Relapses are often associated with a major disruption in a person’s life, such as a job loss or legal problem. They’re usually preceded by early warning signs that appear a week or so in advance, says Alia Warner, PhD, managing director of the University of Texas Health Psychosis Specialty Clinic, in Houston. These signs could include an escalation of usual symptoms, such as hearing louder voices, feeling more depressed or paranoid, or having more relationship problems.
While relapses can’t always be completely prevented, you can take steps to reduce the severity, as well as the likelihood of an occurrence, says Dr. Warner.
Here are some things that can trigger a relapse, plus tips to avoid them.
1. Failure to Take Medication
“Relapses are often related to medication noncompliance,” says Max Schiff, MD, PhD, a psychiatrist at Duke Health in Durham, North Carolina. In most cases, this goes beyond missing a dose or two and involves the person with schizophrenia deciding that medication is no longer needed, says Dr. Schiff. “After being off the medication for a period of time, we see a gradual increase in symptoms.”
If you’re not taking your medication because of unwanted side effects, talk to your doctor. They may be able to adjust the dosage or recommend a different combination of medications.
2. Drug or Alcohol Use
It’s not uncommon for people with schizophrenia to use drugs or alcohol to cope with symptoms, but these substances can trigger a relapse. “Alcohol can interact with some medications and make them less effective,” says Dr. Warner. Drugs, such as marijuana and methamphetamines, can not only trigger a relapse of symptoms, but also cause an episode of psychosis, she says.
Cannabis and cannabis products may be especially likely to trigger psychosis, says Schiff. To play it safe, do your best to avoid using any drugs or alcohol.
3. Sickness
Michelle Hammer
Living with schizophrenia
‘If I feel stress coming on … I’ll just take a break. Not everything has to be done in a certain amount of time.’
Transcript Available
4. Unmanaged Stress
Both good and bad pressure — whether it’s a big event like getting married or a deadline at work — can cause a relapse of symptoms, says Warner.
No one can avoid stress at all times, of course. Nor do experts recommend it. “We don’t want people to avoid too many things, because it can lead to an avoidant behavior cycle, where things become more stressful or scary,” she says.
5. Poor Sleep
“Insomnia, lack of sleep, or just a lack of a regular sleep pattern can increase your stress levels and cause a slow decline [in the condition],” says Schiff. As much as possible, try to stick to a regular bedtime, avoid screens for an hour or more before bed, and skip caffeine for at least a few hours before bedtime, he says.
If you’re still not sleeping well, mention it to your doctor, who may be able to prescribe medication to help you sleep better, says Schiff.
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