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How to Treat Schizophrenia

Learn how to treat schizophrenia from psychiatrist Jeanie Tse in this Howcast video.

Transcript

Hi. I'm Jeanie Tse, and I'm here to talk to you about how to treat schizophrenia. I think the first thing that's important in the treatment of schizophrenia is for the person to have someone that they trust to talk to about the symptoms and their experience, as well to talk about their goals and where they want to go with their life, so that they can make that journey from where they are now in their suffering to where they want to be, with that person accompanying them and supporting them in doing that. And so, engagement, as a psychiatrist, engagement of that person and developing a trusting, therapeutic relationship is the very first step of treating schizophrenia.

The next step is really to address concrete needs. We know that if somebody is still homeless in the streets, if they are under very acute stresses, it's going to be hard for them to take medication regularly, take good care of themselves, get the kind of sleep, and healthy diet that they need to recover from schizophrenia. So, the next step is really making sure the person clean housing that's safe and comfortable for them, and making sure that they have all their needs met. So, having food, having clothing, and having contact with people that can support them. That's the next tenet of treatment for schizophrenia.

After that, I mean, medications are very important to the treatment for schizophrenia. Before we had medications for schizophrenia, before the 1950's, people were institutionalized for very long periods of time because we didn't know how to treat it. And so, people just remained in their symptoms and were housed in what, at that time, were called asylums, in generally poor conditions.

And when we discovered that medications could help with schizophrenia that was a big break through and allowed people to truly make a recovery and lead healthy and productive lives. And so, that's a really important part of treatment. And there are many different medications for schizophrenia. But, most of them are called anti-psychotics and have different side effect profiles. And so, working with a psychiatrist or a doctor, a person with schizophrenia can try to find the anti-psychotic that works best for them and causes the least amount of side effects. Which, sometimes, take some time, but is a worthwhile process to engage in.

There's definitely psychotherapy for schizophrenia, too. And so, one part of that is educating yourself about what is schizophrenia. It's a brain development disorder; you're not a bad person. It's not some personality defect that you have. In fact you're suffering from a brain disorder that can be treated effectively. And so, someone getting education about schizophrenia is important.

Then, thinking about goals. So, we do motivational interviewing to elicit from the person, what are your values and goals? What did you dream about before you became sick? And how can we link all of the things you're trying to do? Whether it's take medication, get off substances, work on hygiene, all those kinds of things. How do those link to your goals of having a family, or working as a writer, whatever it is that person's goal is. So, that's motivational interviewing.

We have all kinds of skills training that's available for people with schizophrenia. So, sometimes social skills are an issue. So, learning how to interact, how to interview for a job, how to resolve conflicts, that's important. And life skills, even people with schizophrenia develop it during a sensitive part of their identity formation and when they're young adults.

And so, sometimes they didn't have the opportunity to learn to cook and do grocery shopping. And even some of these simple things sometimes require training for people with schizophrenia. And so, self-management training, too. Learning what triggers your illness? What you need to do to take care yourself is big as well.

Family psycho-education. So, families and friends and significant others learning about the illness. So, learning how to support you is also really important. Everybody needs support, but especially someone who has an illness or a disability. And so, that's something that has a lot of evidence for being effective in managing schizophrenia.

And, lastly, if a person with schizophrenia has a substance use problem, addressing that, whether by detox or rehab or 12-step programs, or medications that treat the cravings for substance use. Addressing the substance use can reduce the burden of schizophrenia symptoms or psychotic symptoms and the risk for relapse.

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