Schizophrenia is a mental health condition that demands vigilance. Even with a good response to initial treatment, schizophrenia symptoms often return. A return or worsening of symptoms following a period of remission is called a relapse.As many as 80 to 98 percent of people with schizophrenia will experience a relapse, particularly after discontinuing treatment, and most people with schizophrenia have multiple relapses over time.
“Complete remission of schizophrenia symptoms is uncommon,” says Sophia Frangou, MD, PhD, a professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City. “Most people will experience a recurrence of symptoms.”
Some schizophrenia relapses occur without warning, but when early signs are present, they’re usually a return of early symptoms that occurred in the past.
Common warning signs of a schizophrenia relapse include:
Agitation, irritability, or tension
Changes in usual eating patterns
Depression or anxiety
Difficulty concentrating
Difficulty keeping up with personal hygiene
Disturbing or recurring thoughts
Hallucinations
Increasing paranoia or suspiciousness
Insomnia
Loss of interest in usual activities
Social withdrawal
Knowing these symptoms is important, but knowing the symptoms specific to each person with schizophrenia — called “relapse signatures” — is more important. Most people with schizophrenia will experience those early symptoms before a full relapse occurs.
“These warning symptoms can be very specific,” says Michael T. Compton, MD, MPH, a professor of psychiatry at Columbia University in New York City. “For one person, it may be insomnia or worries about the neighbors. For another person, it may be irritability or hearing whispers.”
In fact, the warning signs may be as specific as avoiding certain colors or foods, says Dr. Frangou.
That’s why it’s important to know the earliest symptoms of previous episodes and watch for them. “The first sign of a relapse is repeating symptoms of a previous episode,” says Frangou. Recognizing these symptoms early on can help ensure immediate steps are taken to get proper treatment, says Dr. Compton.
Knowing the common causes of a schizophrenia relapse can tell you when to be on the lookout.
Not taking medication regularly or as prescribed is by far the most common cause of schizophrenia relapse. Persistent use of drugs or alcohol, as well as stress and depression, are also common contributing factors. “Many people with schizophrenia abuse some type of drug — most commonly, marijuana,” says Frangou.
Stress is particularly problematic. “Stress may contribute to schizophrenia relapse, but symptoms of relapse can also increase stress,” she says.
“You may not be able to prevent a schizophrenia relapse, but early recognition and treatment may prevent a hospital admission,” says Compton. “The first thing to do is call [the] doctor to find out if [your] medication needs to be adjusted or restarted.” Other strategies include:
Staying on medication
Avoiding drugs and alcohol
Finding effective ways to cope with stress
Having a social support system
Not withdrawing from friends and loved ones
Sleeping and eating well
Another important strategy to manage a schizophrenia relapse is to get education and counseling support for yourself and your family to help you learn how to live with the condition. “Increasing psychosocial treatments can be an important part of relapse prevention,” says Compton.
You may not always be able to prevent a schizophrenia relapse, but recognizing early symptoms and getting help right away can help prevent a more severe episode, he adds.
Even with treatment, many people with schizophrenia experience relapses, which can cause symptoms such as difficulty concentrating, insomnia, and social withdrawal.
Not taking prescribed medications as directed is the most common cause of schizophrenia relapse.
To mitigate the impact of a schizophrenia relapse, experts recommend staying on prescribed medications, avoiding drugs and alcohol, reducing stress levels, and other strategies.
