December 21, 2006

Schizophrenia & Psychosis - Ways to Speed Recovery and to Prevent a Recurrence

The following document is a handout that is used at the University of California, San Francisco program for early psychosis and schizophrenia treatment. This document was originally developed by the PIER program at Maine Medical Center. It is something that is given to all family members and individuals that join the treatment program. Feel free to print it out and pass it out to anyone you think might benefit from it.

Schizophrenia & Psychosis - Ways to Speed Recovery and to Prevent a Recurrence

There will be a fair amount of uncertainty about causes and outcome, but providing treatment quickly and early has been shown definitively to greatly improve prospects and outcome.

Believe in your power to affect the outcome: you can.

Make forward steps cautiously, one at a time. Go slow. Allow time for recovery. Recovery takes time. Rest is important. Things will get better in their own time. Build yourself up for the next life steps.

Consider using medication to protect your future. A little goes a long way. The medication is working and is necessary even if you feel fine. Work with your doctor to find the right medication and the right dose. Have patience, it takes time. Take medications as they are prescribed. Take only medications that are prescribed.

• Try to reduce your responsibilities and stresses, at least for the next six months or so.

Take it easy. Use a personal yardstick. Compare this month to last month rather than last year or next year.

• Use the symptoms as indicators. If they reappear, slow down, simplify and look for support and help, quickly. Learn and use your early warning signs and changes in symptoms. Consult with your family clinician or psychiatrist. Anticipate stresses.

Create a protective environment

• Keep it cool. Enthusiasm is normal. Tone it down. Disagreement is normal. Tone it down too.

• Give each other space. Time out is important for everyone. It's okay to reach out. It's okay to say "no".

Observe limits. Everyone needs to know what the rules are. A few good rules keep things clear.

• Ignore what you can't change. Let some things slide. Don't ignore violence or concerns about suicide.

• Keep it simple. Say what you have to say clearly, calmly and positively.

• Carry on business as usual. Reestablish family routines as quickly as possible. Stay in touch with family and friends.

• Solve problems step by step.
Make changes gradually. Work on one thing at a time. Look for coping methods that work for you, and work with your clinicians to find other methods when yours don't work.

• Watch for large reactions to even little changes in relationships. Have a plan for what to do and where to get help. Don't get too vigilant.

• Keep a regular sleep and wake cycle. Don't fly more than four time zones in one day. Avoid night shift or rotating shift jobs. Don't do all-nighters, for work or play.

• Keep a balanced life and a balanced perspective.

• Keep up an outside occupation, but don't work too hard for a while.

• Take time to cool out. If it's in your nature, use Zen or other meditation techniques to keep stress, strain and anxiety to a minimum.

• Watch out for the effects of street drugs and alcohol. They make symptoms worse and may cause relapse.

• Never use cocaine, amphetamines ("speed") or hallucinogens at all for any reason. Avoid over-the-counter stimulants like pseudoephedrine, diet pills, No-Doze, and inhalants. They're internal stimulants and can cause biologically rapid onset of psychosis. Keep alcohol to a bare minimum, or use not at all if possible.

• Stay away from nicotine and caffeine, as hard as that might be.

• Explain your circumstances to your closest relatives and friends, and ask them to help and stand by you.

• Learn to accept support from your network of family and friends.

• Don't move abruptly or very far from your family home or home town until this period passes and stability returns. If you have to move prepare well in advance.

• Dodge the bad scenes and look for the good ones.

• Keep a social network intact and try not to change it without lots of preparation.

• Decide who you want to know about your situation. You may have to play the system to protect yourself.

• Attend multifamily Support groups. (offered by your hospital, NAMI, local support centers, etc.)

• Keep hope alive.


Great points. I know these things have helped. The one thing that I know has been hard for me is
Keep it cool. Enthusiasm is normal. Tone it down.

I come from a loud, passionate family, and this is part of my personality. But I knew from when my affected child was very young that this was a personality trait of mine that was not good for her... and was the hardest for me to do ... also to let her hole up during family gatherings and not participate until ready or for as little as she wanted and let people know it is OK, and she is OK... she just needed the quiet ... and we all needed to respect her needs.

This is a lovely list.

Posted by: Naomi at December 21, 2006 07:24 PM

Some of the most important of these are financially and situationally impossible for many people.

Posted by: Cory Schulz at December 21, 2006 08:46 PM

My parents were not at all supportive when i got first got ill(i was originally dxed with sz).Both being educated/intelligent people they read the available books but there was little in the way of tolerance.
Enthusiasm or getting noticably animated about anything was invariably greeted
with 'I think you are getting ill son'or 'Have you taken your pills??'
by my mother.This was especially true if i expressed views that were contrary to hers.
Both my parents treated me
as an adult in terms of paying
keep but very much as a child otherwise.

In terms of keeping up hope -my parents were both found of
telling people that i was sz but that maybe they would find
a cure in a 100 years or so.
I can remember my mum doing this in a crowded local pub while talking to some of her friends; i wanted the earth to swallow me up i was so embarrassed.
My father's response to my mother's belief that something was not right was apparently 'Well he's going mad isn't he?

I strongly believe that a healthy family environment is important.
Often other family members although not necessarily dxed with anything have their own mh/psychological issues that can adversely affect that healthy environment.
While treating the sufferer should be the main priority it is important that pdocs and mh nurses are aware of the issues that other family members have
and how these may impact on the sufferer.

In my case this did not happen.

I think the early years of treating a person with mental illness are by far the most important.
Get it wrong/fail to provide adequate levels of help and support then social functioning,occupational functioning,and functioning in
terms of symptoms and overall QOL can be badly affected.

Posted by: Tim at December 24, 2006 01:54 AM

I agree with Cory.

Posted by: Uncle Sam at December 29, 2006 05:05 PM

Iam writing in as my brother has been diagnosed with schizophrenia. 1st of all I would like 2 say how proud of him I am and how brave I think he is. I never really understood the illness until now. I've been reading a lot about it and the things people go through. I feel for anyone going through the same suituation. I never in a million years thought that this would ever happen 2 him but as I now know it can happen 2 anyone.I learnt that the best way to help the situation is 2 let him know that i am here 4 him every day, he's luved very very much and no matter how hard things get that will never change. Any advise guys?? Melissa xxx

Posted by: Melissa Hunt at January 25, 2007 01:41 AM

i hove aomeone can fnd a cure. especially for tonight. if mr. Valero can find a cure it will be a good help.

Posted by: neil at March 20, 2007 08:14 PM

I am trying very hard to recover from a period of severe instability brought on by schizo affective disorder. I am still very paranoid, but the ECT and haldol have helped. Anyways, I am just wanting to hear from people with the same type of issues... I am struggling and I don't know where to turn.
I now live in a residential care home for people with mental disorders, but I guess the hardest thing is that I can't accept that this isn't reality. I am still plagued by voices and visions, but I am quickly learning to ignore them. Well, slowly. My life has turned all over and I a still in shock and fear for my life, 3 years after my official diagnosis. Is it normal to be in denial this long??

Posted by: alyssa at April 21, 2007 04:12 PM

Hello Alyssa, denial is our worst enemy. I do too suffer from schizo affective disorder, as soon I stop thinking that I was magical or something like that I started to make life plans ( realistic) . never forget who you are. goodluck

Posted by: hugo at May 18, 2007 12:03 AM

My 21 year old son sufferes a psycotic attack last year , but with alot of love and support he has got through this.he still has bad days but you have to stay positive and take each day step by step.

Posted by: susan.neale at July 9, 2007 07:11 AM

This is a response to neil. I'd like to say I'm in the same boat as you but I'd be lying. Truth is... my life is all but ending unless I make a big change right now! My Dad's gonna kick me out of the house if I fail out of school. And the only reason I'm even living with him now is because of the numerous amounts of drugs and alcohol I did in the last two years. I've done so much... I've gotten completely used to the schizophrenia/voices/visuals which I've had for 4 years. I'm not saying,and obviously you can't if you're hospitalized, to use drugs least ignore them(the voices), hell even talk to them and find an agreement on what to talk about. Look up Hearing Voices Movement on Google, it's pretty interesting and I've kinda been following it, now basically I control what my voices say and which one of them speak at what time. Anyways...sorry I'm a little high I just wanted to offer a spot of information. Good luck!

Posted by: Brandon at October 26, 2007 08:33 PM

this is really a question. What can happen to someone who has schizophrenia and works nightshifts?

Posted by: Billy Harris at November 20, 2007 05:14 PM

This is a really good guide and I am definately going to follow these steps. Thank you so much.
This site is helping to see that there is life after mental illness.

Posted by: Ashlekea at January 26, 2008 06:48 PM

My younger brother (29yrs) recently was diagnosed sz. He is taking medication as suggested by the doc. My question is - will he become completely normal as the doc told us? I understand that there may be relapse but at least is there a chance to be normal (with proper medication and family support)? I will do whatever it takes to keep him in good condition till I am alive.

Posted by: john at March 27, 2008 05:09 PM

Thanks for a beautiful site! I have added you in elected!
Necessarily I shall advise your site to the friends!

Posted by: Brytney at June 16, 2008 08:28 PM

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