Planning For The Future
Relapse prevention plan
A relapse is when, after you recover from an episode of psychosis, your symptoms return and you experience another episode.
A relapse prevention plan is a powerful tool for staying well and avoiding a worsening of your mental health issue. Making a plan involves:
- identifying your triggers: what events or situations could set your symptoms off?
- identifying your warning signs: what changes in your thinking, emotions and behaviour signal the early signs of psychosis?
- planning responses: what will you do to cope or seek help when you experience triggers & warning signs?
- listing support people: who will you call when you experience triggers & warning signs?
Having a relapse prevention can make you and the people who care for you feel more secure, even if you never have to use it.
Advance care directives
Because of the way schizophrenia affects thinking, feeling and behaviour, if your symptoms worsen at some time in the future, you may not be able to make good decisions about your care. It can also be hard for the people around you to know whats best for you when the situation is intense and confusing.
An advance care directive is your instructions for what you want to happen if you cant make your own choices, and who you authorise to make decisions for you.
How Is Schizophreniform Disorder Diagnosed
If symptoms are present, your healthcare provider will perform a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose schizophreniform disorder, your healthcare provider might use various diagnostic tests to rule out physical illness as the cause of your symptoms. These tests may be blood tests or imaging studies of the brain.
If your healthcare provider finds no physical reason for the symptoms, he or she might refer you to a psychiatrist or psychologist. These are health care professionals who are specially trained to diagnose and treat mental illnesses.
Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate you for a psychotic disorder. The healthcare provider or therapist bases his or her diagnosis on your symptoms and his or her observation of your attitude and behavior.
Your healthcare provider or therapist then determines if your symptoms point to a specific disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders , which is published by the American Psychiatric Association and is the standard reference book for recognized mental illnesses. According to the DSM-5, a diagnosis of schizophreniform disorder is made if you have characteristic symptoms that last between one and six months.
What If I Am Not Happy With My Treatment
If you are not happy with your treatment you can:
- talk to your doctor about your treatment options,
- ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service and see whether they can help, or
- make a complaint.
There is more information about these options below.
You should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.
Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.
A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.
You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.
An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.
There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.
The Patient Advice and Liaison Service
You can find out more about:
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The Phases And Recovery Of Schizophrenia
Recovery from psychotic episodes is not something that can be predicted. Some people may only experience one psychotic episode that is full-blown. Others have several different episodes. Some people may recover completely, however it is recommended that patients continue with lifelong treatment and support so as to avoid relapsing.
Schizophrenia Myths And Facts
- Schizophrenia is not caused by bad parenting, childhood trauma, poverty, street drugs or alcohol
- Schizophrenia is not contagious
- Schizophrenia is very different from dissociative disorder
- Schizophrenia is no ones fault
- People who experience schizophrenia have a higher risk of suicide. In one study, 20-40% of people with schizophrenia attempted suicide and 5% of people with schizophrenia completed suicide, so all talk of suicide should be taken seriously
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How Is The Diagnosis Made
Some of the symptoms that occur in schizophrenia also occur in other mental health conditions such as depression, mania, and dissociative identity disorder, or after taking some street drugs. Therefore, the diagnosis may not be clear at first. As a rule, the symptoms need to be present for several weeks before a doctor will make a firm diagnosis of schizophrenia.
Not all symptoms are present in all cases. Different forms of schizophrenia occur depending upon the main symptoms that develop. For example, people with paranoid schizophrenia mainly have positive symptoms which include delusions that people are trying to harm them. In contrast, some people mainly have negative symptoms and this is classed as simple schizophrenia. In many cases there is a mix of positive and negative symptoms.
Sometimes symptoms develop quickly over a few weeks or so. Family and friends may recognise that the person has a mental health problem. Sometimes symptoms develop slowly over months and the person may gradually become withdrawn, lose friends, jobs, etc, before the condition is recognised.
Could I Have Schizophrenia
While schizophrenia looks different from person to person, it always causes changes in your abilities and personality. Because it is so different in each person, you may experience some or all of the symptoms below.
- Im hearing voices other people tell me they cant hear
- Im seeing things that other people tell me they cant see
- My thoughts take a long time to form, come too fast together, or dont form at all
- Im convinced Im being followed
- I feel immune to any kind of danger I believe I can save the world
- I sometimes feel like Im not actually in my body, that Im floating
- I used to like being around other people, but now Id rather just be by myself
- I want to end my life or harm myself
- Im having trouble remembering things, concentrating and making decisions
- Im getting confused easily
If you are experiencing any of these symptoms its important to talk to your doctor. People who experience schizophrenia often experience symptoms of anxiety and depression, too.
A look at the terms
Below are the definitions of a few words that you might hear associated with schizophrenia.
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What Are The Types Of Schizophrenia
There are different types of schizophrenia. The International Classification of Diseases manual describes them as below.
- Pranks, giggling and health complaints.
- Usually diagnosed in adolescents or young adults.
- Unusual movements, often switching between being very active and very still.
- You may not talk at all.
- Negative symptoms are prominent early and get worse quickly.
- Positive symptoms are rare.
Your diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but doesnt obviously fit into one of these types alone.
This type of schizophrenia is diagnosed in the later stages of schizophrenia. You may be diagnosed with this if you have a history of schizophrenia but only continue to experience negative symptoms.
There are other types of schizophrenia according to the ICD-10, such as.
- Cenesthopathic schizophrenia. This is where people experience unusual bodily sensations.
- Schizophreniform. Schizophreniform disorder is a type of psychotic illness with symptoms similar to those of schizophrenia. But symptoms last for a short period.
Symptoms meet the general conditions for a diagnosis, but do not fit in to any of the above categories.
Managing Life With Schizophrenia
Schizophrenia an require longer-term treatment. It takes at least six months of symptoms to be diagnosed and treatment may be recommended after symptoms have reduced.
While your mental health issue is being treated, life continues. How can you live the best life you can with schizophrenia?
Doctors can provide medication. They can give you recreational activities and advice. But the desire to get better has to come from you
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Whats The Difference Between Psychosis And Schizophrenia
Psychosis is a syndrome or group of symptoms. Someone experiencing an episode of psychosis is having a break with reality. Major symptoms of psychosis are hallucinations and delusions. Hallucinations are sensations that are not real, such as hearing voices or sounds that arent real. Hearing voices is a common hallucination, but hallucinations can be experiences with any sensehearing, sight, smell, taste, or touch. Delusions are strong beliefs that cant possibly be true. Common delusions include the belief that someone is following or monitoring you, or the belief that you have extraordinary powers or abilities. Other symptoms of psychosis include difficulties concentrating, completing tasks, or making decisions. Thoughts may feel jumbled or confused. Some people have a hard time following conversations or speaking clearly. Psychosis can even affect the way people move or express their emotions.
Psychosis and schizophrenia are treatable. Its important to seek help as soon as possible.
Where can I learn more?
What Are The Three Phases Of Schizophrenia
Research has identified schizophrenia to have three phases, these are as follows:
- Acute / active
It may sometimes seem as though schizophrenia suddenly develops out of nowhere, this, however, is not the case. There is no such thing as waking up one morning and have bouts of full-blown psychosis. The disease instead consists of psychotic symptoms that slowly start to appear, and the sufferer begins to show a way of thinking that is distorted and has difficulty relating to others.
The phases can be explained accordingly:
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Schizophrenia Through The Ages
What does schizophrenia mean?
In 1910, the Swiss psychiatrist Paul Eugen Bleuler coined the term ‘schizophrenia from the Greek words schizo and phren . Bleuler had intended the term to denote a loosening of thoughts and feelings, but, unfortunately, many people read it to mean a split personality.
What does schizophrenia not mean?
Robert Louis Stevensons novel The Strange Case of Dr Jekyll and Mr Hyde did much to popularize the concept of a split personality, which is sometimes also referred to as multiple personality disorder . However, MPD is a vanishingly rare condition that is entirely unrelated to schizophrenia. The vast majority of psychiatrists, myself included, have never seen a case of MPD, and many if not most suspect that such a condition does not exist. Yes, schizophrenia sufferers may hear various voices, or harbour strange beliefs, but this is not the same as having a split personality. Unlike Dr Jekyll, schizophrenia sufferers do not suddenly mutate into a different, unrecognizable person.
Who discovered schizophrenia?
How was schizophrenia thought of in antiquity?
But the spirit of the Lord departed from Saul, and an evil spirit from the Lord troubled him And it came to pass, when the evil spirit from God was upon Saul, that David took an harp, and played with his hand: so Saul was refreshed, and was well, and the evil spirit departed from him.
When did people first start thinking of schizophrenia as an illness?
How did beliefs change?
How Is Schizophreniform Disorder Treated
The goal of treatment for schizophreniform disorder is to protect and stabilize you and relieve your symptoms. Treatment generally consists of medication and psychotherapy . People with severe symptoms or who are at risk of hurting themselves or others might need to be in the hospital until their condition is stabilized.
Medication The primary medications used to treat the psychotic symptoms of schizophreniform disorder such as delusions, hallucinations and disordered thinking are called anti-psychotics. A group of newer medicines, called atypical antipsychotics, are most commonly used. These include:
- Risperidone .
- Asenapine .
- Lurasidone .
Psychotherapy The goal of therapy is to help your learn about the illness, establish goals and manage everyday problems related to the disorder. It also can help you manage the feelings of distress associated with the symptoms and challenge thoughts that might not be based in reality. Family therapy can help families deal more effectively with a loved one who has schizophreniform disorder, enabling them to contribute to a better outcome.
After your symptoms improve, you should continue treatment for 12 months. This includes gradually reducing the dosage of medication and carefully monitoring for signs of relapse . Also, its important to educate yourself and your family to help them cope with your illness and detect early signs of relapse.
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Looking After Your Physical Health
Schizophrenia takes a toll on your physical health as well as your mental health. It can sap your energy, confidence and motivation you might feel less capable of keeping up your physical health or lose the desire to try.
Another major influence on your physical health is the side-effects of antipsychotic medication. Newer antipsychotic medications have fewer side-effects, but weight gain is still a common one.
People being treated for schizophrenia are much more likely than the general population to be overweight, have high blood pressure and develop diabetes.
Theyre also more likely to smoke, drink too much and use recreational drugs, which can have a negative effect on your mental and physical health.
If youre struggling with these problems, you may hear your doctor use the term metabolic syndrome. It means you have some combination of:
- weight gain around the abdomen
- high blood pressure
- low levels of the good cholesterol
- high blood glucose levels.
Metabolic syndrome is common in people with a sedentary lifestyle and unhealthy diet, but its especially common in people with schizophrenia.
There is support to help you get healthy and stay healthy.
Outcomes From Previous Name Changes
The increased interest in changing the name of schizophrenia in recent years has supposedly been influenced by the movement in Japan which was the first country that introduced a new name for the disorder . In 2011, South Korea followed this development and replaced mind-split disease with attunement disorder . In Taiwan mind-split disease was replaced by dysregulation of thought and perception in 2012. Hong-Kong introduced a new name along with the old term splitting of mind which is still in use .
There are studies that confirm the positive effect and the reduction of stigma after introduction of these name changes in Japan and South Korea. It is reported that the new names evoke less prejudice, improve communication between clinicians and patients and promote social integration . But it was also found that the new term was not easy to understand for the public without further explanation. In addition, the media continued using the established name of the disorder .
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Proposals For Alternative Terms
Why changing the name of a disorder and how to select a new one? Is the stigma conveyed by the name or the illness itself? As mentioned above, the concept of dementia praecox transported a much poorer prognosis than schizophrenia or even the group of schizophrenias including 20% of courses with a single, remitting episode. It may be the name itself and its translated meaning which may play a role in cases like in Japan , but what exactly do people imagine by split mind? Negative connotations mainly arise from the underlying or subsumed illness concept and its anticipated practical consequences, and less from the correct meaning of its name which the lay public usually does not know anyway. Whereas today the internet can give information on illness concepts, course and outcome as well as treatment options and prognosis, in former times patients, families or the public were referred to outdated conversation lexica with mainly negative content to inform themselves. Certainly, schizophrenia is still one of the most severe mental illnesses, but much more differentiated information is available nowadays. However, even with a new name the illness will not run a better course until further improved treatment and care options will be available and being supported by ongoing public and targeted campaigns on awareness-building and against stigma .
When Should I See My Doctor
Some people with schizophrenia do not realise they have a problem or avoid health professionals if they have paranoid thoughts. Its important to get professional help to manage schizophrenia. If you or someone you know seems to be experiencing signs of schizophrenia, see your doctor as soon as possible.
It can be hard to recognise signs of schizophrenia at first, but over time the changes in someones thinking and behaviour may get worse.
See a doctor if you or someone you know:
- gets very preoccupied with something
- starts talking or writing very fast, or is talking much less than normal
- seems muddled, irrational or is hard to understand
- withdraws from normal activities
- is hyperactive or starts behaving recklessly
- laughs or cries inappropriately, or cannot laugh or cry or express happiness
- doesnt look after their personal hygiene
- develops depression or anxiety
Although the majority of people with schizophrenia are not violent, severe symptoms can cause some people to have thoughts of suicide or harming others. If you think someone may be at risk of suicide or violence, call triple zero .
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