Schizophrenia is a serious mental illness that affects your thinking, emotions, relationships, and decision making. And because there’s no cure, getting the proper treatment early is the best way to improve chances of managing the illness.
Schizophrenia treatment will center on managing your symptoms. You may need to stay on medication for a long time, possibly even for life. Psychotherapy, a kind of talk therapy, will likely also be a big part of the plan to help you understand and manage your symptoms. The right treatments, along with practical and emotional support from your loved ones, will go a long ways to help you navigate your life.
Types of Psychotherapy
Individual psychotherapy. During sessions, a therapist or psychiatrist can teach the person how to deal with their thoughts and behaviors. They’ll learn more about their illness and its effects, as well as how to tell the difference between what’s real and what’s not. It also can help them manage everyday life. Learn more about the different types of psychotherapy.
Cognitive behavior therapy (CBT). This can help the person change their thinking and behavior. A therapist will show them ways to deal with voices and hallucinations. With a combination of CBT sessions and medication, they can eventually tell what triggers their psychotic episodes (times when hallucinations or delusions flare up) and how to reduce or stop them. Read more on how cognitive behaioral therapy can help thinking patterns.
Cognitive enhancement therapy (CET). This type of therapy is also called cognitive remediation. It teaches people how to better recognize social cues, or triggers, and improve their attention, memory, and ability to organize their thoughts. It combines computer-based brain training and group sessions.
Types of Psychosocial Therapy
If a person with schizophrenia sees improvement during psychotherapy sessions, it’s likely they’ll need more help learning how to become part of a community. That’s where psychosocial therapy comes in.
Social skills training. This type of instruction focuses on improving communication and social interactions.
Rehabilitation. Schizophrenia usually develops during the years we are building our careers. So rehabilitation may include job counseling, problem-solving support, and education in money management.
Schizophrenia is a serious mental illness that cannot be cured but can be treated effectively for most patients. Schizophrenia can cause a range of symptoms, including hallucinations, delusions, disordered thinking and speaking, unusual behaviors, agitation and irritation, a flat emotional affect, and in some people catatonia.
The symptoms are disruptive and cause significant impairment in several areas, such as social interactions, work, school, and family.
Because schizophrenia causes impairment and is chronic, treatment for this condition is crucial. Each individual is different and responds differently to various treatments, but generally the most effective way to treat schizophrenia is to use a combination of antipsychotic medications and psychosocial approaches.
The latter refers to a combination of therapies, social support, social education, and vocational support.
Cognitive Behavioral Therapy for Schizophrenia
Cognitive behavioral therapy, also known as CBT, may be a treatment option for people with schizophrenia. CBT teaches a person to modify beliefs or behaviors that may be leading to negative emotions. The therapy has two main parts: a cognitive component, which helps a person to change his or her thinking about a situation, and a behavioral component, which helps a person to change his or her reactions.
Cognitive behavioral therapy is a short-term, problem-focused approach with the goal of teaching people who have schizophrenia a variety of coping skills to help them manage difficult situations. This type of therapy is typically given for one hour a week during the course of 12 to 16 weeks.
During cognitive behavioral therapy sessions, a person works with a therapist to learn how his or her thoughts, feelings, and behaviors influence each other. In order to change unwanted feelings or problematic behaviors, the therapist teaches strategies to modify negative thoughts and respond to them differently. The therapist teaches the person how to test the reality of his or her thoughts and perceptions, ignore any voices, and manage symptoms.
Cognitive behavioral therapy can also help people with schizophrenia to develop better social and problem-solving skills, reduce the severity of symptoms, and lower the risk of relapse, a period of time when schizophrenia symptoms return.
It’s important to recognize the symptoms of schizophrenia and seek help as early as possible. People with schizophrenia are usually diagnosed between the ages of 16 and 30, after the first episode of psychosis. Starting treatment as soon as possible following the first episode of psychosis is an important step toward recovery. However, research shows that gradual changes in thinking, mood, and social functioning often appear before the first episode of psychosis. Schizophrenia is rare in younger children.
Schizophrenia symptoms can differ from person to person, but they generally fall into three main categories: psychotic, negative, and cognitive.
Psychotic symptoms include changes in the way a person thinks, acts, and experiences the world. People with psychotic symptoms may lose a shared sense of reality with others and experience the world in a distorted way. For some people, these symptoms come and go. For others, the symptoms become stable over time. Psychotic symptoms include:
- Hallucinations: When a person sees, hears, smells, tastes, or feels things that are not actually there. Hearing voices is common for people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice a problem.
- Delusions: When a person has strong beliefs that are not true and may seem irrational to others. For example, individuals experiencing delusions may believe that people on the radio and television are sending special messages that require a certain response, or they may believe that they are in danger or that others are trying to hurt them.
- Thought disorder: When a person has ways of thinking that are unusual or illogical. People with thought disorder may have trouble organizing their thoughts and speech. Sometimes a person will stop talking in the middle of a thought, jump from topic to topic, or make up words that have no meaning.
- Movement disorder: When a person exhibits abnormal body movements. People with movement disorder may repeat certain motions over and over.
Negative symptoms include loss of motivation, loss of interest or enjoyment in daily activities, withdrawal from social life, difficulty showing emotions, and difficulty functioning normally. Negative symptoms include:
- Having trouble planning and sticking with activities, such as grocery shopping
- Having trouble anticipating and feeling pleasure in everyday life
- Talking in a dull voice and showing limited facial expression
- Avoiding social interaction or interacting in socially awkward ways
- Having very low energy and spending a lot of time in passive activities. In extreme cases, a person might stop moving or talking for a while, which is a rare condition called catatonia.
These symptoms are sometimes mistaken for symptoms of depression or other mental illnesses.
Cognitive symptoms include problems in attention, concentration, and memory. These symptoms can make it hard to follow a conversation, learn new things, or remember appointments. A person’s level of cognitive functioning is one of the best predictors of their day-to-day functioning. Cognitive functioning is evaluated using specific tests. Cognitive symptoms include:
- Having trouble processing information to make decisions
- Having trouble using information immediately after learning it
- Having trouble focusing or paying attention
Risk of Violence
Most people with schizophrenia are not violent. Overall, people with schizophrenia are more likely than those without the illness to be harmed by others. For people with schizophrenia, the risk of self-harm and of violence to others is greatest when the illness is untreated. It is important to help people who are showing symptoms to get treatment as quickly as possible.
Schizophrenia vs. Dissociative Identity Disorder
Although some of the signs may seem similar on the surface, schizophrenia is not dissociative identity disorder (which used to be called multiple personality disorder or split personality). People with dissociative identity disorder have two or more distinct identities that are present and that alternately take control of them.