Residual Schizophrenia: Long-Term Effects And Negative Symptoms

Schizophrenia is a chronic mental illness causing changes in the brain that involve symptoms like delusions, hallucinations, cognitive difficulty, disorganized speech, and a lack of motivation. Schizophrenia can also lead to episodes of psychosis, which may require hospitalization. Individuals with schizophrenia may struggle at work or school and in developing social skills. While schizophrenia cannot be cured, it can often be managed effectively through therapy and other treatment options. 

In some cases, a person may have lingering symptoms after a major schizophrenic episode, sometimes called residual schizophrenia. While the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to separate residual schizophrenia as a separate subtype, the fifth edition, the DSM-5, does not make this distinction. Residual schizophrenia may not be as pronounced as other types of schizophrenia. However, this type can still adversely impact a person’s life. 

Are you living with residual schizophrenia?

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What are the symptoms of residual schizophrenia? 

Symptoms during the residual phase of schizophrenia may include less severe symptoms than those found in the active phase of schizophrenia. A person might showcase social withdrawal, reduced emotional expression, and cognitive difficulties. These residual schizophrenia symptoms may not be as severe as during the active phase of the illness but can still impact daily functioning and quality of life. 

Symptoms of schizophrenia

Individuals with schizophrenia may be impacted in various ways, which can affect work and education, as well as interpersonal relationships at home. Symptoms like social withdrawal and difficulty communicating may negatively impact a person with schizophrenia and how they interact with others. Although schizophrenia symptoms may be challenging to live with in daily life, treatment and working with a mental health professional could reduce their impact over time. 

Causes and risk factors of residual schizophrenia

Although the exact cause of schizophrenia is unknown, the American Psychiatric Association notes that the cause could be multifaceted and include genetics, environmental factors, and life stressors. Genetics may be the most prominent risk factor for any schizophrenia spectrum disorder, including catatonic schizophrenia, residual schizophrenia, and paranoid schizophrenia. In families with a history of psychosis, schizophrenia may be more prevalent. 

How lifestyle factors and mental health support can help residual schizophrenia

Schizophrenia may also be linked to other lifestyle factors outside of genetics. In some individuals, an increase in drug use, particularly during adolescence, can cause an increase in schizophrenia symptoms. An increase in stress or anxiety may also incite symptoms in some individuals. For this reason, as with other mental disorders, it may be valuable to work with a professional to identify symptoms and treat residual schizophrenia. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

How is residual schizophrenia diagnosed and treated? 

Although residual schizophrenia is no longer recognized as a separate disorder, some signs and symptoms may help a therapist or psychiatrist diagnose a person with schizophrenia in the residual phase. Only a mental health professional or doctor can diagnose schizophrenia, and there is no single test that might identify this condition.

Getting a schizophrenia diagnosis

The first step in the diagnostic process is often to contact a doctor or mental health professional for a consultation. This individual may help the client identify symptoms and consider their full spectrum of mental and physical health holistically before making a diagnosis. The provider can assess your symptoms and make a final diagnosis of schizophrenia using the DSM-5.

Treating residual schizophrenia and psychosis

Residual schizophrenia treatment may involve multiple approaches; initially, after an acute psychotic episode, a doctor or psychiatrist may prescribe anti-psychotic medication to prevent future episodes. After treating the initial episode, a person with schizophrenia may work with a therapist using cognitive-behavioral therapy (CBT) techniques to manage ongoing symptoms. CBT can help people identify negative thought patterns and reframe them to reduce their impact. Other modalities may also be helpful, such as social recovery therapy, which was designed to support individuals with first-episode psychosis. 

Prognosis and long-term impact

Schizophrenia is a chronic and long-term disorder, so symptoms may impact a person’s daily life, even during the residual stages. The prognosis may not be predictable for all people, which can make it challenging to manage future episodes. Although some individuals with schizophrenia experience a relapse in symptoms, including psychotic episodes and other chronic symptoms, working with a therapist may reduce the frequency and intensity of symptoms over time. 

How negative symptoms of schizophrenia affect relationships and social interactions

Schizophrenia may impact one’s ability to build healthy relationships. People with schizophrenia can experience challenges in getting to know someone and building a long-term relationship. Negative symptoms of schizophrenia include social withdrawal, low energy, and difficulty planning events in advance. These symptoms impact how often a person with schizophrenia interacts with others and how motivated they are to enter new relationships or friendships. 

Mental health support for relationship and work challenges

These relationship struggles can make performing at work or school challenging, which may impact a person financially. Although severe symptoms of schizophrenia can be highly impactful, a therapist or other mental health professional may be a supportive option. Working with a therapist has been shown to reduce schizophrenia symptoms and may provide support for overcoming symptoms of residual schizophrenia. For example, a therapist may work with a person with schizophrenia to increase motivation and provide coaching in terms of how to communicate with others. 

Coping strategies for living with residual schizophrenia

Residual schizophrenia may impact different people in different ways, and different strategies may be more effective for some people than others. Some strategies that can help a person living with schizophrenia reduce symptoms include:  

Continue following medication directions

If you are taking prescription medication, continue to take it according to your doctor’s directions. These medications are often able to help clients prevent more significant symptoms or psychotic episodes. Some people with schizophrenia may have delusions that their medication is harming them or isn’t safe to take. If you’re worried about your medication plan, talk to your doctor. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.

Develop solid routines and structures 

Establishing a daily routine may help you manage symptoms and improve overall functioning. Include regular times for activities like meals, exercise, and sleep. Caring for your body on a schedule may reduce stress and anxiety. If you struggle to develop a healthy routine, consider asking your doctor or mental health provider for support. You can also talk with someone you trust to create a safety plan and daily routine together. 

Create a social support network 

Developing a network of friends and family members who understand you and your schizophrenia symptoms may be beneficial. These supporters may detect a change in mood or notice an increase in symptoms, which can lead to an earlier treatment of symptoms. 

Manage stress and anxiety 

Stress and anxiety can impact schizophrenia symptoms in some individuals. Managing stress through mindfulness activities or lifestyle changes, as well as working with a therapist, may reduce schizophrenia symptoms over time. 

Are you living with residual schizophrenia?

Work with a compassionate counselor

Attend therapy 

Although some coping strategies, such as mindfulness and exercise, might be done without help from a mental health professional, individuals with schizophrenia might find it beneficial to work through symptoms with a therapist or psychiatrist. Studies have shown that online therapy can be an effective way to manage symptoms of schizophrenia in individuals and may be helpful when in-person therapy options are not available. An online therapist can offer CBT and evidence-based coping strategies to help manage and monitor symptoms over time. 

For individuals with schizophrenia, maintaining daily symptoms through online therapy sessions may be beneficial. Online therapy through a platform like BetterHelp can be accessed from any location, which may reduce the anxiety associated with driving to a new building and discussing symptoms in person. An online therapist does not need to live in your specific location to provide adequate services, which may be beneficial when finding a match.