People with schizophrenia need treatment throughout their lives, and sometimes their needs change. If you notice that your loved one with schizophrenia is behaving differently, it may be time to adjust treatment.
Why they may need adjustments
Even if your loved one is doing well with treatment, something may happen that means they need to change their medication or dosage, or add another type of treatment.
These include:
Their condition got worse. “While most people with schizophrenia get better with treatment, schizophrenia sometimes gets worse,” says Chicago psychologist Elizabeth Lombardo, Ph.D.
This may be triggered by an event or situation in their life.
“Patients with schizophrenia often experience worsening of their condition in response to sudden changes in their environment,” says Carol Taminga, M.D., chief of psychiatry at the University of Texas Southwestern Medical Center. Major events and changes, such as the death of a loved one, Could be the trigger. Other triggers include drugs and alcohol, stress, and breaking out of routine.
Coexisting mental illnesses can cause problems. People with schizophrenia often also suffer from other mental illnesses, such as panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, depression or substance abuse. If your loved one has another mental illness, it may cause problems that need to be addressed through treatment adjustments.
There may be a problem with their medications. People with schizophrenia often require changes in medication. Their medications may cause new or worse side effects. It may become less effective over time. Or they may stop taking it, which can make their condition worse.
Behavioral changes to watch out for
If you notice a difference in your loved one’s usual behavior or mood, they may need a change in therapy, says Brittany Webb, LMSW, a therapist at Maple Leaf Clinic in Birmingham, Michigan. These changes may be gradual or sudden.
Here’s what to look for:
- They become withdrawn, antisocial, or isolated.
- They have more symptoms such as paranoia, hallucinations and strange behavior.
- They talk to themselves, laugh, or act silly.
- They get angry for no reason.
- There are changes in their appetite, eating, or sleeping patterns.
- They pay little attention to appearance, hygiene or clothing.
- Their personality or emotions may seem bland.
- They have mood swings.
- They looked frustrated.
- They express suicidal or homicidal thoughts.
These things can also happen if your loved one stops taking their medications, which is common in schizophrenia. Antipsychotic medications often have unpleasant side effects that affect their mood, mind, and body. People may stop taking medications to avoid these side effects.
“It’s hard to tell if they’ve stopped or reduced their medication,” Taminga said. Try to observe your loved one to see if they are taking their medicine as directed.
If they don’t take their medication correctly or you notice side effects becoming more severe, they may need to change their treatment.
What to do if something changes
If you notice anything unusual, talk to your doctor. Even if you do not have legal permission for a doctor to discuss your loved one’s health with you, you can provide information to a doctor. Call the office or leave a message through the online patient portal.
Their doctor may increase or change your loved one’s medications. They may recommend cognitive or behavioral therapy and supportive counseling. They may connect people with schizophrenia to community resources.
When you get help, approach your loved one gently.
“It’s important that caregivers don’t argue or try to argue with a loved one when they show signs of worsening,” Weber says. Avoid using language that is shaming or blaming. Provide a supportive environment while providing them with the assistance they need.
“Help them stay calm and provide them with unconditional love,” Lombardo said. Let them know you’re worried. Reassure them that it is the disease, not them, that is not responding well to treatment.
What to do if it’s urgent
If you notice a significant increase in symptoms or a loved one is experiencing a psychotic episode, contact their treatment team immediately.
“Providers often have emergency, after-hours or crisis hotlines that can be called,” Weber said.
If they are in crisis and pose a danger to themselves or others, seek emergency services. Many cities have alternatives to 911 that can help you connect with someone trained in mental health issues. But if necessary, please call 911. You can also take your loved one to a hospital emergency room and request a psychiatric evaluation.
Share as much information as possible with the emergency room. Provide them with details such as:
- List of medications taken by people with schizophrenia
- any vitamins or supplements they take
- allergy
- Recent or past history of substance abuse
- History of symptoms, including when symptoms began
- Recent stressful events or changes in circumstances
Find the right care
When a loved one has schizophrenia, they need a support network. It starts with their primary caregivers, including their treatment team.
Do your best to ensure your loved one receives regular care from a treatment team who understands their medical history and follows recommendations.
You may need a psychiatrist, a mental health therapist, and a primary care physician. You also receive support from case managers and care coordinators.
“Community mental health agencies typically provide wrap-around services in one location and help manage outpatient care,” Weber said.
Finding the right provider isn’t always easy. Some doctors do not treat mentally ill patients.
“You may have to work hard to get them seen by competent people,” Taminga said. “Stick to it.”
