Why Adjustments May Be Needed
Even if your loved one’s treatment has been working well, situations may arise where it may be necessary to change medications, doses, or add another type of treatment.
These include:
Their condition worsens. “Most people with schizophrenia get better with treatment, but sometimes the condition can get worse,” says Dr. Elizabeth Lombardo, a psychologist based in Chicago.
This can be triggered by life events or situations.
“People with schizophrenia often experience worsening symptoms due to sudden changes in their environment,” says Carol Tamminga, MD, chair of the Department of Psychiatry at the University of Texas Southwestern Medical Center. . Major events and changes, such as the death of a loved one, can be triggers. Other triggers include drugs and alcohol, stress, and breaking away from a regular routine.
Coexisting mental illness can cause problems. People with schizophrenia often have other mental illnesses, such as panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, depression, or substance abuse. If your loved one suffers from another mental illness, it may be causing problems that require treatment coordination.
They may have problems taking their medications. People with schizophrenia often need to change their medications. They may experience new or more intense side effects from the medication. It may become less effective over time. Or, if you stop taking it, your condition may worsen.
Behavioral changes to watch out for
If you notice a change in your loved one’s usual behavior or mood, it may be time for a change in therapy, says Brittany Webb, LMSW, a therapist at Birmingham Maple Clinic in Troy, Mich. These changes can be gradual or sudden.
Here’s what to look for:
- They become withdrawn, antisocial or isolated.
- There are more symptoms such as paranoia, hallucinations, and bizarre behavior.
- They talk to themselves, laugh, or act like that.
- They get angry for no reason.
- Appetite, eating, and sleeping patterns change.
- They do not pay much attention to grooming, hygiene and clothing.
- Their personality and mood seem normal.
- They have severe mood swings.
- They look depressed.
- Expressing thoughts of suicide or murder.
This can also happen if your loved one goes off their medication, which is common in schizophrenia. Antipsychotics often have unpleasant side effects that affect your mood, thoughts, and body. People may stop taking the medication to avoid these side effects.
“It can be difficult to tell whether they have stopped or reduced their medication,” says Tamminga. Monitor your loved one to ensure they are taking their medications as directed.
If you are not taking your medication properly or notice that side effects are getting worse, you may need to change your treatment.
What to do if something changes
If you notice any changes from the norm, consult your doctor. You can give information to your doctor even if he or she is not legally permitted to discuss your loved one’s health. Please call our office or leave a message through our online patient portal.
Your doctor may increase or change your loved one’s medications. They may recommend cognitive or behavioral therapy and supportive counseling. They can also connect people with schizophrenia to community resources.
Be gentle with your loved one while you seek help.
“It is important for caregivers not to argue or try to dispute when their loved one shows signs of deterioration,” says Webb. Avoid shaming or disparaging language. Provide a supportive environment while getting the help you need.
“Help them stay calm and give them unconditional love.” Lombardo says. Let them know you care. Reassure them that it is the disease that is not responding well to treatment, not them.
What to do in an emergency
If symptoms increase significantly or if your loved one is experiencing a psychotic episode, contact your treatment team immediately.
“Providers often have emergency lines, night lines or crisis lines you can reach,” says Webb.
If you are in crisis and are a danger to yourself or others, call emergency services. Many cities have alternatives to 911 that can connect you to someone trained in mental health issues. But call 911 if you need to. You may want to take your loved one to a hospital emergency room and request a psychiatric evaluation.
Share as much information as possible with the emergency room. Please provide the following details:
- List of medications taken by patients with schizophrenia
- What vitamins or supplements they take
- allergy
- Recent or past history of drug abuse
- History of your symptoms, including when they started
- Recent stressful events or changes in environment
Find the right care
When a loved one has schizophrenia, they need a support network. This starts with the primary caregiver and includes the treatment team.
Do your best to ensure your loved one receives regular care with a care team that knows their medical history and follows their recommendations.
You may need a psychiatrist, mental health therapist, or primary care physician. You may also receive support from case managers and care coordinators.
“Community mental health agencies often offer comprehensive services in one location that can help manage outpatient treatment,” says Webb.
Finding the right supplier isn’t always easy. Some doctors do not treat mentally ill patients.
“You may have to work hard to get your photos seen by capable people,” says Tamminga. “Endure.”
