How to Cope With Schizophrenia Relapse or Breakthrough Symptoms
Relapse is a scary thought. Just when we have some recovery time under our belt, relapse or breakthrough symptoms threaten to make our carefully constructed card castle come crashing down. But the more that you are self-aware and practice wellness and self-care, the less scary relapse can be.
The threat of relapse symptoms
I am no stranger to relapse and breakthrough symptoms. I've been living with schizoaffective disorder (a form of schizophrenia) since I was 19 and I'm now 48. I have a good deal of stability under my belt, and I pride myself on being able to live successfully and thrive with schizophrenia.
But there are times, especially when experiencing a good deal of stress, when I am threatened with relapse or breakthrough symptoms. I do take medication for my symptoms. And I see a therapist and have a healthy self-care routine. But sometimes even all those supports are not enough to block out the symptoms I experience.
Symptoms of schizophrenia
Schizophrenia has both positive and negative symptoms and I experience both at different times.
Positive are not good symptoms, but merely symptoms indicating something is present or something that is happening to you. Negative symptoms are not necessarily bad, but the absence of something, like motivation or meaningful activity.
Positive symptoms are better known as hearing voices, loss of touch with reality or psychosis, having strange beliefs or delusions, or paranoia. Negative symptoms can be becoming withdrawn in social situations, lack of interest or pleasure in things that once made you happy, feeling numb, or just general lack of wanting to engage in life.
When I start to experience these things, a few things start to happen.
When I notice breakthrough symptoms
The very first thing I notice when I'm approaching a positive symptom breakthrough is that my thoughts become "loose." This is the best way that I can put it. What that means is that my thoughts which are usually very tight and coherent start to become "loose" and difficult to understand. They don't make sense and I have a hard time staying focused.
Soon, I might start to hear things in other rooms (like voices) that aren't really there. My thoughts will start not to make any sense and may start to become like word salad and have a lack of cohesion. I may start to think that I'm sick or dying (delusional thoughts) or other weird beliefs.
But... Before this happens, I try to intervene with my treatment team.
Preventing severity or duration of relapse
My doctors may need to tweak my medication or I may need to up my self-care game. Usually the "loose" thoughts are my first red flag that I need to do something to help my wellness.
Acting at the very first sign of symptoms may not prevent a relapse, but can certainly affect the severity and duration of the relapse. I encourage everyone who starts to feel "off" at all, really examine what's going on with them and seek help to stave off a breakthrough of troubling symptoms.
Knowing your red flags and taking early action
Since I also work full-time, I might need to take a few days off to manage symptoms and being upfront with my employer about what I'm going through has been helpful. The most important thing that you can do during this time is everything you can to stay well and keep your stability moving forward.
Talking about your symptoms and not hiding what is going on with you can also be helpful. Taking action early is key in making the relapse manageable and getting you back to a more stable place in quick fashion. Know your own red-flag thoughts and behaviors – and know them well!
Coping with a relapse as best as I can
It’s the same preventative measures with negative symptoms too, except I may do some extra therapy or seek out support from friends or family to get me to be more social and not isolate. I may exercise more, incorporate more movement into my day, and do more things that include mindfulness, like meditation or yoga practice. I might try to find meaning in my days and be extra gentle with finding things that have importance to me.
It really helps to also talk to my treatment team, because they might recommend a medication tweak in this case, too.
Getting to know your schizophrenia symptoms
I think what’s important is that after you have been diagnosed, is that you really get to know yourself and you get to know your symptoms. Sticking to a plan for treatment and having a good support system is helpful as well.
And one other thing... This journey is YOURS! You need to hold yourself accountable for your own wellness and your own recovery. Not all things can be solved with medication or by doctors or professionals. You have to take action to improve your own recovery and fight for your own wellness. Be self-aware, resilient, and have a healthy sense of autonomy.
Following instincts, making a plan
And when things feel "off," you need to act as soon as possible to maintain all the positive gains of recovery that you’ve already made.
Make sure that you create a plan when you're well that you can enact when you’re not so that when you start to struggle with relapse or breakthrough symptoms, you can manage it and it becomes a bump on the road of recovery, not a derailment.