Schizophrenic episodes vary greatly in length, from days or weeks to months or even longer, but for a formal schizophrenia diagnosis, psychotic symptoms must persist for at least six months, with prominent signs like hallucinations or delusions present for at least one month. Some people experience only one episode, while for others, they recur in phases, influenced by treatment, support, and the underlying condition, though early intervention generally leads to better outcomes.
Schizophrenia and psychosis
A first acute episode of psychosis can be very difficult to cope with, both for the person who is ill and for their family and friends. Drastic changes in behaviour may occur, and the person can become upset, anxious, confused, angry or suspicious of those around them.
The Following are Some Signs of Worsening Schizophrenia:
Disorganized speech: If the person with schizophrenia is speaking in a jumbled or incoherent manner, this could indicate that their medication needs to be adjusted or that they are experiencing a relapse of their illness.
If possible, offer the person choices of how you can help them so that they are in control. Convey a message of hope by assuring them that help is available and things can get better. If the person is unwilling to talk with you, do not try to force them to talk about their experiences.
Depending on the severity of the schizophrenic episode, the person may lose touch with reality, and the world can seem like a confusing jumble of sights, sounds, and information. A schizophrenic episode can last days or weeks—in rare cases, even months, says D'Souza.
Schizophrenia has been described as the “worst disease” to afflict mankind. It causes psychosis, which is an abnormal state of mind marked by hyperarousal, overactivation of brain circuits, and emotional distress. An untreated episode of psychosis can result in structural brain damage due to neurotoxicity.
The "25 rule" (or "rule of quarters") in schizophrenia suggests that outcomes fall into four roughly equal groups: 25% recover fully, 25% improve significantly with some ongoing support, 25% improve somewhat but need considerable help, and 25% have a poor outcome with chronic illness or suicide risk, highlighting the varied nature of schizophrenia's long-term course, though some sources use a "rule of thirds" with similar proportions for different outcomes.
During a schizophrenic episode, it's important to stay calm and patient to help the person feel stable. Use short, clear sentences to help people understand, make sure the environment is safe by getting rid of any potential hazards, and reduce noise and other distractions.
Stress can worsen symptoms. Learn ways to keep it under control. Seek help right away. Call your healthcare provider if you notice a change or increase in symptoms.
Early diagnosis and appropriate treatment make it possible to recover from psychosis. Some people who receive early treatment never have another psychotic episode.
Most people with schizophrenia are never violent and indeed do not display any dangerous behaviour. However a small number do become violent when they are suffering from the acute symptoms of psychosis because of the influence of the hallucinations and delusions on their thinking.
Avoiding drugs and alcohol
Alcohol and drug use can also cause other mental health problems, such as depression and anxiety as well as causing damage to your physical health. Drugs and alcohol can also react badly with antipsychotic medicines.
The main psychological triggers of schizophrenia are stressful life events, such as:
Among these, the 5 A's of Schizophrenia serve as essential markers for identifying and assessing the disorder. These include Alogia, Avolition, Anhedonia, Affective Flattening, and Asociality. Each of these symptoms represents a diminished or absent function that is critical for daily living and social interaction.
Schizophrenia is a mental illness that causes psychosis, but schizophrenia also has other symptoms. And it isn't the only cause of psychosis. In some cases, other mental illnesses cause psychosis, including depression, bipolar disorder, dementia and borderline personality disorder.
Lifelong treatment with medicines and psychosocial therapy can help manage schizophrenia, though there is no cure for it. These treatments are needed, even when symptoms ease. Some people may need to stay in a hospital during a crisis if symptoms are severe.
Someone with existing genetic risk factors for the disorder may develop an active case of schizophrenia after extended substance abuse. Using drugs, such as marijuana, cocaine and amphetamines, can also exacerbate schizophrenic symptoms and worsen their severity.
The most important part of treatment for schizophrenia is medication. It is nearly impossible to manage symptoms without antipsychotic drugs.
Most patients diagnosed with schizophrenia struggle at nighttime. The next-day effects can include a worsening of psychotic experiences, affective disturbances, and inactivity, which in turn affect the next night's sleep. Objective and subjective cognitive abilities may be affected too.
Here are some tips:
Give the person some physical space. Avoid a confrontation – sometimes leaving the house to wait for everyone to calm down is more productive. Have a plan – know who you are going to call if the aggressive behaviour continues or you feel there is a risk of harm to the person, yourself or others.
Treatment can help many people with schizophrenia lead highly productive and rewarding lives. As with other chronic illnesses, some patients do extremely well while others continue to be symptomatic and need support and assistance.
Speech may be mildly disorganized or completely incoherent and incomprehensible. Disorganized (bizarre) behavior may take the form of childlike silliness, agitation, or inappropriate appearance, hygiene, or conduct.
Disability Ratings for Schizophrenia
100% disability rating: a 100% disability rating for this condition is assigned when the veteran suffers total occupational and social impairment.
There's no single test for schizophrenia and the condition is usually diagnosed after assessment by a specialist in mental health. If you're concerned you may be developing symptoms of schizophrenia, see a GP as soon as possible. The earlier schizophrenia is treated, the better.