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Spotting the signs of an acute schizophrenic episode

Recognising the initial signs of an acute schizophrenic episode can be very useful. It may be possible to prevent a full-blown schizophrenic episode through the use of antipsychotic medicines and counselling.

The initial symptoms of an acute schizophrenic episode can vary from person to person but the most commonly reported symptoms include:

  • loss of appetite,
  • anxiety,
  • sleeping problems,
  • beginning to neglect your personal hygiene and household chores,
  • beginning to feel increasingly suspicious and fearful about other people, and
  • beginning to hear voices which make it increasingly difficult to concentrate.

If you are concerned that your schizophrenia symptoms may be getting worse you should contact your GP or your care coordinator.

You may also want to ask somebody that you trust about whether they think that your symptoms are getting worse.

Avoiding drugs and alcohol

A large minority of people with schizophrenia are also drug and alcohol abusers. One study estimated that 16% of people with schizophrenia had a drug problem, and 32% had an alcohol problem. The most commonly abused recreational drug was cannabis.

While alcohol and drugs may provide some short-term relief from your symptoms of schizophrenia, it is important to remember that they will make your symptoms worse in the long run. Alcohol can cause depression and psychosis, while most illegal drugs will increase the levels of dopamine in your brain, which will make your schizophrenia worse.

People with schizophrenia who have drug or alcohol problems are more likely to end up homeless or in prison compared to people with schizophrenia who do not abuse alcohol or drugs.

Drugs and alcohol can also cause your antipsychotic medicines to react in unpredictable and, possibly dangerous, ways.

If you are currently using drugs or alcohol and you are finding it hard to stop, you should contact your community mental health team (CMHT) or GP because they will be able to help you.

Dealing with voices

People with a limited understanding of schizophrenia often dismiss how upsetting and frightening it can be to hear voices. Finding ways to control those voices can sometimes be an important part in coping more successfully with schizophrenia.

You may find it helpful to:

  • keep as busy as possible,
  • spend time with other people,
  • listen to a personal stereo, or MP3 player, and
  • remember that the voices cannot hurt or control you.

You may also wish to join a self-help or support group for people who have similar symptoms to you.


Rates of smoking among people with schizophrenia are three times higher than in the general population. If you are a smoker, you are placing yourself at significant risk of cancer, heart disease and stroke.

The nicotine in cigarettes has also been found to decrease the effectiveness of antipsychotics. This means that smokers often require a higher dose, which increases their risk of experiencing unpleasant side effects.

If you smoke, stopping will give you both short and long-term health benefits, as well as reducing the severity of any side effects that you may be experiencing.

Diet and exercise

If you have schizophrenia it is important not to neglect your general health. Eating a healthy diet and taking regular exercise will not only improve your health, it can also help boost your mood.

For most people, a minimum of 30 minutes of exercise a day at least five times a week is recommended. The exercise should be strenuous enough to leave your heart beating faster and you should feel slightly out of breath afterwards. Examples of the intensity of exercise that you should be doing include going for a brisk walk or walking up a hill.

You should also eat a low-fat, high-fibre diet that includes plenty of fresh fruit and vegetables (at least five portions a day) and whole grains.


You should make a conscious effort to control the amount of stress in your life because high stress levels are a major risk factor for an acute schizophrenic episode.

Some ways to help relieve stress include:

  • relaxation techniques, such as meditation or breathing exercises,
  • physical activities, such as yoga or Tai Chi (a Chinese martial art), and
  • taking regular, vigorous exercise.

If you are currently undergoing cognitive behavioral therapy (CBT), your therapist should also be able to provide you with advice about ways that you can reduce stress.

view information about Schizophrenia on www.nhs.co.uk »

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