Schizophrenia: An Information Guide

Will I need to be hospitalized?

If, during an active phase of schizophrenia, you are frightened, disorganized, violent or suicidal, admission to hospital will probably be recommended for your own care and protection. If the symptoms of illness are not too severe, treatment on an outpatient basis may be possible, especially if the health care professionals providing treatment are familiar with you and your illness.

Can I be kept in the hospital against my will?

In Ontario, you cannot be admitted and kept in hospital against your will unless you are in danger of harming yourself or others, or are unable to care for yourself. In such a case, you may be found mentally incapable of giving consent to being treated, and may then be committed to hospital involuntarily. If this happens, you will be visited by a Rights Advisor, who will explain your legal rights. This service is free. If you are a patient in one of Ontario’s provincial psychiatric hospitals, you may obtain free advice and representation from a psychiatric patient advocate located in the hospital. The laws applying in any given area can be discussed with your therapist. People who live outside of Ontario can contact their local mental health association for further information.

Is outpatient treatment necessary?

You will probably be discharged from hospital after the active phase is over, when you are well enough to manage in the community. You will need to see your physician as long as medication is required. Treating physicians may be psychiatrists or general practitioners. Besides doctors, you may see other mental health professionals. These may include social workers, nurses, psychologists or occupational therapists, who will help plan and carry out treatment programs. Even if symptoms disappear, it is important to have professionals you can call if you have concerns about your condition.

Will I suffer a relapse?

Although some people have only one episode of schizophrenia, schizophrenia can be a condition that includes relapses. It is important to be aware of stresses that trigger relapses so these can be reduced or avoided. It is important to seek treatment as soon as symptoms return. If you stop your medication too soon, your chances of relapsing increase significantly.

Are all uncomfortable feelings due to schizophrenia?

No, not all uncomfortable feelings are symptoms of illness. After active phases of schizophrenia, you may feel sad, angry, ashamed, guilt-ridden, inadequate or anxious about the future. These feelings are quite natural and it is helpful to discuss them with a therapist, family member or friend. Sometimes, people who have schizophrenia may be so afraid of relapse that they withdraw and become fearful of trying new things. This is understandable but it is important to find the support, courage and confidence necessary to achieve the best possible quality of life.

What should be done if I feel suicidal or have thoughts of harming others?

Tell your doctor immediately if you feel suicidal or have thoughts of physically harming others. If you do not have a doctor, or if the doctor is not available, go or get someone to take you to the emergency department of the nearest general or psychiatric hospital for help.

Will alcohol, coffee or other drugs affect my schizophrenia?

A large number of people with schizophrenia use alcohol and nonprescription drugs, either alone or in combination. They find that the short-term effects of these substances help to “numb” their symptoms or to “kill time.” However, substance use can interfere with how your medication works, and can have a range of negative consequences. Street drugs can worsen the symptoms of schizophrenia, even in people who are already taking antipsychotic medication. Substance use should be avoided at all costs.

Alcohol, taken in conjunction with antipsychotic medication, has a sedating effect that causes drowsiness. It is extremely risky to drive or work around heavy machinery if antipsychotic medications are combined with alcohol.

Caffeine and similar stimulants are found in tea, coffee, cola drinks and, to some degree, in chocolate. If you are taking antipsychotic medication, you may find that caffeine intensifies the side-effects of your medication, particularly restlessness. If a large quantity of caffeine is consumed, it may also interfere with how effective your medication is.