Psychosis, and particularly in the form of schizophrenia, is often seen as a serious life altering condition. However, in clinical practice many patients can attain remission or at least substantial remission, which enables them to lead the personal and professional lives they want. While medication plays a significant role, particularly in the acute stages and their aftermath, psychotherapy and social support gain additional prominence in relapse prevention over the long-term. They are also indicated in patients who may not have had a full psychotic episode yet but are at greater risk for one. Work on internal and external communication patterns has shown in individual cases to be very helpful as a psychotherapeutic approach to support the patient in fulfilling own needs and aspirations, while increasing treatment compliance and the overall quality of life. Communication-Focused Therapy®, as developed by the author, offers a theoretical framework and an extensive toolset for this approach to treatment.
Keywords: psychosis, schizophrenia, psychotherapy, Communication-Focused Therapy®, CFT®, medication, psychiatry
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© 2019 Christian Jonathan Haverkampf
Schizophrenia in virtually all cases requires lifelong treatment, even when symptoms have subsided. Treatment includes better coping skills in everyday life, strategies to reduce stress and become aware of early warning signs of a psychotic episode, psychotherapy to better manage life, and medication. Medication may be life-long, but does not have to be.
Medication for an independent, autonomous life
Treatment with medication (antipsychotics) and psychosocial therapy can help manage the condition. In some cases, hospitalization may be needed. However, medication has drastically reduced the need for hospitalization. Many patients who had to be hospitalized for most of their lives in earlier times can now care for their families or work as highly paid managers in large corporations.
Medication allows people with schizophrenia to lead normal lives. Especially the newer generation of antipsychotics has increased the quality of life significantly, while reducing some of the side-effects of the earlier generation of antipsychotic medication. Still, antipsychotic medication has overall still not reached the low side-effect profiles of newer antidepressants. While tardive dyskinesia has become rarer with the second-generation antipsychotics (SGAs) and is virtually absent in clozapine especially and the potentially lethal malignant neuroleptic syndrome is a very rare phenomenon, they are often associated with side-effects from weight gain (especially olanzapine) to drowsiness (quetiapine). It seems that we are only willing to accept the greater potential side-effects of modern antipsychotics because of the enormous improvement they can bring in a patient’s quality of life.
Schizophrenia and Medication (2)