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Mental Illness Guide: Care, Support, and Education
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What are the warning signs that I am getting sick again?

Why do people get sick again

During the difficult period of getting sick, the goal is to reduce harsh symptoms.  The mental health workers and patient must work together to find the reason that the person with serious mental illness is getting sick again.  There must be an agreement and support from the patient, family members, and other persons involved in the treatment plan during this period.

Getting sick again

People who have serious mental illness may get sick many times.  There are many reasons why a person may get sick.  Here are some of the reasons.

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Sometimes the ill person has stopped taking medication for a long enough period to get sick again.

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Sometimes the amount of medication is not high enough to prevent the person from getting sick.

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Perhaps the person is not receiving enough positive support either at home or from community services.

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Perhaps the person is experiencing a lot of stress in his/her life.

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Perhaps the person has recently experienced an event causing a lot of stress.   For example, death of a loved one, the loss of a job, moving to a new place to live, or something else that caused stress.

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Maybe the individual is simply worn out, or needs more sleep.

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Maybe the person is using alcohol or street drugs.

Remember, if you or a family member thinks that the situation is getting worse, you should contact a treatment program immediately.

How to keep from getting sick again

The first goal of treatment is to keep from getting sick again.  For most people, this means taking medication.  The doctor may have to make changes to figure out which medicine and how much of it works best for each person.  It may take several weeks to see the effects of a change in medication.  When a person is under more stress the doctor may ask him/her to take more medication, or a different kind of medication just for stress.

Families say that signs that point to getting sick again are usually the same as the signs that happen before the person got sick the first time. Often it will take time for family and friends to become aware of the person getting worse due to an increase in symptoms.   Listed below are some common signs that a person with serious mental illness is getting sick again.  Remember, the signs will be different for each person.  If any of the signs are present, trust your feelings and call a mental health professional immediately.

Warning signs that a person with serious mental illness is getting sick again

You should be aware of changes that occur in your personality and in your everyday schedule.  You and your family members should keep a diary to help you in recalling the signs that happen before you get sick again.  In the diary, you should also write down strange behaviors, questions, and thoughts that you want to share and discuss with mental health professionals and others involved with your treatment.

Below is a list of common warning signs.  This list is only a guide.  Use this list to help you remember the things that have happened in the past before you got sick.  Write down a list of these things.  Add other things to your list that you have noticed, which may not be in the list below. Families have noted that the signs that point to getting sick again are usually the same as those that happen before they got sick the first time.

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Missing scheduled appointments with doctors or other treatment team members.

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Complaining about having to take medication.

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Doing less than usual during the day.

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Drinking more caffeine and smoking more than usual.

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Spending time with people who drink alcohol or use street drugs.

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Not being able to sleep, having unusual waking hours, having the days and nights mixed up.

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Stop visiting and going out with friends, staying by yourself most of the time, being unconcerned about most matters.

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Less social relationships.

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Going from being busy and in a hurry to being restless and not wanting to do anything.

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Spending a lot of time discussing religion.

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Being unfriendly, mistrustful or fearful.

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Getting angry too quickly with friends or family when you disagree.

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Not keeping your clothes and self clean.

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Writing and printing words that are not clear or do not have meaning.

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Having a lot of emotional responses to unimportant matters.

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Having a sad and blank look on your face.

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Staring, not blinking, or blinking a lot.

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Liking a lot of noise and light.

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Smelling and tasting things differently.

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Showing strange behaviors like refusing to touch people, constantly wearing gloves, shaving head or body hair, and threatening to hurt yourself.

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Having everyday thoughts that become confusing or do not connect right.  Sentences may be unclear or may not make sense.  It may be difficult to think, to follow conversations, or to remember things.  Thoughts may seem to speed up or slow down.  When a person with schizophrenia talks strangely and not the normal way, he or she might do some of the following:

-Talk too much
-Talk to people who are not there, make-believe people
-Talk back to the radio or TV
-Pray or sing out loud at wrong times
-Leave the room for no reason while holding a conversation
-Not want to talk

Remember, if you or a family member thinks that the situation is getting worse, you should contact the mental health professionals immediately.

Avoid street drugs

Street drugs are drugs such as alcohol, marijuana, cocaine, and other drugs.  People who have a mental illness may use street drugs to reduce symptoms of the illness and try to improve their mood.  Using street drugs often causes more problems for the person.

When people who have mental illness use street drugs, they are more likely:

bulletTo get sick again and have to go to the hospital.
bulletTo be homeless or unemployed.
bulletTo be violent or take part in a crime

Why would someone with mental illness use drugs and alcohol?

There are many reasons that people with mental illness might use street drugs and alcohol.  Some of those reasons are the same for people who do not have a mental illness.  For example, alcohol can make people feel more comfortable around other people.  People with schizophrenia may feel really tense around others because they are afraid or are not good at talking with people.

They may also use street drugs and alcohol to try to stop their symptoms.  For instance, they may try to “drown out” the voices by drinking or using drugs.  They also may try to stop the side effects of their medications.  For example, they may feel very restless and drink to try to calm down.

People with a mental illness are much more likely than others to have problems with street drugs and alcohol. About 50% of people with a mental illness use alcohol or street drugs.  People with mental illness who use street drugs or alcohol have a harder time getting and staying well.

Why is it harder for people with mental illness who use street drugs and alcohol to do well?

It can be hard for the doctor to figure out which symptoms the drugs cause and which are caused by the mental illness.  Thus, it can be harder for the doctor to treat the person, unless the doctor knows how to treat someone with both problems.

People with both problems sometimes find it very hard to fit in.  People with mental illness may not understand about drugs and alcohol problems.  People with drug and alcohol problems may not understand the mental illness.  It is a good idea to find a treatment program that can treat both problems.