Schizophrenia: Working With Your Team to Manage Symptoms

This article is for people who have schizophrenia, and for those who care for them. It's also for others who want to learn more about this condition. The goal is to help you take an active role in working with your treatment team.

You'll explore

• Who the members of your care team are

• What your role is when working with your team

• How to work with your team to create a management plan that's right for you

• How to track your symptoms

• What to do if you feel that your treatment isn't working

If you or someone you care for was diagnosed with schizophrenia, you may know that it includes:

• Positive symptoms, such as hallucinations, delusions, and trouble thinking

• Negative symptoms, such as flat affect (little emotion), less pleasure in daily life, trouble doing daily activities

• Cognitive symptoms, such as trouble focusing, remembering, or paying attention

The causes of schizophrenia aren't fully understood, but genes and the environment are thought to play a role.

Schizophrenia is a treatable illness. More medicines are available to treat it than ever before and those who have it can often do well if they agree to and follow their treatment plan.

Positive symptoms may include hallucinations.

You don't have to manage schizophrenia alone. Your care team may include:

Team Member	What They Do
Psychiatrists	Diagnose and treat mental illness. Prescribe and manage your medicines.
Psychologists, counselors	Provide psychosocial treatments, like cognitive behavior therapy or family therapy.
Nurse practitioners, physician assistants	Prescribe and manage medicines, and may provide psychosocial therapy.
Nurses	Administer medicines and work with you and other members of the team to coordinate care.
Social workers	Help arrange social services, like Medicare/Medicaid, disability payments, and other financial needs.
Family members	Family members can be an important source of support and of information for the team.
You	Your team members are experts on mental health, but you are the expert on you.

Creating a treatment plan for schizophrenia is a team effort. Your team can share valuable information and guidance with you and your care partner.

But you also know what you want and need from your treatment and can advocate for yourself. You know your

• Goals and what you want to accomplish

• Preferences for treatment

• Abilities (what you're best at)

• Values (what's most important to you in life)

• Expectations for what you want treatment to provide for you

Communicate that information to your team. Then, together, you can come up with the options that will get you where you want to be.

Write down your answers to these questions and bring them in with you when you visit your care team. The answers below each question are just examples. Your answers might be completely different.

• What do you most want out of life?

  You might say: a job, an apartment, friends

• What do you most want out of treatment?

  You might say: for other voices to stop bothering me so much, or to have the energy to get up and take a shower in the morning

• What do you most want to avoid from treatment?

  You might say: to not gain weight, to avoid sexual side effects, or to not have tremors that make me look odd to others

Here are some questions you might want to ask your team:

• What is likely causing my symptoms?

• What can I expect over time?

• What's the best treatment for me? Are there other kinds of treatment we could try?

• What kinds of services might help me?

• How can I take care of myself every day? What changes do I need to make to my habits or routine?

There can be many parts to your treatment for schizophrenia. You may have supportive counseling, family counseling, and vocational counseling, to name only a few.

But almost everyone with schizophrenia will need medicine to help control symptoms. You can ask your team:

• What medicine might help me?

• How long will it take to work?

• How might it help me?

• What side effects can I expect? How can we manage them?

• Are there any clinical trials for schizophrenia medicines that might be right for me?

It's a good idea to track your symptoms to see which ones are getting better and whether any might be getting worse. You or your care partner can track your symptoms on a calendar, in a notebook, or on your smartphone.

• Write down the 2 or 3 symptoms that are most bothersome to you. Think about positive, negative, and cognitive symptoms, and your mood (anxious, depressed, irritable)

• Each day, rate whether each symptom is: (0) not present; (1) very mild; (2) possibly getting worse; (3) very bothersome

• Also write down any medicine side effects that you have on that day

Share your tracker with your treatment team. They should also be asking you similar questions. It will help you and your team decide if your medicine is working or if you need a different one or a change in your dose.

If a troubling new symptom happens, tell your provider; don't wait for your next appointment. Find out who to call and what number to use.

Your team can help you find a program that focuses on how your condition affects you and your family.

Family psychoeducation helps the person with schizophrenia achieve

• Fewer relapses

• Fewer hospitalizations

• Better family relationships and greater support

It helps the family

• Learn about schizophrenia

• Feel less distressed about dealing with the illness

• Learn about available community resources

• Understand how to deal with crises if they happen

Following your treatment plan, every day, is the best way to control your symptoms, stay out of the hospital, and reach the goals that you've decided you want to achieve. Here are some things you can do that can help:

• Take your medicine exactly as prescribed. If it's daily, pair it with something else you do at the same time every day, like brushing your teeth in the morning or going to bed at night

• Figure out a daily routine and follow it. For example, if you have a job or attend a day program, show up every day, even on the days that you don't feel like getting out of bed

• Give a family member or friend permission to be your check-in person. Ask them to call you every day to see how you're doing

Congratulations!

You have successfully completed the program: Schizophrenia: Working With Your Team to Manage Symptoms