much, and not too little. It’s not just your doctor’s job to figure out the dosage and drug that’s right for you. Be honest and upfront about side effects, concerns, and other treatment issues.
- Pursue therapies that teach you how to manage and cope with your symptoms. Don’t rely on medication alone. Supportive therapy can teach you how to challenge delusional beliefs, ignore voices in your head, protect against relapse, and motivate yourself.
- Set and work toward life goals. Having schizophrenia doesn’t mean you can’t work, have relationships, and get involved in your community. It’s important to set meaningful goals for yourself and participate in your own wellness.
Find help for schizophrenia
Click here for Schizophrenia.com’s list of clinics that specialize in the early diagnosis and treatment of schizophrenia.
Support makes an immense difference in the outlook for schizophrenia—especially the support of family and close friends. When you have people who care about you and are involved in your treatment, you’re more likely to achieve independence and avoid relapse.You can develop and strengthen your support system in many ways:
- Turn to trusted friends and family members. Your closest friends and family members can help you get the right treatment, keep your symptoms under control, and function well in your community. Tell your loved ones that you may need to call on them in times of need. Most people will be flattered by your request for their help and support.
- Find ways to stay involved with others. If you’re able to work, continue to do so. If you can’t find a job, consider volunteering. If you’d like to meet more people, consider joining a schizophrenia support group or getting involved with a local church, club, or other organization.
- Take advantage of support services in your area. Ask your doctor or therapistabout services available in your area or contact hospitals and mental health clinics. You can also learn more about the support services available by contacting the National Alliance on Mental Illness. Call (800) 950-6264 or go to www.nami.org.
The importance of a supportive living environment
Treatment for schizophrenia cannot succeed if you don’t have a stable, supportive place to live. Studies show that people with schizophrenia often do best when they’re able to remain in the home, surrounded by supportive family members. However, any living environment where you’re safe and supported can be healing.
Living with family is a particularly good option when your family members understand the illness well, have a strong support system of their own, and are willing and able to provide whatever assistance is needed. But your own role is no less important. The living arrangement is more likely to be successful if you avoid using drugs or alcohol, follow your treatment plan, and take advantage of outside support services.
If you’ve been diagnosed with schizophrenia, you will almost certainly be offered antipsychotic medication. But it’s important to understand that medication is just one component of schizophrenia treatment.
- Medication is not a cure for schizophrenia. Rather it works by reducing the psychotic symptoms of schizophrenia such as hallucinations, delusions, paranoia, and disordered thinking.
- Medication only treats someof the symptoms of schizophrenia. Antipsychotic medication reduces psychotic symptoms, but is much less helpful for treating symptoms of schizophrenia such as social withdrawal, lack of motivation, and lack of emotional expressiveness.
- You should not have to put up with disabling side effects. Schizophrenia medication can have very unpleasant—even disabling—side effects such as drowsiness, lack of energy, uncontrollable movements, weight gain, and sexual dysfunction. Your quality of life is important, so talk to your doctor if you or your family member is bothered by side effects. Lowering your dose or switching medications may help.
- Never reduce or stop medication on your own. Sudden or unsupervised dosage changes are dangerous, and can trigger a schizophrenia relapse or other complications. If you’re having trouble with your medication or feel like you don’t need to take it, talk to your doctor or someone else that you trust.
Finding the right schizophrenia medication
Since many people with schizophrenia require medication for extended periods of time—sometimes for life—the goal is to find a medication regimen that keeps the symptoms of the illness under control with the fewest side effects.
As with all medications, the antipsychotics affect people differently. It’s impossible to know ahead of time how helpful a particular antipsychotic will be, what dose will be most effective, and what side effects will occur. Finding the right drug and dosage for schizophrenia treatment is a trial and error process. It also takes time for the antipsychotic medications to take full effect.
Some symptoms of schizophrenia may respond to medication within a few days, but others take weeks or months to improve. In general, most people see a significant improvement in their schizophrenia within six weeks of starting medication. If, after six weeks, an antipsychotic medication doesn’t seem to be working, your doctor may increase the dose or try another medication.
Types of medications used for schizophrenia treatment
The two main groups of medications used for the treatment of schizophrenia are the older or “typical” antipsychotic medications and the newer “atypical” antipsychotic medications.
The typical antipsychotics are the oldest antipsychotic medications and have a successful track record in the treatment of hallucinations, paranoia, and other psychotic symptoms. However, they are prescribed less frequently today because of the neurological side effects, known as extrapyramidal symptoms, they often cause.
Common extrapyramidal side effects of the typical antipsychotics include:
The danger of permanent facial tics and involuntary muscle movements
When the typical antipsychotics are taken long-term for the treatment of schizophrenia, there is a risk that tardive dyskinesia will develop. Tardive dyskinesia involves involuntary muscle movements, usually of the tongue or mouth. In addition to facial tics, tardive dyskinesia may also involve random, uncontrolled movements of the hands, feet, trunk, or other limbs. According to the National Alliance on Mental Illness, the risk of developing tardive dyskinesia is 5 percent per year with the typical antipsychotics.
In recent years, newer drugs for schizophrenia have become available. These drugs are known as atypical antipsychotics because they work differently than the older antipsychotic medications. Since the atypical antipsychotics produce fewer extrapyramidal side effects than the typical antipsychotics, they are recommended as the first-line treatment for schizophrenia.
Unfortunately, these newer atypical antipsychotic medications have side effects that many find even more distressing than extrapyramidal side effects, including:
If you or a loved one is bothered by the side effects of schizophrenia medication, talk to your doctor. Medication should not be used at the expense of your quality of life. Your doctor may be able to minimize side effects by switching you to another medication or reducing your dose.The goal of drug treatment should be to reduce psychotic symptoms using the lowest possible dose.
|Common Schizophrenia Medications|
|Typical antipsychotics (1st generation)||Atypical antipsychotics (2nd generation)|
|Common Schizophrenia Medications|
|Typical antipsychotics (1st generation)|
|Atypical antipsychotics (2nd generation)|
The symptoms and course of schizophrenia are different for everyone, and some people will have an easier time than others. But whatever your situation, you can make things better by taking care of yourself. Not only will the following self-care strategies help you manage your symptoms, they will also empower you. The more you do to help yourself, the less hopeless and helpless you’ll feel.
- Manage stress. Stress can trigger psychosis and make the symptoms of schizophrenia worse, so keeping it under control is extremely important. Know your limits, both at home and at work or school. Don’t take on more than you can handle and take time to yourself if you’re feeling overwhelmed.
- Try to get plenty of sleep. When you’re on medication, you most likely need even more sleep than the standard 8 hours. Many people with schizophrenia have trouble with sleep, but lifestyle changes (such as getting regular exercise and avoiding caffeine) can help.
- Avoid alcohol and drugs. Some evidence indicates a link between drug use and schizophrenia. And it’s indisputable that substance abuse complicates schizophrenia treatment and worsens symptoms. If you have a substance abuse problem, seek help.
- Get regular exercise. Studies show that regular exercise may help reduce the symptoms of schizophrenia. That’s on top of all the emotional and physical health benefits! Aim for 30 minutes of activity on most days.
- Do things that make you feel good about yourself. If you can’t get a job, find other activities that give you a sense of purpose and accomplishment. Cultivate a passion or a hobby. Helping others is particularly fulfilling.
There are many government programs and community services that may be helpful as part of your schizophrenia treatment and recovery. To explore your options, make contact with local mental health facilities, social service agencies, support groups, and public housing authorities.
Job and social skills training
Vocational and social rehabilitation teaches basic life skills to people with schizophrenia so they can function in their families or communities. There are many different types of rehabilitation programs that can help you learn how to live more independently and make the most of your capabilities. Vocational rehabilitation programs teach you job skills and help you find full or part-time employment. Other programs may include training in handling finances, using public transportation, communicating with others, and finding living arrangements.
Medical coverage for schizophrenia
In most instances when you’re unable to work due to mental illness, government funds are available to assist you with basic needs such as housing, food, clothing, and medical expenses. Most private insurance policies do not fully cover these expenses.
Depending on the situation, you or your family member may qualify for social security assistance.There are two types of social security assistance available:
- Social Security Disability (SSD) is granted for people who have worked and contributed to the social security system. After one year this is referred to as Medicare funding.
- Supplemental Security Income (SSI) is granted based on financial need for low-income persons. An individual is eligible for SSI if he or she does not have a work history and is therefore ineligible for SSD, or if the individual’s SSD funding isn’t sufficient for complete care. SSI is considered Medicaid funding.
Medical aid and coverage for schizophrenia is a very complex issue. Your doctor, social worker, or case manager may be able to offer advice and help you find coverage. You can also contact your local Social Security or social services office directly.
Residential support services for schizophrenia
If an at-home living arrangement isn’t the right fit for you, you may want explore residential facilities in your community. Options in your area may include:
- Residential treatment facilities or 24-hour care homes – A more structured living environment for those who require greater assistance with medications and daily living tasks or for those going through an acute psychotic episode.
- Transitional group home – An intensive program that helps individuals transition back into society and avoid relapse after a crisis or hospitalization. Includes skills training and rehabilitation services.
- Foster or boarding homes – A group living situation for people with schizophrenia who are able to function relatively well on their own. Foster and boarding homes offer a certain degree of independence, while providing meals and other basic necessities.
- Supervised apartments – An option for those whose condition is less severe or well-managed with medication. Residents live alone or share an apartment, with staff members available on-site to provide assistance and support.
Free Toolkit Program
Resources & References
Helpguide’s Yellow Pages
Resources for public assistance, social services, and other health and human services.
New Hope for People with Schizophrenia – (American Psychological Association)
General information about schizophrenia diagnosis and treatment
Schizophrenia:The Journey to Recovery – Comprehensive schizophrenia handbook discusses diagnosis and treatment issues including hospitalization, confidentiality, independent living, and emergency planning. (Canadian Psychiatric Association in co-operation with the Schizophrenia Society of Canada)
Schizophrenia: An Information Guide – Covers common concerns about schizophrenia and its treatment, including treatment options and relapse prevention. (Centre for Addiction and Mental Health)
Antipsychotic medications and side effects
Medications – A thorough guide to the safe use of medications for mental illness, including the antipsychotics prescribed for schizophrenia. (National Institute of Mental Health)
Antipsychotic Drugs: Summary of Affordable Alternatives – Offers drug recommendations for schizophrenia treatment, based on safety, side effects, dosing convenience, and cost. (Consumer Reports Health)
Antipsychotic Side Effects Checklist (PDF) – Printable screening checklist for monitoring the common side effects of the antipsychotic medications for schizophrenia. (National Mental Health Association)
Tardive Dyskinesia – Learn about tardive dyskinesia, an involuntary movement disorder caused by long-term antipsychotic treatment. (Natioinal Alliance on Mental Illness)
Psychosocial treatment and rehabilitation for schizophrenia
Assertive Community Treatment (ACT) – Learn about ACT, a community-based program that helps people with serious mental illness such as schizophrenia get the treatment and supportive services they need. (National Alliance on Mental Illness)
Assertive Community Treatment: Information for Consumers – More information about the personalized, team approach of ACT for schizophrenia, including housing assistance, medication support, and counseling. (SAMHSA’s National Mental Health Information Center)
Supported Employment – Introduction to programs that help people with schizophrenia and other mental disorders find and maintain employment. (SAMHSA’s National Mental Health Information Center)
Delving deeper into schizophrenia diagnosis and treatment
Practice Guidelines for the Treatment of Patients with Schizophrenia (PDF) – Comprehensive look at current expert recommendations for both the acute and maintenance phase of schizophrenia treatment. (American Psychiatric Association)