Guest Blog on Schizophrenia: Questions & Answers (Part 1)
Awhile back, we asked you all to share any questions you had about schizophrenia. We were fortunate to get the help of Michelle Friedman-Yakoobian, Ph.D., to answer your questions! Michelle is the clinical team leader for the Center for Early Detection, Assessment & Response to Risk (CEDAR). CEDAR assists young adults who are experiencing new or worsening symptoms that may be warning signs for psychosis by providing comprehensive consultations and ongoing clinical care.
Below are her responses to the first four questions that were submitted. In the coming weeks, we will be posting more Q&A sessions with her that answer the other questions shared. So stay tuned for continuous dialogue about this topic!
1. How do young adults living with schizophrenia achieve recovery? Will I ever be able to be independent?
Having a positive, trusting relationship with your doctor is a great step toward achieving recovery. You want to make sure your doctor knows about your background, goals, interests and strengths. He or she should also understand what treatment outcomes are most important to you. All of these things should play an important role in your treatment. It can take time to develop a trusting relationship with your doctor. Some things that can help include:
- Attending meetings. Do your best to attend all of your scheduled meetings, even on days you don’t feel like going to appointments. You can’t develop a good working relationship with someone unless you see him or her regularly so he or she can have time to get to know you.
- Speaking up. Be sure to speak up about any questions or concerns you have when you are meeting with your doctor. A good doctor will be much happier to have a chance to talk with you about your concerns about a medication rather than find out that you stopped taking it on your own without talking about it first. Your doctor will be able to help you most effectively if you are open and honest about your feelings…even if you think your doctor may not like what you're saying. It may help you to write a list of questions before you go to a meeting so that you don't forget to ask something that is important to you.
- Going slow. Recovery is a marathon, not a sprint. You are better off taking small, manageable steps toward recovery than trying to take on too much at once before you are ready..
- Be willing to ask others for help. Many young people mistakenly believe that being “independent” means that you do everything by yourself. The most successful people (including CEO’s of companies, the president, Oprah Winfrey, etc.) know that it is important to have a support network of individuals who you can rely on to help you. Being independent means doing for yourself what you can, but also relying on your support network (including family, friends and health care providers) to help with tasks that you need help with. With this in mind, you can definitely be independent!
To make you and your doctor are on the same page about your treatment, check out the Getting the Most out of Your Health Care Provider tip sheet in the Educate Yourself resource group on StrengthofUs.org. This tip sheet can help you develop an open, collaborative partnership with your doctor and resolve any concerns you may have about your treatment.
Also, check out the Finding Your Strength tip sheet in the Taking Charge resource group on StrengthofUs.org for some strategies young adults have shared that helped them achieve and maintain recovery.
2. What services and supports are available for young adults living with schizophrenia? Are there any support groups available? What does the research say is effective?
Finding services can be tricky. Here are some tips for finding out about resources:
- The following website has information about centers for treating early psychosis: Schizophrenia.com. If there isn’t a center near you, you may want to try calling the one that is the closest to you. You can ask them if they can make recommendations for services in your area.
- Contact your National Alliance on Mental Illness (NAMI) state organization and local affiliate to ask for recommendations. You can do this by visiting www.nami.org/local.
- Ask your current doctors for recommendations.
Some types of treatment that have the strongest research evidence include: medication, family psychoeducation, individual therapy (cognitive behavioral therapy, supportive therapy, interpersonal therapy, illness management and recovery and supported work and/or education). Usually, a combination of all of these treatments is most effective. To learn more about these treatments, visit the Educate Yourself resource group on StrengthofUs.org.
Another great resource to check are local clubhouses. Clubhouses often provide help with creating daily structures, building job skills, finding jobs, obtaining GED/educational coaching and participating in social activities. A list of clubhouses can be found at the International Center for Clubhouse Development.
The following websites include some helpful information about treatments for schizophrenia that have been found by research to be effective:
3. How does a young adult living with schizophrenia deal with weight gain caused by a medication?
If you're experiencing weight gain from your medication, talking with your doctor may be your best bet. He or she may have some good ideas to help. This may include changing your medication, lowering the dose, taking your medication at a different time of the day or learning how to maintain your weight. You and your health care provider should work together to find the lowest and most effective dose to reduce potential side effects like weight gain.
You may want to access the Tracking Medications worksheet in the Education Yourself resource group on StrengthofUs.org to see how different medications, doses and other factors impact you.
For a list of common side effects across medications classes and strategies for coping with these side effects, check out Managing Side Effects in the Educate Yourself resource group on StrengthofUs.org. This information can help you determine, with your health care provider, the treatment that works best for you.
Here are some some additional things that can help you stay healthy:
- Eat a heart-healthy diet. This diet should include lots of heart-healthy foods, such as fruits, vegetables, whole grains, fat-free or low-fat milk and milk products, lean meats, poultry, fish, beans, eggs and nuts.
- Limit foods with saturated fats, trans fats, cholesterol, sodium (salt) and added sugars.
- Participate in regular physical activity for at least 30-60 minutes a day on most days of the week. If you haven’t been active for a while, start slow (walk for 5-10 minutes) and gradually work your way up. If there is an affordable option for you, enrolling in an exercise class or a sports league can be great for help with motivation.
- Limit your intake of alcohol (or avoid drinking at all). Stopping your intake of alcohol is one of the quickest ways to begin to reduce weight gain (check out this Alcohol Calorie Counter to help you calculate the number of calories that you are currently consuming from alcohol). Avoiding alcohol also benefits your mental health as alcohol can cause psychiatric symptoms to get worse. For some tips on how to tell friends you don't want to drink, check out How to Get Way with Not Drinking in the Relationships resource group on StrengthofUs.org.
- Eat 3-6 small meals throughout the day, including breakfast. Many people mistakenly believe that skipping meals will lead to weight loss. Skipping meals can actually cause you to gain more weight. Skipping meals also lowers your blood sugar, causing sudden hunger pangs and food cravings that can lead to overeating.
For more tips on maintaining a healthy weight, check out Exercise and Healthy Lifestyle in the Taking Charge resource group on StrengthofUs.org. Also, the Exercise and Healthy Living worksheet can help you develop an effective exercise and nutrition plan.
4. How can a young adult who is on heavy tranquilizers like Risperdal become motivated to exercise and be healthy?
Be sure to talk with your doctor about your concerns. Each person responds differently to medications. One person may feel that Risperdal is like a heavy tranquilizer while another person may feel more energetic and focused when taking Risperdal. You and your doctor can work together to find the right medication (or combination of medications) that will work for you. Here are some additional ideas:
- While you're working with your doctor to find the right medication(s), start exercising slowly. Only commit to taking the first step. If you haven’t exercised in a year, don’t expect yourself to start by running 5 miles. Instead, make a commitment to yourself that you will take a 5-minute walk once this week. Once you get out there, you may decide to walk for a bit longer.
- Schedule exercise on your calendar, just like you would any other appointment.
- Enlist someone to help motivate you to exercise (relative, friend, therapist).
- Find a partner (relative, friend, health care provider) to exercise with you.
Thanks to all of you who submitted questions. We are thrilled to provide this first of three Q&A sessions to you all!
Got some tips and tricks of your own you want to share with other StrengthofUs community members? Leave a comment below!