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If symptoms seem to get worse, or symptoms that had been in remission reappear, the person may be in relapse. Relapse is sometimes caused by a new source of stress, or an old source of stress that has gotten worse. And, sometimes, a relapse can happen for no apparent reason, even if a person is closely following his or her doctor’s instructions.

One of the best ways to manage relapse is to identify the early warning signs. It is helpful if the first signs of a relapse can be pinpointed so your doctor can help you develop an action plan to manage any future relapse. Relapse symptoms may be subtle and can include:

  • Change in sleeping habits (too much or too little sleep)
  • Straying from the treatment plan
  • Tension, agitation, or irritability
  • Change in eating habits – problems with eating, lack of appetite, or increased appetite
  • Decreased ability to concentrate or focus Signs of depression (i.e., apathy, sadness, hopelessness, uncontrollable crying)
  • Anxiety, particularly restlessness, increased feelings of fear or apprehension, or anxious habits such as nail biting
  • Social withdrawal
  • Decline in personal hygiene
  • Unusual, disturbing, or recurring thoughts
  • Other signs that have preceded previous relapses

[Source: Modified from “Relapse in Schizophrenia,” by M.I. Herz and C. Melville, 1980,
American Journal of Psychiatry, 137, pp. 801-805.]

The key to recognizing signs of relapse is to look for behavior changes that indicate the person’s behavior has gotten worse. Because schizophrenia tends to impair thinking, the person may need a friend or family member to recognize that he or she is relapsing. Be proactive and keep the lines of communication open. If you see signs of relapse, discuss your concerns and contact the health-care provider to convey what you have observed. Be as specific as possible, identify any stressors that may be present and evaluate ways to decrease those stressors to help the person more effectively cope.

Seek support through Mental Health America and the National Alliance on Mental Illness, where you can find contact information for local chapters. Also seek support from friends and other family members.