5 Schizophrenia Triggers to Avoid
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
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.
Angela D. Harper, MD
Medical Reviewer
Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.
A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.
Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.
Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.
She and her husband are avid travelers and have been to over 55 countries and territories.
Maria Masters
Author
Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and she has held positions at Men's Health and Family Circle. Her work has appeared in Health, on Prevention.com, on MensJournal.com, and in HGTV Magazine, among numerous other print and digital publications.