“Your daughter has schizophrenia,” I told the woman.
“Oh, my God, anything but that,” she replied. “Why couldn’t she have leukemia or some other disease instead?”
“But if she had leukemia she might die,” I pointed out. “Schizophrenia is a much more treatable disease.”
The woman looked sadly at me, then down at the floor. She spoke softly. “I would still prefer that my daughter had leukemia.”
“This book is a product of a thousand such conversations,” writes research psychiatrist and schizophrenia specialist E. Fuller Torrey, M.D., in Surviving Schizophrenia: A Manual for Families, Patients And Providers. Getting a diagnosis of schizophrenia can be devastating. Families and patients alike think there’s no hope. What follows may be shock, shame and confusion. But schizophrenia isn’t a death sentence or an inevitable descent into psychosis and violence, as some movies and shows would have you believe. Even though it may be terrifying, receiving a proper diagnosis is a good thing: It’s one step closer to the right treatment.
“Earlier treatment and shorter duration of untreated psychosis is associated with better treatment response, less likelihood of relapse and better clinical outcome,” said Sandra De Silva, Ph.D, psychosocial treatment co-director and outreach director at the Staglin Music Festival Center for the Assessment and Prevention of Prodromal States (CAPPS) at UCLA, departments of psychology and psychiatry.
Here’s a look at what effective treatment for schizophrenia entails, how you can manage the disorder, and what to do if you notice early warning signs.
Early Diagnosis of Schizophrenia
Schizophrenia rarely occurs unexpectedly. Instead, it produces a gradual decline in functioning. There are usually early warning signs, referred to as the “prodrome,” which last one to three years, and provides the perfect place to intervene.
Early symptoms are the same as in psychotic illnesses, but “they are experienced at a milder, subthreshold level,” De Silva said. The key symptoms to look for are “suspiciousness, unusual thoughts, changes in sensory experience (hearing, seeing, feeling, tasting, or smelling things that others don’t experience), disorganized communication (difficulty getting to the point, rambling, illogical reasoning) and grandiosity (unrealistic ideas of abilities or talents),” according to De Silva. Just one of these symptoms is the “greatest predictor of psychosis to date — greater than having a parent with schizophrenia,” she said. In fact, according to recent research, 35 percent of individuals who presented with one of these symptoms developed psychosis within 2.5 years. Substance use, such as alcohol and marijuana, also has been shown to boost risk.
Early Intervention for Schizophrenia
So what can you do if you think your loved one is showing these early signs? There are various prodromal clinics in the U.S. and some abroad that offer services — usually including regular evaluations and treatment — for at-risk youth and their families. At De Silva’s clinic, CAPPS, individuals from 12 to 25 years old get a diagnostic screening, assessments, and case management at no charge. Early treatment aims to reduce the risk of developing schizophrenia, delay its onset (which research shows has a better prognosis), decrease severity after onset, and improve outcomes in all areas, De Silva said.
Treatment of Schizophrenia
“The longer an illness is left untreated, the greater the disruption to the person’s ability to study, work, make friends, and interact comfortably with others,” De Silva said. A combination of treatments is best for individuals with schizophrenia. Medication is the mainstay of treatment, “used to minimize hallucinations, help the individual think more clearly, focus on reality, and sleep better,” according to Dawn Velligan, Ph.D, professor and co-director of the Division of Schizophrenia and Related Disorders at the Department of Psychiatry, UT Health Science Center at San Antonio . However, “decades of research have shown that psychosocial treatments “are also important in improving symptoms and quality of life,” she added.