Therapy for Schizophrenia

Those living with a mental illness must often pursue treatment to live life as healthily as possible. If you or a loved one is struggling with the symptoms of schizophrenia, you may be considering your options for treatment. As you explore the different types of therapy and treatments available to manage schizophrenia in teens and adults, keep in mind that managing symptoms can take time. Often, it is only through trial and error that you can find the right combination of therapy options and tools that work most effectively for you or your loved one.

What is schizophrenia? 

The American Psychiatric Association describes schizophrenia as, "a serious mental illness characterized by incoherent or illogical thoughts, bizarre behavior and speech, and delusions or hallucinations, such as hearing voices.” Most people develop this condition in their late teens to mid-30s. People can experience different levels of this mental illness, and not everyone has all of the same symptoms or the same risk level. Some people may not experience early psychosis but rather more unrecognizable signs, such as a drop in academic performance or a change in friends. It's also possible for symptoms to change over the course of someone's life. In some cases, symptoms can look like schizoaffective disorder, bipolar disorder, or other mental health conditions, so accurate diagnosis with a mental health professional can be crucial.

Symptoms of schizophrenia

The Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition defines schizophrenia as a psychotic disorder in which someone has two or more of the following symptoms or diagnostic criteria for an extended amount of time during a month-long period (however this may only be for several weeks or less if successfully treated):

If you find yourself wondering, "Do I have schizophrenia?" You can read more about the symptoms of schizophrenia on the National Institute of Mental Health (NIMH) website.

Schizophrenia treatment options

Although there is no cure known to treat the medical condition of schizophrenia, there is ongoing research looking for additional forms of treatment and ultimately, a cure. However, the most effective treatment available is the specific plan that caters to each person’s individual needs. These treatment plans are generally made by the person living with schizophrenia in conjunction with a treatment team, including a mental health professional and medical provider. 

Antipsychotic medications 

The main form of schizophrenia treatment available currently is antipsychotic medication. It is not the only type of treatment available, but it generally is going to be part of any treatment plan. The medications used to treat schizophrenia are believed to be beneficial to the patient because they impact dopamine, a neurotransmitter in the brain. These medications are known as typical antipsychotics, as opposed to second-generation medications (also known as atypical antipsychotics) or second-generation antipsychotics, which are serotonin-dopamine antagonists.

When it comes to the dosing for medication, the ultimate goal for long-term treatment is to have people on the lowest dosage possible for the patient to still see positive effects along with a reduction in symptoms without severe side effects or long-term risks. This process can take time. Patients generally need to continue working with a psychiatrist and health care team who can monitor the medication that they are on along with how it is impacting their symptoms. It can take weeks to be able to see if a medication is beneficial. It’s also worth keeping in mind that some antipsychotic medications can cause adverse side effects and unwanted feelings. Many can cause weight gain, and long-term use of some antipsychotics can cause movement disorders, like tardive dyskinesia. One must weigh both the benefits and possible side effects when deciding if the risks are worth the potential positive outcomes.

Along with antipsychotic medications, people may need to take additional medications such as anti-anxiety or antidepressant medication. This can help them make more progress in overcoming their symptoms.

One concern with medication is that the patient will not take the medication as needed. If someone stops taking the medication without consulting their psychiatrist or doctor, they may start to struggle or experience worsening symptoms. Some people are reluctant to take the medication because of the adverse side effects that could occur. However, for many people with schizophrenia, medication is a necessary form of treatment to help get the disorder under control.

Individual counseling for schizophrenia

Talking therapy sessions for schizophrenia can be important for helping people with schizophrenia improve their coping skills, learn how to control stress and anxiety, and learn to recognize the early warning signs that they are starting to struggle with their symptoms. If they can learn how to identify and work through these problems early on, they may be able to address the symptoms more productively as they arise. In some cases, there may be comorbid mental health conditions that benefit from treatment and support services in tandem. These may include anxiety and moderate to severe depression.

Options for individual schizophrenia talking therapies include psychosocial, cognitive behavior, cognitive enhancement, cognitive remediation, arts therapies, and electroconvulsive therapy. Cognitive behavioral therapy (CBT) is a type of talk therapy that helps people recognize negative thoughts and behaviors and replace them with more positive ones. Psychosocial therapy can be one piece of the puzzle in psychosocial interventions that include motivational enhancement, case management, relapse prevention, and more. These psychosocial treatments can be helpful as an early intervention in restructuring thinking and responding to stress. You can learn about the other treatments available in individual therapy on BetterHelp’s advice page. 

Support groups for schizophrenia

Support groups and self-help groups can also be a useful social tool for those with a mental illness like schizophrenia. Group sessions may be led by a peer support specialist who has personal experience with mental illness, or mental health professionals such as a therapist. A support group may also help individuals with social interactions and skills training or discover self-management techniques from others coping with the same or similar symptoms. On the National Alliance on Mental Health website, you can find peer support groups around the country to help with everything from stress management to substance abuse. Some support groups are focused on peer support and care, whereas others may be marketed toward family members of those with schizophrenia.

Family and group counseling

While individual or group therapy can be very important for the person experiencing schizophrenia, a family intervention can assist the familial unit in supporting the family member with schizophrenia. The symptoms of schizophrenia can cause tension and frustration within relationships. Attending family therapy and receiving family education about this neuropsychiatric disease can lead to more understanding within the family. It can be an effective way for family to solve problems and get their questions answered and find the support that they need. 

Vocational rehabilitation

The purpose of vocational rehabilitation is to help people with schizophrenia learn the skills that they need to be able to find employment opportunities and then keep jobs once they have them. People with this disorder can work, live, and improve their quality of life when they can get chronic schizophrenia symptoms under control. Assertive community treatment (ACT) is another type of community-based treatment that may include vocational rehabilitation and supported employment, along with reaching other goals, such as reducing homelessness and long hospital stays.

Hospitalization

While hospitalization is not a form of therapy, it can be a necessary step in treatment for some individuals with schizophrenia cope with symptoms during an acute psychotic episode. This only needs to be a temporary solution during an acute episode to get symptoms under control. If an individual is refusing to take their medicine or if they are not properly taking care of themselves, then it may be necessary for them to be under medical care for some time. The main goal of this is to help get the person to a place where they can care for themselves properly on their own.

This step can also be necessary for individuals who are a danger to themselves or others. While being diagnosed with schizophrenia doesn't automatically mean that someone is going to become a danger to themselves or others, if they are not managing their symptoms, some may reach this level. At this point, it’s crucial that they get immediate attention.

In some cases, individuals with schizophrenia may benefit from high-level medical support options like electroconvulsive therapy (ECT). ECT is done under anesthesia with a medical doctor. Talk to your primary care provider or psychiatrist to learn more about this treatment option.

Stigma and misconceptions about schizophrenia

There is a stigma that surrounds mental health and mental illness, including mental disorders like schizophrenia. This stigma can make it very difficult for people with schizophrenia to get the help that they need. They might be afraid of what others will think so they may use self-management techniques to cope instead of seeking appropriate treatment. 

How online counseling can help schizophrenia

If you are looking for help for yourself or a loved one with the management of schizophrenia, having a therapist for schizophrenia on your health team can be beneficial. There are a variety of options available for online therapy, such as the service offered by BetterHelp. Online therapy can be a powerful tool for those who want to strengthen their own mental health and improve their lives. 

Online therapy can be effective for those with mental illness as well as those supporting loved ones through mental health disorders. An analysis of veterans living with schizophrenia and experiencing suicidal ideation showed that an online-based intervention was successful in improving their symptoms. The majority of participants had fewer thoughts of suicide, successfully showing the efficacy of online therapy for treating serious mental health disorders such as schizophrenia.

If you or someone you know is having suicidal thoughts, contact the 988 Suicide & Crisis Lifeline immediately by visiting their website or texting/calling 988. Free support is available 24/7. Please also see our Get Help Now page for more immediate resources.