Can you live a “normal” life with schizophrenia? In one sense, this question can be stigmatizing. Why? Because it can imply that people who live with an acute mental illness like schizophrenia are “abnormal” and that it’s questionable as to whether they can live “normal” lives.
In reality, though, the word “normal” is problematic: There is no universal standard for what is a “normal life.” People have to cope with all sorts of serious and/or chronic medical conditions that may require significant lifestyle changes. Schizophrenia happens to be one of them (the only difference being that it is a brain and mental health condition). In other words, the notion of a “normal life” is a fallacy to begin with.
“Can a Schizophrenic Live a Normal Life?” – What Patients and Families Often Ask
Stigmatization aside, this question of whether one can live a “normal life” is frequently the vocabulary that people use when they worry about a loved one with schizophrenia. Many ask, “Can a schizophrenic live a normal life?” Their intention in these cases is usually not to stigmatize. It’s to get more information and maybe some reassurance that their loved one is going to be okay.
The good news is that if you’re asking this question, you’re not alone. The question frequently comes up in online mental health forums and chat rooms; and those affected by schizophrenia are not the only people to have this worry. The same question occurs among those living with other serious medical diagnoses, such as dementia, Parkinson’s disease and certain cancers, among other conditions. They and their families naturally want to know what to expect from life after a debilitating diagnosis. Who wouldn’t?
Just as they deserve honest answers that they can trust, so do families that are facing schizophrenia. With this in mind, we reached out to Chief Clinical Officer at FHE Health Dr. Beau Nelson, DBH, LCSW. Dr. Nelson oversees the mental health and addiction treatment programs at FHE Health, so can speak with authority about the impact of schizophrenia on quality of life, function and other factors.
Living a “Normal Life” with Schizophrenia – Is It Possible?
When we put this question before Dr. Nelson, he gave a qualified “yes.” Preferring to use metrics like daily function and quality of life rather than the word “normal,” he said, “With this disorder it is possible to function and have quality of life, but the disorder presents challenges and needs to be managed very well in order to achieve best results.”
The “challenges” to which Dr. Nelson was referring were the severe symptoms that can accompany a diagnosis of schizophrenia. He said that “schizophrenia is a disorder that is characterized by disorganized thinking and the presence of psychosis, delusions and—many times—paranoia.” Dr. Nelson also explained that schizophrenia is a “genetic disorder” in which “the brain does not process or function properly,” and it “can be related to environment, altered brain chemistry or the structure of the brain.”
Can all symptoms subside?
“No,” Dr. Nelson said, “if by this you mean, ‘Will symptoms of schizophrenia just go away?’” He clarified that “sometimes people are exposed to drugs or stress that can mimic some of the symptoms of schizophrenia, but a diagnosis of schizophrenia means that the symptoms will need to be managed through medications, therapy and a coordination of other services for the patient.”
Encouragingly, though, when “symptoms are well-managed on medications” and the patient “takes [their medications] consistently,” “they will see marked improvement and functioning.”
How long will this go on?
“Schizophrenia is a lifelong illness and must be managed for a patient’s lifetime,” Dr. Nelson said.
Will schizophrenia get worse untreated?
“Yes,” Dr. Nelson said. He explained that untreated schizophrenia makes the brain more vulnerable to serious and lasting damage from the disorder, so that with each successive episode of symptoms, symptoms can “increase in duration and severity and will make it harder to manage the illness … Past a certain point, someone with untreated schizophrenia will not be able to function in normal life.”
How Treatment Can Improve Daily Function and Quality of Life
What that means is the earlier the intervention and treatment, the better the outcome for everyone concerned. What might that process look like? Here is how Dr. Nelson answered that question:
A patient who is willing to take medication, participate in counseling and access services as part of their treatment can stabilize and be at a better level of functioning. Patients often present to an inpatient treatment when they are off medications, have had legal or other consequences of poor decision-making and are not able to care for themselves. Time in a structured program, with psychiatric care and counseling services can help to improve a patient’s symptoms and lead to higher functioning.
What is treatment like for someone with schizophrenia?
Treatment for schizophrenia typically involves a period of stabilization (voluntary or involuntary) in a psychiatric unit, Dr. Nelson said. During this time of inpatient treatment, the patient should begin receiving a combination of medication, therapy and other supports…
Antipsychotic medications like Risperdal, Abilify and others help to ease the delusions and hallucinations of schizophrenia and improve treatment outcomes. In this way, they play a major role in effective treatment. Dr. Nelson emphasized the importance of these “medications to regulate brain chemistry, so that the patient is clearer, more grounded in reality and free from the delusions and paranoia that can go along with this disorder.”
Dr. Nelson also noted that thanks to new developments in medicine, a number of medications now occur in a long-acting, injectable form that lasts about 30 days. This gives patients the option of receiving their medication once monthly rather than having to remember to take it daily. (Medication adherence can be a problem when treating schizophrenia.)
Therapy is another important element of treatment. Once a person is stabilized, they can begin developing self-care skills, practicing activities of daily living and accessing supports through therapy.
Therapy teaches patients “about the illness, self-care and coping skills,” with the goal of helping them “increase their functioning and learn how to live with their illness.” The aim is to be supportive and help the patient “cope with their symptoms and challenges,” by providing them with problem-solving and social skills. Socialization activities and being around other people can also be helpful.
Other Supports and What to Expect
What else might patients and loved ones expect from treatment for schizophrenia? Dr. Nelson said that after stabilization in inpatient treatment, many patients benefit from continuing in a supportive environment where they can continue to work on their self-care and independent living skills and receive intensive clinical support.
A plan of “aftercare” for after discharge is also key. It should include a supportive living environment and ongoing psychiatric and therapy services in the community.
Why Support and Treatment Are Key
While it may be tempting for someone with schizophrenia to think they don’t need support or treatment, facing this diagnosis alone is not a good idea. Dr. Nelson cited studies that show, in fact, that “one of the best protective factors for living well with the diagnosis is to be married, possibly because this close support can help to ensure that the condition is managed well.”
“Given the symptoms of this diagnosis,” Dr. Nelson recommended that “professional and long-term supportive case management or other services be on board to help a patient live at their best.” He noted that if a person with schizophrenia has mild symptoms and practices good self-care, they may find the disruptions to their life are relatively “minor.” On the other hand, though, “a patient with severe symptoms and no insight or management of their illness will not do well and will often be unwilling to participate in services that could benefit them.”
“As with any life issue, it is always best to have a good support system,” Dr. Nelson said. The same trusted advice might be given to a family facing another serious medical condition.