Warning Signs of a Schizophrenia Relapse

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Starting treatment for schizophrenia means you can start to live a full and rewarding life again. But it’s possible you will have a relapse, even when properly treated. That’s what doctors call it when your symptoms come back. This happens to most people with schizophrenia.

A relapse often has warning signs. If you recognize these signs, or someone in your family does, it may prevent a relapse. You can also be more alert for a relapse if you know your risk factors. 

Preventing a relapse is important. It can cause problems with your work, school and relationships. In most cases, you can treat a relapse and get your disease back under control. But each relapse makes your disease harder to treat. That's why it's important to recognize and prevent a relapse whenever you can.

Risk Factors for a Relapse

Not taking your antipsychotic medication is the biggest cause of relapses. You may be tempted to stop or slow down your medication because you feel better. You might want to stop because of side effects. But, you should never change the way you take your medication unless your doctor says it's OK. You also may be more likely to have a relapse if you:

  • Abuse drugs or alcohol
  • Recently started treatment
  • Are under a lot of physical or emotional stress

Warning Signs of a Relapse

You and people close to you should learn to recognize the warning signs of schizophrenia. Studies show that 70% of people with the illness and 93% of their family members have learned to do this. That's important because the warning signs often appear up to a month before the actual relapse occurs. These early warnings might help you stop a relapse before it starts.

Common warning signs include:

  • Hearing voices in your head
  • Feeling very suspicious
  • Having trouble sleeping 
  • Having false beliefs or trouble thinking clearly
  • Feeling anxious, depressed or angry
  • Not taking care of yourself
  • Staying away from friends and family
  • Experiencing changes in appetite
  • Losing interest in things
  • Having less energy

Your Relapse Prevention Plan

Preventing a relapse starts with taking your medication. Next, keep up with your psychosocial treatments. These are the treatments that teach you how to manage your disease. It’s also important to have a good support system: your family and friends may be your best early-warning system.

Your prevention plan tool box: 

  • Take your medication
  • Keep all your doctor and therapy appointments
  • Recognize warning signs
  • Attend weekly support group sessions
  • Attend frequent family education sessions
  • Get to your doctor as soon as you or your family suspect a relapse 

If your doctor suspects a relapse, you and your doctor can try to prevent it in several ways. These could include changing your medication, changing your psychosocial treatments, or adding social support. Lowering sources of stress also helps. 
Relapse is a common part of schizophrenia. But, you can lower your risk by knowing the signs and having a plan.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 2

  1. Schizophrenia. National Institutes of Health. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

  2. Lamberti JS. Seven Keys To Relapse Prevention in Schizophrenia. J Psychiatr Pract. 2001;7(4):253-259. 

  3. Emsley R, et al. The Nature of Relapse in Schizophrenia. BMC Psychiatry. 20138;13: 50. 

  4. Psychotic Relapse. Schizophrenia Research Institute. http://www.schizophreniaresearch.org.au/library/browse-library/course-and-outcomes/psychotic-relapse...

  5. Schizophrenia. University of Rochester Medical Center. https://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=85&ContentID=P00762

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