What will you learn?
1. What situations may require changing treatment for people with schizophrenia?
2. What co-existing psychiatric conditions can affect the need for therapy adjustments?
3. What behavioral changes might indicate the need for a treatment change?
4. What steps should you take if you notice changes in the behavior of a loved one with schizophrenia?
5. What should you do in case of a sudden worsening of the health condition of a person with schizophrenia?
Why treatment adjustments may be necessary
People with schizophrenia need treatment throughout their lives, and sometimes their needs change. If you notice a difference in the behavior of your loved one with schizophrenia, it may be time for a treatment adjustment.
When the condition worsens
Even if your loved one's treatment has been working well, situations can arise that necessitate changing medications or dosages, or adding another type of therapy. This may be due to a deterioration in their condition, which can sometimes be triggered by life events or circumstances. As Dr. Elizabeth Lombardo, a psychologist from Chicago, notes, "While most people with schizophrenia improve with treatment, schizophrenia can sometimes get worse."
Co-existing psychiatric illnesses
People with schizophrenia often have other psychiatric conditions, such as panic disorder, PTSD, OCD, depression, or substance abuse. These co-existing conditions can trigger problems that require treatment adjustments.
Medication issues
It's common for people with schizophrenia to need a change in their medication. They may develop new or more intense side effects, or the medication may become less effective over time. Another issue is the discontinuation of medication, which worsens the patient's condition.
Behavioral changes to watch for
Your loved one may need a treatment change if you notice differences in their usual behavior or mood. As Brittany Webb, a therapist at Birmingham Maple Clinic in Troy, MI, points out, these changes can be gradual or sudden.
Signs to look for:
- Becoming withdrawn, antisocial, or isolated
- Increased symptoms, such as paranoia, hallucinations, and bizarre behavior
- Talking to themselves, laughing, or acting inappropriately
- Unprovoked anger
- Changes in eating or sleeping habits
- Neglect of personal hygiene or attire
- Flattened personality or mood
- Mood swings
- Depression
- Expressing suicidal or homicidal thoughts
What to do if there's a change
If you notice a change in behavior, talk to your loved one's doctor. Even if you don't have permission to discuss their health, you can provide information to the doctor. Contact the office or leave a message through an online patient portal.
The doctor may increase or change your loved one's medication, recommend cognitive-behavioral therapy or supportive counseling, or connect them with community resources.
What to do if it's urgent
If symptoms worsen rapidly or your loved one has a psychotic episode, contact their treatment team immediately. Many cities have alternatives to 911 that connect you with someone trained in mental health issues. You can also take your loved one to a hospital emergency room for a psychiatric evaluation.
Find the right care
A person with schizophrenia needs a support network, starting with their primary caregiver and including their treatment team. Ensure your loved one receives regular care from a team that knows their history and follows through with recommendations. This may include a psychiatrist, mental health therapist, primary care physician, case managers, and care coordinators.
