Living With Schizophrenia And PTSD: Strategies For Success
Post-traumatic stress disorder (PTSD) and schizophrenia can be co-occurring conditions that may impact a person’s life in many ways. Although they are distinct diagnoses, both can be linked to traumatic events, and they may have overlapping symptoms in some cases. Both schizophrenia and PTSD can be chronic, and neither currently has a cure. However, each disorder can be treated using a combination of medication, lifestyle changes, and psychotherapeutic techniques.
Understanding schizophrenia and post-traumatic stress disorder (PTSD)
Individuals with both schizophrenia and post-traumatic stress disorder may experience symptoms differently than how each of the disorders usually impacts a person on its own. Schizophrenia and PTSD can interact with or exacerbate one another, and how these two mental disorders impact a person may depend on a variety of factors. To better understand these disorders, it may be beneficial to first learn about each one.
What is schizophrenia?
Schizophrenia can be considered a severe mental illness that usually includes positive symptoms or psychotic symptoms, such as hallucinations and delusions, as well as disorganized thinking and speech.
In addition, people with schizophrenia may experience negative symptoms, such as reduced speech and social withdrawal. Psychotic disorders listed in the Diagnostic and Statistical Manual, 5th Edition (DSM-5), like schizophrenia and schizoaffective disorder, may include periods of intense psychotic symptoms and periods of remission, during which positive symptoms are reduced or eliminated.
The cause of schizophrenia is not yet completely understood. However, the condition may be linked to childhood trauma, genetics, and environmental factors. For individuals with schizophrenia, treatment is usually multidimensional and may include prescribed antipsychotic medications and therapy to manage symptoms and learn coping strategies. These treatments may vary based on age and other needs. For example, elderly individuals with chronic schizophrenia may have different medication needs than young people who have just been diagnosed.
What is post-traumatic stress disorder (PTSD)?
Post-traumatic stress disorder is a psychiatric disorder that can impact people who have experienced or witnessed a traumatic event, such as a natural disaster, war, a near-death experience, a serious accident, or another event that was perceived as deeply upsetting and fear-inducing.
Individuals with PTSD may be impacted by symptoms that can make attending school or work and developing and maintaining relationships difficult. PTSD symptoms often include the following:
- Intrusive thoughts: A person with PTSD may experience intense imagery or flashbacks related to the traumatic experience. These are often vivid and can make it seem like the person is reliving the event.
- Altered mood or cognition: Thoughts associated with the traumatic event can cause a person to experience mood swings.
- Arousal and reactivity: Individuals with PTSD may experience irritability and anger, and they may become highly observant of their surroundings. They tend to react to startling events with heightened intensity.
- Avoidance: Avoiding a place or situation that may trigger PTSD memories can be common for people with this disorder. For example, a person who has PTSD due to a severe car accident may avoid driving or riding in a vehicle. This type of avoidance can make managing daily responsibilities difficult.
Not all individuals who experience trauma will develop PTSD. Treatment for this disorder can involve prescribed antidepressants or anti-anxiety medication, as well as psychotherapy techniques, such as cognitive behavioral therapy. With treatment, PTSD triggers can be identified, and symptoms can be managed over time.
Living with schizophrenia and PTSD
For some people, schizophrenia and PTSD can occur comorbidly. Schizophrenia symptoms and comorbid posttraumatic stress disorder symptoms may overlap and impact a person in different ways. Having both PTSD and schizophrenia can lead to an exacerbation of symptoms in both disorders. For example, the presence of hallucinations or delusions in schizophrenia may be triggered or intensified by traumatic memories or reminders of the traumatic event in PTSD.
The compounding effects of living with schizophrenia and PTSD
Individuals with schizophrenia and PTSD may be at a higher risk of relapse or worsening symptoms compared to those with only one of the disorders. Traumatic experiences or stressors related to PTSD can trigger psychotic episodes in people with a comorbid psychotic disorder like schizophrenia. In addition, the combination of PTSD and schizophrenia can have an impact on an individual's quality of life, potentially affecting their relationships, work or school performance, and overall well-being. For people with both disorders, having a team of mental health professionals to identify and separate PTSD symptoms from psychotic symptoms of schizophrenia may improve treatment outcomes.
Strategies for managing symptoms of schizophrenia and PTSD
Although living with both schizophrenia and PTSD can be challenging, various coping skills may be helpful for managing symptoms.
Building a support system
Building a support system of friends, family members, and mental or medical health professionals can be beneficial. Your support network can help you maintain social contact and improve your overall quality of life. A strong support system may help a person notice small changes that may otherwise go unnoticed.
Medication management through a mental health professional
A mental health professional may prescribe different medications, including antipsychotics, to treat schizophrenia, as well as antidepressants to treat PTSD symptoms. To manage symptoms, follow all your doctor’s recommendations and communicate about any side effects you may be experiencing.
Lifestyle modifications
Some lifestyle and environmental factors may impact symptoms of schizophrenia and PTSD. Maintaining nutrient-rich eating habits, getting enough sleep, and exercising regularly are all frequently recommended for individuals living with these disorders.
Vocational and educational support
For individuals with PTSD and schizophrenia, it can be challenging to find success at school or in the workplace due to symptom-related disruptions. Seeking vocational and educational support can provide a framework for managing these disorders at work or school.
Self-care
Both schizophrenia and PTSD symptoms can be improved by practicing self-care. This generally involves developing mindfulness skills, reducing or eliminating substance use, and engaging in hobbies and fun activities.
Cognitive behavioral therapy (CBT)
CBT is a therapy technique that usually involves identifying thought patterns that may act as triggers and replacing them with more constructive thoughts. CBT can be helpful for both PTSD and schizophrenia.
Finding mental health support for schizophrenia and PTSD
There is not a single strategy that may work for all people with these disorders. Effectively managing symptoms often requires a combination of treatments and coping strategies. For individuals living with PTSD and schizophrenia, remember that you are not alone and that there is support available.
The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.
Treatment options for schizophrenia and PTSD
Treatment for PTSD and schizophrenia often depends on an individual's symptoms and the severity of both conditions. Keeping this in mind, many treatment plans consist of a multidimensional approach involving a combination of doctor-prescribed medication and psychotherapy along with lifestyle changes. Finding support and developing a treatment plan often starts by working with a therapist or other mental health professional.
Benefits of online therapy
For people with severe mental disorders like schizophrenia or psychiatric disorders like PTSD, finding the right in-person therapist can be a challenge. Online therapy options typically empower a person to find a therapist who is a good fit for them and who can meet at convenient times. With online therapy, office visits aren’t required, and individuals can connect with mental health professionals from any location with an internet connection, providing them with additional flexibility.
Effectiveness of online therapy
Online cognitive behavioral therapy may be an effective treatment option for schizophrenia, although individuals experiencing acute psychotic symptoms may need to seek in-person support. Online therapy can also be an effective form of treatment for PTSD. During an online session, a therapist may work with a person experiencing both disorders to identify triggers and develop coping strategies.
Takeaway
Frequently asked questions
Can you have schizophrenia and PTSD at the same time?
When mental health conditions occur at the same time, they’re often called “comorbid.” According to some estimates, about 29% of people with schizophrenia will experience post-traumatic stress disorder (PTSD) at some point, compared with 7.8% among the general population.
Part of the reason these disorders commonly co-occur is that they share many of the same risk factors, such as surviving serious traumas like sexual assault, and because schizophrenia can increase the risk that someone is exposed to traumatic events that may lead to PTSD.
What is the best living situation for schizophrenics?
Schizophrenia is a serious mental illness, but with treatment, most people can live independently and carry out daily functioning without assistance. New schizophrenia research has found that people with schizophrenia can also succeed in higher education and hold down highly demanding jobs. However, if someone is experiencing psychosis symptoms or other severe symptoms, they may need additional support, such as assisted living.
Where is the best place for a schizophrenic to live?
The best place for someone with schizophrenia to live depends on preference, symptom severity, and other individual factors. Like everyone else, people with schizophrenia are individuals with unique needs, and something that works best for someone might not work for someone else.
People generally benefit from living in supportive environments, with or nearby friends, family, and community members. Some people with schizophrenia may do best living in a structured living environment, like an assisted living facility, where they can receive assistance with things like medications or daily tasks.
What makes schizophrenia worse?
Some things that might make schizophrenia symptoms worse include:
- Substance abuse
- Non-compliance with prescribed medications
- Major life stressors, like starting a new job, moving, or having a child
- Exposure to trauma, like physical or sexual assault
- Inadequate sleep
- Lack of social support
Schizophrenia spectrum disorders can often be effectively managed with medications, talk therapy, stress-management strategies, self-care, and social connectedness.
What should a person with schizophrenia avoid?
Genetic and environmental factors, like adverse life events and substance use, are associated with schizophrenia development and worsening symptoms. People with schizophrenia, including those with a sudden traumatic loss precipitating late-onset schizophrenia, should avoid:
- Treatment non-compliance: It may be tempting to stop taking psychological medicine or going to therapy when you feel better, but it’s important to continue managing the mental health condition even when you feel good.
- Substances: Substances like alcohol, cannabis, and nicotine may trigger visual and auditory hallucinations or other symptoms.
- Neglecting self-care: Lack of adequate sleep, exercise, stress management, and structure can increase the risk of relapsing symptoms.
- Avoiding help after major stressors: Traumatic life events, like a sudden traumatic loss, can contribute to worsening schizophrenia symptoms. When traumatic stressors occur, consider reaching out to your support system for help right away.
These risk factors can significantly increase the risk of relapsing schizophrenia symptoms. If you do not have schizophrenia, but do have a genetic predisposition (such as a strong family history), consider following this advice, too.
What kind of job is good for someone with schizophrenia?
Research suggests that people with schizophrenia can excel at any type of job, depending on factors like skills, strengths, individual strengths, and symptom challenges. Some people with schizophrenia may prefer jobs in quiet environments that aren’t overstimulating, whereas other people may prioritize jobs with a supportive and encouraging environment.
What are good hobbies for schizophrenics?
People who develop schizophrenia can enjoy a diverse range of hobbies. The following hobbies can help promote mental wellbeing, social connection, and self-compassion:
- Meditation, mindfulness, and/or yoga
- Learning to play a musical instrument
- Joining an exercise class
- Dancing
- Volunteering for a cause you care about
- Journaling
- Support groups
Engaging in hobbies can support cognitive functioning and well-being for people experiencing symptoms of schizophrenia.
Does schizophrenia get worse at night?
Many people diagnosed with schizophrenia or schizoaffective disorder report experiencing symptoms that worsen at night. According to clinical psychology research, these worsening symptoms are primarily caused by sleep disturbances and fewer external distractions.
Within psychiatric hospitalization settings, staff can help patients with nighttime symptom challenges by developing consistent nighttime routines, sleep hygiene practices, and medication management. People experiencing auditory hallucinations may further benefit from auditory stimulation at nighttime, such as a white noise machine or listening to music.
Where is the best place to live for mentally ill people?
Many mental disorders in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), benefit from treatment with psychotherapy, medications, and destigmatizing supportive communities. The “best” place for someone with a mental illness will depend on personal preference and other factors, but here are some suggestions to look for:
- Access to affordable mental health services, such as trauma-informed care providers
- Housing affordability and access to specialized housing programs, if needed
- A supportive environment
- Nearby family and/or friends
- Outdoor recreation spaces, such as parks or hiking trails
- Transportation infrastructure
In general, systematic reviews suggest that quality of life can be improved with supportive environments that promote personal autonomy and foster environments for continuous self-improvement.
How does the mind help people with schizophrenia?
People with schizophrenia can use their minds to improve their mental health in the following ways:
- Body-mind-spirit practice: A study published in the Community Mental Health Journal found that practices like yoga, tai chi, mindfulness, and relaxation can improve symptoms of stress and anxiety while improving daily functioning.
- Cognitive behavioral therapy (CBT): CBT is a short-term therapy that can help people with challenges like schizophrenia, anxiety disorders, psychological trauma, or psychotic PTSD manage challenging thoughts, feelings, and behavior. This type of therapy uses strategies like cognitive restructuring and Socratic questioning to restructure the mind. Research has supported its effectiveness for many disorders in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5).
- Journaling: Those who have or are at risk of developing schizophrenia often benefit from a journaling practice. This can help you learn to recognize triggers, warning signs, and thought patterns that affect mood and behavior.
- Positive self-talk: People with schizophrenia, including very late-onset schizophrenia, have a higher likelihood of trauma exposure, such as sexual abuse, physical abuse, or serious injury. People with schizophrenia are also at a heightened risk of developing PTSD or engaging in suicidal behavior. Practicing self-compassion, like talking to yourself the way you would a close friend, can help people boost self-esteem and optimism.
Whether you experience primarily negative symptoms or more positive symptoms like hallucinations and paranoia, these mind-based techniques can help with self-esteem and symptom management.
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