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Schizophrenia

Schizophrenia is a serious but treatable mental illness that can change how a person thinks, feels and behaves, including hearing voices or holding beliefs that are not true. Starting care early, staying on prescribed medicine, and adding therapy, family support and help with work or school can make a real difference. This guide also explains how to help a loved one and what to do in a crisis.

If you or someone you know is thinking about suicide, call or text 988 (or chat online) to reach the 988 Suicide & Crisis Lifeline, and in a life-threatening situation call 911 (NIMH). The Lifeline is free, confidential and open 24/7 (988 Lifeline).

Call 911 or go to the nearest emergency room if someone is in danger of hurting themselves or someone else. Examples include voices telling them to do something harmful, threats of violence or self-harm, or being unable to stay safe. People with psychosis may hear voices that give instructions (NHS), and in some cases a person in a psychotic episode may harm themselves or become threatening or violent toward others; the risk of violence and suicide decreases with treatment (NIMH). The risk of suicide is highest in the early stages of illness (NIMH statistics) and may be higher after an acute episode or a hospital stay (NHS).

Get urgent medical help if a person is not eating or drinking. In extreme cases a person with schizophrenia might stop moving or talking for periods of time, a rare condition called catatonia (NIMH). A medical review lists decreased oral intake as a sign of catatonia and malnutrition among its complications (Smith & Holmes, 2023). Do not wait to see if it passes.

Never stop an antipsychotic medicine suddenly or on your own, even if you feel well. NIMH says not to stop a medication without first talking to a health care provider, who can adjust the plan safely (NIMH). The NHS adds that stopping could bring a relapse of symptoms (NHS). For clozapine, MedlinePlus says your doctor will probably decrease the dose gradually (MedlinePlus).

What is schizophrenia?

Schizophrenia is a serious mental illness that affects how a person thinks, feels and behaves. People with schizophrenia may appear to have lost touch with reality, which can be distressing for them and for family and friends. It can make everyday activities hard, but effective treatments are available, and treatment can help people stay in school, keep a job, become independent and enjoy relationships (NIMH). MedlinePlus is plain that there is no cure, and that medicine can help control many of the symptoms; therapy, family education, rehabilitation and skills training can help with day-to-day life (MedlinePlus). The NHS notes that most people with schizophrenia make a recovery, although many will have occasional relapses (NHS).

People are usually diagnosed between ages 16 and 30, after a first episode of psychosis. Gradual changes in thinking, mood and social functioning often appear before that first episode, and schizophrenia is rare in younger children (NIMH). Across U.S. studies, the prevalence of schizophrenia and related psychotic disorders is estimated at between 0.25% and 0.64% (NIMH statistics).

The three groups of symptoms

  • Psychotic symptoms are hallucinations, delusions and thought disorder. Hallucinations are seeing, hearing, smelling, tasting or feeling things that are not there, and hearing voices is common. Delusions are strong beliefs that are not objectively true, such as believing that people on television are sending special messages or that others are trying to hurt you. Thought disorder is unusual or illogical thinking, such as jumping from topic to topic (NIMH). The NHS notes that hallucinations are very real to the person having them, and that the voices are more often rude, critical or abusive than friendly (NHS).
  • Negative symptoms are a loss of motivation, less interest in or enjoyment of daily activities, withdrawal from social life, and difficulty showing emotions. They are sometimes mistaken for depression (NIMH), and for laziness or rudeness (NHS).
  • Cognitive symptoms are problems with attention, concentration and memory, which can make it hard to follow a conversation or remember appointments. A person’s level of cognitive functioning is one of the best predictors of their day-to-day functioning (NIMH).

Early warning signs

People often show behavior changes before psychosis develops, such as suspiciousness or unease with others, trouble thinking clearly, pulling away from people, a decline in self-care, disrupted sleep, confused speech, or a sudden drop in grades or job performance (NIMH). Because these changes can look like a teenage “phase,” they are easy to miss (NHS). If they intensify or do not go away, reach out to a health care provider (NIMH). In the U.S., first-time psychosis typically goes more than a year before treatment starts, and people tend to do better when effective treatment begins as early as possible (NIMH RAISE).

Common myths

  • It is not a “split personality.” Schizophrenia is not dissociative identity disorder (NIMH, NHS).
  • Most people with schizophrenia are not violent. They are more likely than others to be harmed by other people. The risk of self-harm and violence to others is greatest when the illness is untreated or occurs together with alcohol or drug misuse (NIMH).

What causes it?

The exact cause is unknown, and several factors may contribute. Schizophrenia sometimes runs in families, but many genes appear to be involved and no single gene causes it by itself. Poverty, stressful or dangerous surroundings, and exposure to viruses or nutritional problems before birth may also play a role, and people with schizophrenia are more likely to have subtle differences in some brain areas and connections (NIMH). In identical twins, if one has schizophrenia the other has about a 1 in 2 chance of developing it, compared with about 1 in 100 in the general population, which tells us genes are not the whole story (NHS). Most people with an affected relative will not develop the disorder (MedlinePlus Genetics). Stressful life events can trigger an episode in someone already vulnerable, but they do not cause schizophrenia on their own (NHS). Psychosis is no one’s fault (NHS Likemind).

How it is diagnosed

There is no single test. Diagnosis usually follows an assessment by a mental health professional, such as a psychiatrist, who checks that the symptoms are not caused by another condition (NHS). Psychosis can also come from sleep deprivation, some prescription medicines, and alcohol or drug misuse, and schizophrenia is typically diagnosed by excluding these other causes (NIMH). A psychiatrist may also consider related conditions such as bipolar disorder or schizoaffective disorder, and may assess for depression, anxiety, post-traumatic stress disorder and substance misuse (NHS). See our Bipolar guide, Depression guide and Anxiety guide.

Why steady care matters

NIMH-supported research is working to improve coordinated specialty care, and to identify people likely to develop schizophrenia before psychosis begins, so that treatment can start earlier (NIMH).

Schizophrenia is one of the top 15 leading causes of disability worldwide. Heart disease, liver disease and diabetes contribute to an increased risk of dying younger, partly because these conditions are more common and often go undetected and untreated; an estimated 4.9% of people with schizophrenia die by suicide (NIMH statistics). These facts are a reason to get full care — mental and physical — not a prediction for any one person. Many people recover, and starting treatment as soon as possible after the first episode of psychosis is an important step (NIMH).

Where to start: talk to a primary care provider, who can refer you to a psychologist, psychiatrist or clinical social worker (NIMH). NIMH also lists state and county health departments, insurers, school health centers and employer assistance programs as ways to find a provider (NIMH). For early psychosis, NIMH points to the Early Psychosis Intervention Network clinics in 17 states and to SAMHSA’s Early Serious Mental Illness Treatment Locator (NIMH).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Care from a psychiatric team: antipsychotic medicine (as daily pills or liquid, or as a long-acting injection given every few weeks), therapy such as CBT for psychosis and family education, help with work or school, and for a first episode, coordinated specialty care. Clozapine for symptoms that don’t improve with usual medicines. Hospital or crisis care when needed. Outpatient care under Medicare Part B is 20% of the approved amount after the deductible; inpatient psychiatric care under Part A has a 2026 deductible of $1,736. All Marketplace plans must cover mental health care, and Medicaid is the largest payer for mental health services. 988 is free. Medicine prices being researched. There is no cure, but medicine and therapy can control symptoms for many people, and many people recover, with occasional relapses. Starting early and staying in treatment gives the best chance.
Chiropractic No role in treating schizophrenia. Chiropractic care is for spine and joint problems and does not treat psychosis. About $55–$100 for a follow-up visit and $90–$200 for a first visit, if you choose it for a back or neck problem. We found little research on chiropractic care for schizophrenia. It should never replace medicine or therapy.
Acupuncture Needle sessions added to — never in place of — medicine and therapy. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Many studies, of limited quality. In the only sham-controlled comparison (two small studies) a 2026 review found no clear advantage, so the evidence is uncertain.
Herbal medicine Omega-3 fatty acids, ginkgo and Chinese herbal formulas have been tested as add-ons to antipsychotics. None is a proven treatment. St. John’s wort should be avoided. Cost estimate being researched. Small or limited trials, some tentatively encouraging, none a replacement for medicine. Supplements can interact with medicines, and St. John’s wort has case reports of worsening psychotic symptoms.
Massage therapy Relaxing hands-on bodywork for stress, alongside standard care. At one national chain, about $125–$160 for a 60-minute massage for non-members, and memberships about $70–$90 a month; prices vary by location. May help you relax, but we found little research in schizophrenia and it does not treat psychosis. Low risk with a trained therapist.
MBHA Wellness Coach A steady sleep and daily routine, a medicine routine, spotting early warning signs, a written crisis plan, physical activity and healthy eating, help quitting smoking, avoiding alcohol and drugs, and connecting you and your family with support. Cost estimate being researched. Healthy routines and early action support treatment and may help prevent relapse, but they don’t replace medicine, therapy or a psychiatric team.

Approach 1 of 6

Conventional medicine (AMA)

Treatment focuses on managing symptoms, improving day-to-day functioning and reaching personal goals such as finishing school, working and having good relationships (NIMH). The NHS describes schizophrenia as usually treated with an individually tailored combination of medicine and talking therapy (NHS). We name medicine categories only — your prescriber chooses the medicine and the dose.

1. Antipsychotic medicine

  • What it does. Antipsychotic medicine can make psychotic symptoms less intense and less frequent. It is usually taken every day as a pill or liquid, and some forms are given by injection once or twice a month (NIMH). Agitation and hallucinations typically go away within days, delusions usually within a few weeks, and the full effect can take up to 6 weeks (NIMH).
  • Two main types. Older, first-generation (“typical”) medicines and newer, second-generation (“atypical”) medicines (NHS). The choice should follow a discussion between you and your psychiatrist about likely benefits and side effects (NHS). Some people need to try several before finding the one that works best (NIMH).
  • Long-acting injectables. The NHS describes slow-release (“depot”) antipsychotics given as an injection every 1 to 4 weeks (NHS). In a 2021 review of 137 studies, long-acting injectables were linked to a lower risk of hospitalization or relapse than oral antipsychotics in each type of study. In the randomized trials the difference was modest, so injectables are an option to discuss, not a rule (Kishimoto et al., 2021). NIMH suggests talking with your provider about side effects, cost and whether you prefer a daily pill or a monthly injection (NIMH).
  • Clozapine. If symptoms do not improve with usual antipsychotic medicine, a provider may prescribe clozapine; people taking it must have regular blood tests to check for a potentially dangerous side effect that occurs in 1% to 2% of patients (NIMH). MedlinePlus warns of a severe drop in white blood cells, seizures and heart inflammation, and says to call your doctor right away for signs of infection such as fever or a sore throat. Talk to your doctor if you do not take clozapine for 2 days or longer (MedlinePlus).

Side effects and safety

  • Common side effects when starting include weight gain, dry mouth, restlessness and drowsiness. Some go away over time and others last, so report them to your provider (NIMH). The NHS adds blurred vision, constipation, reduced sex drive and, with older medicines, shaking and muscle spasms. Cholesterol, blood sugar and blood pressure may need monitoring (NHS).
  • Long-term use of older (typical) medicines may lead to tardive dyskinesia, uncontrollable muscle movements that range from mild to severe. If you think you have it, check with your provider before stopping the medicine. Providers may ask people taking newer medicines to have weight, glucose and lipids monitored regularly (NIMH).
  • The FDA requires all antipsychotics to carry a black box warning about increased rates of stroke and death in older adults with dementia (NIMH).
  • If you take antipsychotic medicine and stop smoking, or start again, talk to your doctor or psychiatrist, because your prescription may need to be monitored and adjusted (NHS).

Stay on your medicine and talk before changing anything. Take it as prescribed even if you start to feel better, since continuous medicine helps prevent relapse (NHS). Stopping a medicine too soon may cause unpleasant or harmful effects (NIMH). Most people take medicine for 1 or 2 years after a first episode to prevent further episodes, and for longer if the illness is recurrent (NHS). If side effects are hard to live with, ask about alternatives rather than stopping (NHS).

2. Therapy and skills programs

Psychosocial treatments help people find solutions to everyday challenges while attending school, working and forming relationships. People who take part regularly are less likely to relapse or be hospitalized. Examples are cognitive behavioral therapy (CBT), behavioral skills training, supported employment and cognitive remediation (NIMH).

  • CBT. In CBT you can learn to recognize examples of delusional thinking and get help avoiding acting on those thoughts. It usually takes a series of hour-long sessions over several months (NHS).
  • Family education and therapy. Programs teach family and friends about symptoms and treatment, help them manage their own distress and build coping skills (NIMH). A network analysis of 72 studies with 10,364 people found that family interventions, relapse prevention programs, CBT, family psychoeducation and patient psychoeducation each reduced relapse at one year compared with usual care, although confidence in the estimates ranged from moderate to very low (Bighelli et al., 2021). A second analysis of 90 trials found almost all family intervention models cut relapse, and that family psychoeducation alone was superior to the more complex models (Rodolico et al., 2022).
  • Supported employment. A meta-analysis of 17 trials found that individual placement and support was more than twice as likely to lead to competitive employment as traditional vocational rehabilitation (Modini et al., 2016).
  • Arts therapies have been shown to ease negative symptoms for some people (NHS).

3. When more support is needed

  • Assertive community treatment is a team approach for people likely to have repeated hospitalizations or homelessness (NIMH).
  • Hospital care. A very severe episode may require inpatient care (NHS).
  • Advance planning. A written crisis plan or advance statement can say what you want family or friends to do and whom to contact if you become unwell again. It is not legally binding, but care teams follow it whenever possible (NHS). See the early psychosis and family sections below.

What it costs

  • Medicare Part B (outpatient): covers psychiatric evaluation, medication management, individual, group and family counseling, partial hospitalization and intensive outpatient programs, plus certain injections that are not usually self-administered. After the deductible you pay 20% of the Medicare-approved amount, and hospital outpatient departments may add a copayment (Medicare.gov).
  • Medicare Part A (inpatient): in 2026 each benefit period has a $1,736 deductible, then $0 a day for days 1–60, $434 a day for days 61–90 and $868 a day for lifetime reserve days. Part A pays for up to 190 days of care in a psychiatric hospital over your lifetime (Medicare.gov).
  • Marketplace plans cover psychotherapy, counseling, inpatient mental health services and substance use treatment as essential health benefits, and cannot charge more for a pre-existing condition (HealthCare.gov). Medicaid is the single largest payer for mental health services in the U.S. (Medicaid.gov).
  • Therapy without insurance: the nonprofit Open Path Collective offers individual sessions at $40–$70 and family sessions at $40–$80 after a one-time $65 membership fee (Open Path Collective). Open Path is therapy only, and serious illness usually needs a psychiatric prescriber too.
  • Prescription medicines, injections and lab tests: MBHA cost estimate being researched. The 988 Lifeline is free (988 Lifeline).

How well it works — what to expect

Schizophrenia has no cure, but medicine can control many of the symptoms (MedlinePlus). The NHS says most people make a recovery, with occasional relapses (NHS), and that recognizing the signs of an acute episode, taking medicine as prescribed and talking to others can reduce the chance of severe relapses (NHS). Treatment aims to help people stay in school, keep working and enjoy relationships, which is why therapy, rehabilitation and support matter as much as medicine (NIMH).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in treating schizophrenia. It focuses on the spine and joints and cannot treat psychosis. We found little research on chiropractic care as a treatment for schizophrenia, and what treats schizophrenia is the care described in the conventional section (NIMH). Never use it in place of medicine, therapy or a psychiatric team.

If you choose it for a separate problem

Many people with schizophrenia also have everyday aches such as back or neck pain. Mild side effects are common after spinal manipulation, such as soreness, stiffness or headache, and most go away within 24 hours. Serious problems are very rare. Tell any practitioner about your health conditions and medicines, because a serious problem may be more likely in people with underlying health problems (NCCIH).

What it costs

A first appointment commonly runs about $90–$200, and a self-pay follow-up about $55–$100. Multi-visit plans can add up to $500–$1,000 (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is sometimes explored as an add-on for schizophrenia, particularly in China. The research is limited in quality, and it should only ever be added to — never used in place of — medicine and therapy.

What the research says

  • A Cochrane review of 30 trials found that all were at moderate risk of bias. It concluded that limited evidence suggests acupuncture added to standard antipsychotics may help global and mental state, with few side effects, and that better designed large studies are needed (Shen et al., 2014).
  • A 2026 review pooled 55 trials with 4,256 people. Acupuncture plus antipsychotics improved overall symptoms compared with antipsychotics alone (low certainty), but not compared with sham acupuncture, and only two small studies made that comparison. The authors say this leaves the specific effect of acupuncture uncertain (Choi et al., 2026).

In short: acupuncture may feel calming for some people, but it is not proven to treat schizophrenia. If you try it, keep taking your medicine and tell your psychiatric provider.

Safety

Relatively few complications have been reported. Problems have come from non-sterile needles and poor technique; the FDA requires acupuncture needles to be sterile and single-use, and most states license acupuncturists (NCCIH). Choose a licensed practitioner.

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics with shared rooms charge about $50–$90 (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement replaces antipsychotic medicine. Dietary supplements are not approved by the FDA before they are sold (NCCIH), and the FDA can’t test all of them; products have been found to contain hidden prescription drugs, and “natural” does not always mean safe (NCCIH). The NHS advises checking with your healthcare team before taking any over-the-counter remedy or nutritional supplement, since these can interfere with your medicine (NHS).

St. John’s wort — avoid it

NCCIH notes case reports of St. John’s wort worsening psychotic symptoms in people with bipolar disorder or schizophrenia (NCCIH). It also interacts, in sometimes life-threatening ways, with many medicines (NCCIH). Don’t take it without your prescriber’s advice.

What has been studied

These are research findings, not treatment recommendations. We found no supplement that has been shown to treat schizophrenia.

  • Omega-3 fatty acids (fish oil). A 2021 meta-analysis of 20 double-blind trials with 1,494 people found that adding omega-3s to treatment was associated with improved symptoms, mainly general and positive symptoms but not negative ones. The authors called the findings tentative and said larger studies are needed (Goh et al., 2021).
  • Ginkgo extract. A 2015 review of 8 placebo-controlled trials with 1,033 people reported benefit on total and negative symptoms when it was added to antipsychotics. All the trials were done in China, and the authors said its safety needs more evidence (Chen et al., 2015).
  • Chinese herbal medicine. A 2005 Cochrane review of seven trials found that herbal medicine combined with antipsychotics may be beneficial, but in the one trial comparing herbs against antipsychotics, people did better on the antipsychotic. The authors said traditional Chinese medicine is under-evaluated (Rathbone et al., 2005).

Before you try any herb or supplement, talk with your prescriber or pharmacist, especially if you take clozapine or another antipsychotic. Never use a supplement in place of prescribed medicine. We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage can be a pleasant way to relax and ease muscle tension. We found little research on massage for schizophrenia, and it does not treat psychosis. The best-known study is very small: six hospitalized people with residual schizophrenia received a foot bath and leg massage three times a week for four weeks, and symptom scores and quality of life scores improved. With only six people measured before and after, it can’t show that massage caused the change (Kito & Suzuki, 2016).

Safety

The risk of harm appears to be low. Rare serious problems such as a blood clot, nerve injury or broken bone have occurred, sometimes with vigorous deep-tissue massage or in frail older adults. Forty-five states and the District of Columbia license or certify massage therapists (NCCIH). Tell the therapist about your health conditions and medicines, go at your own pace and speak up if you want to stop.

What it costs

Prices vary by location. At one national chain, published franchise price lists show about $125–$160 for a 60-minute massage for non-members and about $65–$90 for additional member sessions, and memberships run about $70–$90 a month (The Pricer). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you build the everyday habits that support your treatment. These habits work best alongside medicine, therapy and your psychiatric team; they don’t replace them. A coach is not a clinician and doesn’t diagnose or change treatment.

Medicine routines and a care plan

The NHS advises taking medicine as prescribed even when you feel better (NHS). A coach can help you set up reminders and keep a list of questions and side effects to bring to appointments, and help you write down your care plan.

Know your early warning signs

Learning to recognize the signs that you are becoming unwell can help you manage the illness. Signs can include losing your appetite, feeling anxious or stressed, disturbed sleep, feeling suspicious or fearful, worrying about other people’s motives, hearing quiet voices now and again, and finding it hard to concentrate. You may want to ask someone you trust to tell you if they notice your behavior changing (NHS). Catching a relapse early may mean it can be prevented with medicine and extra support (NHS). A coach can help you write your own list and share it with your care team.

Sleep, stress and routine

The NHS advises a regular sleep pattern, avoiding too much stress, and giving the week some structure, even if you are not working (NHS). Disrupted sleep is also one of the warning signs of psychosis (NIMH), so notice and report changes.

Move your body

A 2024 network meta-analysis of 47 studies with 4,031 people found that several kinds of exercise, including yoga and combined resistance and aerobic exercise, were linked to better symptoms, quality of life, mood or thinking in schizophrenia (Yang et al., 2024). A coach can help you choose something you enjoy and build up gradually. Check with your doctor first, especially if you have heart or metabolic problems.

Eating well and quitting smoking

A balanced diet with plenty of fruit and vegetables and regular exercise can reduce your risk of cardiovascular disease and diabetes. Stopping smoking has been shown to improve the mental health of people with schizophrenia (NHS). See the physical health section below.

Avoid alcohol and drugs

Regularly drinking too much alcohol or using illegal drugs can trigger psychosis and make symptoms of schizophrenia worse, and drugs and alcohol can react badly with antipsychotic medicines. If you find it hard to stop, ask your care team for help (NHS). See the section below.

Build connection and purpose

Peer support from a trained worker who has recovered from psychosis or schizophrenia, day centers, work projects and supported housing are all options the NHS describes (NHS). NIMH suggests looking for support groups and family education programs, such as those offered by the National Alliance on Mental Illness (NIMH). A coach can help you explore what is available locally and set small goals around school, work or volunteering. If things feel unbearable, call or text 988 (988 Lifeline).

What it costs

Cost estimate being researched.

Another approach

Early psychosis and coordinated specialty care

When someone has a first episode of psychosis, the earliest care matters most. Coordinated specialty care (CSC) is a recovery-focused team program for first-episode psychosis. Professionals work together to provide psychotherapy, medication, case management, employment and education services, and family education and support, and the team makes treatment decisions together with the person and their family (NIMH).

  • The parts of CSC. Individual or group therapy tailored to your recovery goals; family support and education; medication management; supported employment and education with a coach; and case management for practical problems (NIMH RAISE).
  • The evidence. In NIMH’s RAISE research, people who received CSC stayed in treatment longer and improved more in symptoms, relationships and quality of life than those who received typical care, and they were more involved in work and school (NIMH RAISE). A 2018 meta-analysis of 10 randomized trials with 2,176 people found early intervention services better than usual treatment on all 13 outcomes it could analyze, including fewer hospitalizations and less treatment dropout (Correll et al., 2018). NIMH says CSC is now the standard of care for early psychosis (NIMH).
  • Hope. With early diagnosis and appropriate treatment it is possible to recover from psychosis. Some people who receive early treatment never have another episode; for others, recovery means living a fulfilling life even if symptoms sometimes return (NIMH).
  • Finding a program. NIMH lists the Early Psychosis Intervention Network clinics, the Psychosis-Risk and Early Psychosis Program Network directory, SAMHSA’s Early Serious Mental Illness Treatment Locator and the NAMI HelpLine (NIMH). If you are a young person or the parent of one, ask a primary care provider about early psychosis programs.

Another approach

For families: how to respond and how to help

It can be hard to know what to do when someone you love is experiencing psychosis. Here is what health agencies suggest.

When they are hearing voices or holding unusual beliefs

Helping them get and stay in treatment

Warning signs of suicide

The NHS lists making final arrangements such as giving away possessions or saying goodbye, talking about death, self-harm, and a sudden lifting of mood. If you see these signs, get professional help, tell the person they are not alone, and stay with them if there is immediate danger. Remove available means such as sharp objects and medication (NHS). In the U.S., call or text 988, or call 911 in a life-threatening situation (NIMH).

Looking after yourself

Having a relative with psychosis can be upsetting and stressful for you too. Keep calm, make time for yourself and get the support you need (NHS Likemind). Family education programs can help families manage their own distress, build coping skills and strengthen their ability to provide support (NIMH). Ask the care team about family psychoeducation or family therapy; the NHS describes sessions over about six months that cover information about the illness, practical problem-solving and planning for a crisis (NHS).

Another approach

Physical health and living well

Physical health deserves as much attention as mental health. Heart disease, liver disease and diabetes contribute to the higher risk of dying younger among people with schizophrenia, and possible reasons include higher rates of these conditions and under-detection and under-treatment of them. NIMH puts the estimated average potential life lost in the U.S. at 28.5 years (NIMH statistics). That is a population average and a reason to act, not a forecast for you.

  • Regular check-ups. The NHS advises a check-up at least once a year to monitor the risk of cardiovascular disease and diabetes, including weight, blood pressure and blood tests, and says the care plan should include a healthy eating and physical activity programme and support to give up smoking (NHS, NHS).
  • Medicine monitoring. Weight, glucose and lipid levels may be checked regularly for people taking newer antipsychotics (NIMH).
  • Speak up about physical symptoms. One reason for early death is that medical conditions go under-detected and under-treated (NIMH statistics), so mention new symptoms and ask for checks.
  • Other mental health conditions. About half of people with schizophrenia have a co-occurring mental or behavioral health disorder (NIMH statistics). See our Depression and Anxiety guides.

Another approach

Cannabis, alcohol and other drugs

Many people with schizophrenia also have problems with drugs and alcohol. Substance use can interfere with schizophrenia treatment, so NIMH says a program that treats both is important for recovery (NIMH). Substance misuse is more common in people with schizophrenia than in the general population (MedlinePlus Genetics).

  • Cannabis and risk. Studies have shown that using drugs, particularly cannabis, cocaine, LSD or amphetamines, can increase the risk of developing schizophrenia or psychosis, and teenagers and young adults who use cannabis regularly are more likely to develop schizophrenia later; the risk may be higher with stronger forms. It is not clear whether drugs directly cause the symptoms or whether people at risk are more likely to use them (NHS). MedlinePlus Genetics says some studies show young people who use cannabis frequently may have an increased risk (MedlinePlus Genetics). A meta-analysis of 10 studies with 66,816 people found that heavier cannabis use was linked to a higher risk of psychosis, with a dose-response pattern, though a causal link cannot be unequivocally established (Marconi et al., 2016).
  • After an episode. If someone has had psychosis before, using drugs can cause a relapse or stop symptoms from getting better. Alcohol and drugs can also cause depression and anxiety and can react badly with antipsychotic medicines (NHS, NHS).
  • Overdose risk. If drug use is part of the picture, learn the signs of an overdose; see our Drug Overdose guide.
  • Asking for help. Tell your care coordinator or doctor if you find it hard to stop (NHS). Combined treatment for schizophrenia and substance use is what NIMH recommends (NIMH).

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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