People with schizophrenia need treatment throughout their lives, and sometimes their needs change. If you notice a difference in the behavior of your loved one with schizophrenia, it may be time to adjust treatment.

Why they may need an adjustment

Even if your loved one’s treatment has worked well, things can happen that mean you need to change medications or doses, or add another type of treatment.

These include:

His condition worsens. “While most people with schizophrenia improve with treatment, schizophrenia can sometimes get worse,” says Chicago-based psychologist Elizabeth Lombardo, PhD.

This may be triggered by an event or circumstance in your life.

“People with schizophrenia often deteriorate when faced with sudden changes in their environment,” says Carol Tamminga, MD, chair of psychiatry at the University of Texas Southwestern Medical Center. Major events and changes, such as the death of a loved one, can be a trigger. Other triggers include drugs and alcohol, stress, and getting out of a regular routine.

Co-occurring psychiatric illnesses can cause problems. It is common for people with schizophrenia to also have other psychiatric conditions, such as panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, depression, or substance abuse. If your loved one has another psychiatric condition, it may trigger an issue that may need to be addressed with a treatment adjustment.

They may have problems with their medication. It is common for people with schizophrenia to need a change in medication. They may develop new or more severe side effects from their medication. It may become less effective over time. Or they might stop taking it, which makes their condition worse.

Behavioral changes to consider

Your loved one may need a change in treatment if you notice differences in their usual behavior or mood, says Brittany Webb, LMSW, a therapist at Birmingham Maple Clinic in Troy, MI. These changes can be gradual or sudden.

Here’s what to look for:

• They become withdrawn, antisocial, or isolated.
• They have more symptoms, such as paranoia, hallucinations, and strange behavior.
• They talk to themselves, laugh, or act out.
• They get angry for no reason.
• Your appetite, eating or sleeping patterns change.
• They pay less attention to grooming, hygiene or the way they dress.
• Your personality or mood seems flat.
• They have mood swings.
• They seem depressed.
• They express suicidal or homicidal thoughts.

These things can also happen if your loved one stops taking their medications, which is common in schizophrenia. Antipsychotic drugs often have unpleasant side effects that affect your mood, thoughts, and body. People can stop taking their medications to avoid these side effects.

“It can be difficult to know if they have stopped or reduced the medication,” Tamminga says. Try to watch your loved one to see if he or she is taking the medicine as directed.

If you are not taking your medications correctly or if you notice that your side effects are getting worse, you may need a change in treatment.

What to do if there is a change

If you see a change from the norm, talk to your doctor. Even if you are not legally allowed to have the doctor talk to you about your loved one’s health, you can still provide information. Call the office or leave a message through an online patient portal.

Your doctor may increase or change your loved one’s medication. They may recommend cognitive or behavioral therapy and supportive counseling. They can connect the person with schizophrenia to community resources.

While you are receiving help, approach your loved one gently.

“It is important for a caregiver not to argue or try to argue with a loved one when they show signs of worsening,” Webb says. Avoid language that sounds like shaming or blaming. Provide them with a supportive environment while giving them the help they need.

“Help them stay calm and offer them unconditional love,” says Lombardo. Let them know that he is worried. Reassure them that it is the disease, not them, that is not responding well to treatment.

What to do if it is urgent

If you see a significant increase in symptoms or if your loved one is having a psychotic episode, contact their treatment team immediately.

“Providers often have an emergency, after-hours, or crisis line they can contact,” Webb says.

If they are in crisis and pose a danger to themselves or others, seek emergency services. Many cities have alternatives to 911 that can put you in touch with someone trained in mental health issues. But call 911 if necessary. You can also take your loved one to a hospital emergency room and request a psychiatric evaluation.

Share as much information as you can with the emergency department. Give them details like:

• A list of medications that a person with schizophrenia takes.
• Any vitamins or supplements they take.
• Allergies
• History of recent or past substance abuse.
• History of symptoms, including when they started.
• Recent stressful events or changes in your environment.

Find the right care

When a loved one has schizophrenia, they need a support network. It starts with your primary caregiver and includes your treatment team.

Do everything you can to make sure your loved one receives regular care with a treatment team that knows their history and follows recommendations.

You may need a psychiatrist, a mental health therapist, and a primary care doctor. You can also get support from case managers and care coordinators.

“Community mental health agencies often provide comprehensive, one-stop services that can help manage outpatient care,” Webb says.

It is not always easy to find the right suppliers. Some doctors do not accept patients with psychosis.

“You may have to work hard to get a capable person to see them,” Tamminga says. “Follow him.”