Schizophrenia is a psychotic disorder that means you have recurring psychoses. In psychosis, you experience reality differently and have delusions or hallucinations. With early treatment and support, you can often recover and have a working everyday life.

This text is about schizophrenia, which is a psychotic disorder. Mental illness is a collective name for illnesses where reality is perceived differently. You can read more about psychoses here.

You who are related to someone who has a mental illness can read more in this article.

Symptoms of schizophrenia

Schizophrenia often develops over a long period of time. It may take several years from the first symptoms to arrive, until the onset of the disease. You are most often diagnosed with schizophrenia at the earliest in the late teens or as a young adult.

These symptoms of schizophrenia are common, among others:

  • Delusions
  • hallucinations
  • thought disorders

When you have delusions, you experience the reality changed or different. For example, you may feel persecuted even though no one else sees it that way. It’s called paranoia. You may feel monitored, or think you have supernatural powers and are selected to do something important.

Hearing voices or other sounds is a form of hallucination that is common in schizophrenia. Another common experience is being exposed to radiation or something else harmful. You may also think that you have contact with dead people, or with a higher power.

You can also feel scents that no one else knows or experience things happening in the body that cannot be explained.

These symptoms of schizophrenia are sometimes called positive symptoms. This means that symptoms are added to a person. The opposite is negative symptoms, and are those taken from a person. Examples of negative symptoms are being apathetic, forgetful or losing the ability to communicate with the surroundings.

In schizophrenia, you can have both positive and negative symptoms.

Other symptoms

You often have a lot of trouble sleeping both before, during and after a psychosis. It is common for you to have severe anxiety, feel empty, apathetic or have suicidal thoughts.

You can be very sensitive to different sensations, such as sound and light. It can vary from day to day how much trouble you experience.

It can feel difficult to plan and do things at home, such as cleaning, shopping and paying bills. You may also have difficulty taking care of yourself, and may, for example, forget to wash or brush your teeth.

If the psychoses are long-lasting or recurring, it can affect life in many ways. For example, you may find it difficult to cope with work or study, and have contact with other people. 

To be diagnosed with schizophrenia, you must have had psychosis symptoms for at least six months, and have difficulty managing your everyday life.

Early signs

Before the psychosis breaks through, you may have vague symptoms. It is usually called early signs. Recognizing your early signs, and seeking care before becoming ill is an important part of recovering from schizophrenia.

It is different from person to person how these characters are labeled. For example, it may be a feeling of emptiness or a feeling that you are changing mentally. A common early sign is that you will have difficulty getting to rest and sleeping. Having difficulty concentrating or having memory disorders are other examples of early signs.

When and where should I seek care?

Contact a health care center if you think you are developing psychotic illness schizophrenia. You can also contact a psychiatric clinic directly.

  • You hear voices urging you to perform actions that you feel you cannot resist.
  • You are worried that you may be hurting yourself or someone else.
  • You feel very bad and have thoughts of taking your life.

If you have schizophrenia and feel that you are getting sick

Contact your psychiatric ward if you have had a psychosis before, and notice that you are getting sick. Your relatives can also contact the care provider in your place. The sooner you receive treatment, the faster you can begin to feel better again.

Tell the health care provider that you have given them your permission, so the health care provider knows about it. Often people in your area notice more quickly if the symptoms come back than you do yourself. It is important that you learn to recognize the early signs of psychosis.

Treatment of schizophrenia

You can receive treatment to reduce delusions and hallucinations, and to reduce the risk of new psychoses. Getting enough sleep and getting regular routines are also part of the treatment.

The goal of the treatment of schizophrenia is to be able to manage your symptoms, get a day-to-day life with you and be able to do activities that make you feel good.

As the symptoms subside, you can eventually arrange your existence with the support of relatives, health care and social services so that it works well for you. It can take several years to recover from schizophrenia, and several types of treatment are needed.

You can receive care at home or in a hospital

You can be treated at a psychiatric clinic or at home. It depends on the circumstances, and what suits you and your loved ones. It is important that you feel safe in a place where care is provided.

The faster you can get treatment, the faster you can recover. It is important that you get your routines organized as soon as possible. You need to get treatment with drugs and get some sleep.

It is also important that you get good contact with the healthcare staff, especially the person who will be your closest contact person.

The treatment consists of different parts

The treatment of schizophrenia depends, among other things, on how you feel, what symptoms you have and how they affect your everyday life. The treatment consists of different parts:

  • Antipsychotic drugs.
  • Psychotherapy and support calls.
  • Education, group meetings and support from the social service.

It is important that you are involved in your drug treatment

Antipsychotic drugs relieve the symptoms of schizophrenia so that other treatments can work. You can read more about drugs in schizophrenia here.

It is important that you participate in decisions regarding your medicines, as you will usually take them for a longer period of time. Then it is important that you endure the side effects so that you do not stop taking them.

You can also help decide which form you want to take your medicines, whether you want to take them as tablets, capsules or as a short-acting or long-acting syringe.

Being involved in deciding on your drug treatment is also an important part of your recovery.

Therapy and call support

With the help of psychotherapy or talk support, you can get help managing emotions and thoughts, and process experiences you have had in connection with psychosis.

You can also have difficult experiences before, which you can get help working in therapy. In addition to KBT therapy, music therapy and imaging therapy are among the recommended therapies.

The therapy can help you understand yourself better and what you can do to avoid getting a new psychosis. You can start therapy once you have been using antipsychotic drugs for a while and the symptoms have subsided.

Training and group meetings

You can have great help from support in the form of psychosocial efforts from the social services in your municipality. One of the most important parts is that you get an education and help to understand your illness. It’s called psychoeducation.

Then you will, among other things, learn to recognize early when you start to feel bad, so-called early signs. It is important to learn to recognize early signs to prevent relapse.

For example, you may receive group therapy with others who have similar experiences. An example of group treatment is “an independent life” which is abbreviated ESL. The goal of the social service efforts is to get you working everyday life, and the support you need to recover in the longer term.

Housing support

You can sometimes get support from the social service in your municipality. There are various forms of support and assistance, depending on your needs.

With so-called housing support, you can stay home, and get help with what you find difficult to manage or manage on your own. For example, it may be shopping, cleaning or paying bills and maintaining contacts with the authorities.

If you have a greater need, it may instead be better to live in a so-called group home. It is an accommodation consisting of apartments where there is staff during the day.

It can be good to live where you have many contacts and maybe close relatives, to reduce the risk of isolating yourself. It is the social service that decides what kind of housing assistance you receive.

Contact person through the municipality

Most often you get your contact person through psychiatry, who in turn has contact with various authorities, such as the social services and the Social Insurance Office. But sometimes you can also get a contact person through the municipality who can be social support in various leisure activities.

If you have been hospitalized

It is important that you get in touch with the psychiatric outpatient before you are discharged from the hospital. The outpatient takes over responsibility for your care when you are discharged.

At the hospital, you write a plan for what the next time will look like after you have been discharged. This may include, for example, how to renew your recipes and that you have visiting hours booked at the outpatient clinic.

If you are admitted several times, you can agree with the outpatient psychiatry about something called self-chosen admission.

To be involved in your care

It is important that you are involved in the decisions regarding your treatment, as far as possible. The treatment should be based on you and your needs. The goal is for you to come back to work in everyday life. Your relatives can join in and plan if you agree to it.

If you want, you can often get a coordinating contact person to help you make decisions about your treatment.

Permanent care contact or interpreter

You can ask for a so-called permanent care contact if you meet many different people in connection with your care. It can often be the same person as the coordinating contact person.

SIP – coordinated planning for contributions from the social service

When it comes to efforts that will be granted by the social service, you should have a so-called coordinated individual planning. It is often shortened to SIP. If you get a SIP, it usually replaces the care plan.

SIP can be good support for you and your loved ones by making it clear who is responsible for what. In psychiatry on the one hand, and in the social services on the other.

You can take the initiative for a SIP yourself. Ask your contact or a relative for help if you need it.

When you have a SIP, a permanent care contact is always appointed in the open care. They make sure that a plan is drawn up. Read more about regular care contact and SIP here.

If you receive care against your will

If you receive hospital care, it can either be voluntary, because you and your loved ones think it feels best. But sometimes you may need to be hospitalized even if you don’t want to. Then it is called compulsory care. It is a doctor who decides on compulsory care.

You have the right to get a support person if you are forced to decide on forced care. The support person should be supported during the time you are in the hospital, and a short time thereafter. The support person has a duty of confidentiality and should not work in the department where you receive care.

If you do not understand why you are being treated against your will, a doctor or other healthcare professional should explain it to you.

How can I avoid getting sick again?

There are some things you can think of to reduce the risk of getting sick again.

The most common causes of relapse in a psychotic illness are the following factors:

  • That you stop taking your medicines.
  • That you feel stressed or have too much going on at the same time.
  • That you happen to conflict with your loved ones.
  • That you use drugs or alcohol.
  • That you do not notice early signs.
  • That you lack a functioning crisis plan.

Talk to your doctor about your medicines

Talk to your doctor if you have any concerns about your medication. It may be that you have side effects and think that you would feel better without medication.

If you want to stop taking your medicines, it is important that you first discuss the matter with your doctor, and do not decide to stop on your own.

Sometimes you may need to get more information about how the drug works, sometimes you may need to switch to another type that produces fewer side effects or reduces the dose.

Try to reduce stress

Plan so you don’t have too much going on at the same time. Ask someone for help if you find it difficult. Try to live as regular a life as possible with fixed sleep routines.

If you have been experiencing external stress or change that has affected, worried or stressed you, it is extra important that you stick to your routines, such as sleeping at night and continuing to take your medication.

It is good if you can reduce stress and sleep more if you notice that you are getting worse. If you do not get better, it is important to seek care on time.

Get to know early signs

It is important that you learn to recognize early signs that you are getting sick. It is good if you and the people around you describe what the early signs are, and discuss it with your therapist. 

Then you can help recognize the symptoms and make sure you get treatment of schizophrenia at an early stage before you get too sick. The sooner you receive care, the sooner you can recover.

Establish a crisis plan

Establishing a so-called emergency plan means that you and your relatives agree in advance with the contact person or doctor about what applies at early signs. Then you can plan and decide what will happen if you start to get sick. 

In the emergency plan, you can give other people permission to decide when you need to seek care. It can be a great help to be reminded of what you agreed on in the emergency plan on the day you get sick and may have lost sight of the disease.

Intervention with related parties

You may start to feel worse if you feel criticized, cared for or overprotected by your immediate surroundings. If you feel it can help to go on a so-called psycho-pedagogical intervention, PPI with your relatives.

Talk to your coordinating contact person or social services manager if you need help arranging an intervention with your relatives.

You can recover from schizophrenia

How well you will be able to recover depends on several things. What influences are, among other things, what psychosocial symptoms you have, what support you have around you, how your life worked before you became ill and how involved you are in your treatment.

The more you get involved in your treatment and learn about the disease, the faster you will be able to recover.

Many people get better within the first three months after falling ill if the drugs have an effect. It is common to experience strong feelings of depression, insecurity, and anxiety up to a year after being ill.

The risk of getting a new psychosis decreases the longer it goes on, as long as the treatment works well and you get the support and help you need.

Recovery can take time

The recovery to get a working everyday life is a process that is moving forward, though it may take time. You can have a life you enjoy, with social relationships and contexts that feel meaningful. Most people who have been ill with a psychotic illness feel the best about living as independently as possible.

In addition to managing their symptoms, it is important to feel needed and to do things that feel meaningful. Many can manage with a relatively low dose of drugs after a few years.

Find support from others

Often, friends or family can be involved and support you in your recovery, if you wish. You can also get support in associations and associations.

By meeting other people with similar experiences, you can share experiences and get advice. It can make your life easier.

Here are some associations and associations that organize activities such as self-help groups and chat forums:

  • RSMH, National Association for Social and Mental Health
  • NSPH, National collaboration for mental health
  • Schizofreniförbundet

Visit regular doctor’s visits

It is good if you go to the doctor regularly to check your blood values, weight and waist measurements. The reason is that some antipsychotic drugs can cause you to gain weight. It can increase the risk of type 2 diabetes and high blood pressure.

Take care of your teeth

Some antipsychotic drugs can cause dry mouth. It can increase the risk of getting holes in your teeth. Therefore, it is good to take care of your teeth carefully and go to a dentist or dental hygienist at regular intervals.

You may also have the right to receive financial support since dental care costs as much as medical care and is covered by the healthcare’s high-cost protection.

Find work using individualized support

You can get help finding and applying for a job with the help of so-called individualized support. It is called with another term for Individual placement and support and is abbreviated IPS.

The purpose of the support is that you should find and be able to keep a job as soon as possible. It is important for several reasons that you get meaningful employment.

You can read more about what forms of work support are available on the Employment Service’s website. The municipality can sometimes also help to organize an internship on a daily basis. Contact your municipality to find out what applies where you live.

Ehtisham Nadeem

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