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Section 5
Prevention of Relapse in Schizophrenia

Question 5 | Test | Table of Contents

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In the last section, we discussed the stigma of schizophrenia.  Three topics included in this section are prejudices, stereotypes, and who to tell.  We also discussed how clients can deal with prejudice and stereotypes.

In this section, we will discuss avoiding relapses.  Three aspects of avoiding relapse that we will examine are signs of relapse, decreasing stress and dating, and other healthy habits that can help avoid relapse.  The focus of this section is to provide you with information on how Mike learned to avoid relapses.  Therefore, as you listen to this section, consider ways to adapt these methods to avoid relapse for your client.   

Three Aspects of Avoiding Relapse

♦ #1  Signs of Relapse
First, let’s discuss signs of relapse.  Mike experienced periodic relapses.  Mike, age 26, had paranoid auditory hallucination relapses.  He described two voices speaking softly to one another at first.  The longer Mike’s relapse was, the louder the voices got.  Mike stated, "Relapses are so frustrating.  I kind of depend on my medication to work, but sometimes, I still get sick.  I know it’s not my fault that I have schizophrenia, but I wish I had more control over it." 

To help Mike learn to acknowledge his personal signs of relapse, I gave him some typical warning signs which are common to schizophrenic relapse.  I stated, "It is helpful to know your own warning signs so that you can get help as early as possible.  Some early warning signs may be changes in appetite, weight loss, decreased or increased sleep, disturbed sleep, or changes in energy level.  There may also be symptoms such as paranoia, feeling people are looking at you, or a return of other symptoms you experienced previously.  As soon as you notice a change or a new symptom, notify someone immediately."

 Consider the client who has schizophrenia that you are treating.  Do you agree that a client’s awareness of his or her own signs of relapse can be an important step in avoiding relapse? 

♦ #2  Decreasing Stress and Dating
Second, let’s look at decreasing stress and dating as a way clients can avoid relapses.  As you know, stress does not cause schizophrenia.  However, once a client has schizophrenia, stress can affect the client’s health.  Mike began to equate stress with his relapses.  Mike stated, "Right before I start hearing the voices in my head, it seems like I’m always on the verge of a panic attack.  I get real anxious." 

To decrease his stress, Mike made sure that he slept well, maintained a good diet, and exercised.  Also, I showed him a deep breathing exercise that he could use when momentary stress began to build up.  If your client experiences high levels of stress, you might consider adapting a breathing or relaxation exercise to help decrease stress. 

In addition to decreasing stress, Mike informed me of his intent to begin actively dating again.  Mike stated, "I figured since I’m exercising regularly and watching what I eat, I should get back into the dating scene.  You’re always telling me about ‘communication skills’ and ‘social ability.’"  Would you agree that dating and intimate relationships can be productive ways for clients to avoid relapse?  Can you think of ways to prompt your client to date, if he or she is ready to tolerate it?

♦ #3  Other Healthy Habits That Can Help Prevent Relapse
In addition to signs of relapse, decreasing stress and dating, the third aspect of avoiding relapses that we discuss is other healthy habits that can help prevent relapse.  Have you found that staying well is often a more difficult challenge for clients than getting well?  In my experience, this is sometimes due to problems with medication or skipping doses, but other times clients experience difficulty avoiding relapses because of improper management of recovery interference.

  Mike stated, "I take my medication all the time, just like I’m supposed to.  But I sill have relapses."  At a later session, Mike devised a list of healthy habits he used to prevent relapse.  Perhaps your client could benefit from hearing Mike’s list.  Feel free to share it with your client or play this section, if your client would be receptive. 

Mike’s List of Healthy Habits to Prevent Relapse
1. Take medication as prescribed.
2. Go to your therapy sessions.
3. Keep your doctor appointments.
4. Reduce stress.
5. Take one step at a time.  The road to recovery is long.
6. Do enjoyable activities.
7. Do not use drugs or alcohol.
8. Get plenty of sleep with a regular sleep schedule.
9. Eat foods that are healthy.
10. Exercise ten to twenty minutes a day.
11. Talk with your family and friends.
12. Know your own signs of relapse.
And
13. Build a routine into your days.

As you can see, Mike found that by staying busy, taking his recovery slow, and living healthy he could avoid relapses.  As you know, each client requires a different recovery method, but could your client benefit form any of the techniques described here?  Has your client identified his or her signs of relapse?

In this section, we have discussed avoiding relapses.  Three aspects of avoiding relapse that we have examined are signs of relapse, decreasing stress and dating, and other healthy habits that can help prevent relapse.  

In the next section, we will discuss coping with positive symptoms of schizophrenic psychosis.  Three specific coping strategies for positive symptoms that we will examine are reality testing, self talk, and coping when losing control.
Reviewed 2023

Peer-Reviewed Journal Article References:
Hartmann, W, Kind, J., Meyer, J. E., Müller, P., & Steuber, H. (1980). Neuroleptic drugs and the prevention of relapse in schizophrenia: A workshop report. Schizophrenia Bulletin, 6(3), 536–543.

Husted, J., Severson, R., & Husted, S. (2010). Preventing relapse in persons with serious mental illness. Journal of Rural Mental Health, 34(1), 33–35.

Kamath, V., Crawford, J., DuBois, S., Nucifora, F. C., Jr., Nestadt, G., Sawa, A., & Schretlen, D. (2019). Contributions of olfactory and neuropsychological assessment to the diagnosis of first-episode schizophrenia. Neuropsychology, 33(2), 203–211.

Lampropoulos, D., Troïan, J., D'Amico, C., Bentata, L., & Apostolidis, T. (2018). Evidence for the influence of social dominance orientation and intergroup relations on the stigma of schizophrenia. European Journal of Health Psychology, 25(4), 133–139.

Lecomte, T., Potvin, S., Samson, C., Francoeur, A., Hache-Labelle, C., Gagné, S., Boucher, J., Bouchard, M., & Mueser, K. T. (2019). Predicting and preventing symptom onset and relapse in schizophrenia—A metareview of current empirical evidence. Journal of Abnormal Psychology, 128(8), 840–854. 

QUESTION 5
What are three aspects of avoiding relapse? To select and enter your answer go to Test.

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