Suboxone Withdrawal: Symptoms, Timeline, and Treatment


Key Takeaways

  • Suboxone withdrawal symptoms usually last for a week, but some can last up to 10 days.
  • Do not change your dose or stop taking Suboxone without talking to your doctor first.
  • It’s important to reach out for help to manage feelings like anxiety and depression during withdrawal.

Suboxone (buprenorphine/naloxone) is a prescription medication used to treat opioid use disorder(OUD). While it doesn’t produce psychoactive effects, Suboxone is still an opioid—which means that you will experience withdrawal symptoms if you try to quit it suddenly, aka “cold turkey.” Your doctor may recommend tapering your dose over time to minimize withdrawal symptoms.

How Long Does Suboxone Withdrawal Last?

If you are planning to stop taking Suboxone, it can be helpful to know what to expect in terms of how long withdrawal symptoms might last.

Symptoms of Suboxone withdrawal usually last for a week but may last up to 10 days.

Specific withdrawal symptoms may occur at different times, so while some might fade quite quickly, others may linger for a bit longer. For example, muscle aches and joint pain typically decline after the first 72 hours, while feelings of restlessness and anxiety may last for up to a week. Other physical cold-like symptoms, such as a runny or stuffy nose, generally disappear after 10 days.

However, you may experience feelings of general discomfort and opioid craving for a few months. Talk to your doctor about what you can do to manage these continued feelings. Your doctor can prescribe medications that may help, or you might try counseling, support groups, and lifestyle changes to help manage continued discomfort and cravings that you might experience. 

Symptoms of Suboxone Withdrawal

If you are using Suboxone as directed for the treatment of opioid addiction or to treat pain, you can expect to experience withdrawal symptoms if you miss a dose or try to quit abruptly.   

Physical Symptoms of Withdrawal from Suboxone

Suboxone causes most of the physical symptoms typical of opioid withdrawal. These include:

  • Chills
  • Goose bumps
  • Muscles aches and pains
  • Nausea or vomiting  
  • Runny nose
  • Stomach cramps or diarrhea
  • Sweating
  • Tremors or twitching
  • Teary eyes

If you take Suboxone to treat opioid addiction, then your withdrawal symptoms should be less severe than what you have experienced in the past.

To get a better idea of how mild to moderate opioid withdrawal symptoms compared to more intense symptoms, you can check out the Clinical Opiate Withdrawal Scale (COWS). Health professionals use this scale to determine the severity of opioid withdrawal syndrome.  

Psychological Symptoms of Suboxone Withdrawal

Some psychological symptoms of Suboxone withdrawal include:

  • Anxiety
  • Depression
  • Restlessness

Additionally, the psychological challenges associated with withdrawal are not always caused by withdrawal itself. Withdrawal can trigger the return of mental health problems that were muted by drug use, such as anxiety and depression.

After withdrawal, people are also forced to take a good look at the damage that their drug addiction has wrought. It is not unusual to struggle with issues of guilt and regret.

Figuring out how to get your life back on track can feel overwhelming and emotionally exhausting. That’s why it’s so important to reach out for help.

Suboxone Withdrawal Timeline

The timeline of Suboxone withdrawal is also a bit different from withdrawal from other opioids. Suboxone is a long-acting opioid, which means withdrawal symptoms can take several days to appear. 

Suboxone Withdrawal Timeline

Suboxone withdrawal typically begins within two to four days after taking the last dose, peaks around days three to five, and resolves within seven days.

Sometimes, however, psychological symptoms can linger for several weeks. This may include depression and an inability to feel pleasure.  

Recap

Suboxone withdrawal can lead to a number of withdrawal symptoms including cold-like symptoms, anxiety, stomach issues, and muscle aches. Such symptoms usually peak within five days and largely resolve within a week.

Coping With Suboxone Withdrawal

You can avoid the symptoms of withdrawal from Suboxone by working with your doctor to taper down your dose. Tapering means gradually reducing your dose over time.  

Tapering Schedule

Suboxone tapering schedules typically take place over the course of 7 to 28 days.

Some studies have shown that overall success (measured by a period of prolonged abstinence) tends to be better with a shorter, seven-day taper. However, one study found that many people attempt to self-taper without medical supervision, which is associated with poor success rates. 

Other studies have found that withdrawal symptoms are managed best by a slow, flexible tapering schedule. With a flexible taper schedule, your doctor can slow the dose reduction if you experience any uncomfortable symptoms.  

Do Not Taper On Your Own

If you have been acquiring your Suboxone illicitly or do not have a close relationship with your doctor, it can be tempting to try tapering down on your own. Tapering on your own increases the likelihood of failure. Unsuccessful attempts to quit are discouraging and psychologically distressing.

If you are still struggling with withdrawal despite the Suboxone taper, your doctor may recommend one or more support medications.

Withdrawal Medication Treatment

Lucemyra (lofexidine hydrochloride) is a medication approved by the FDA in May 2018. It is the first non-opioid medication approved to treat the symptoms of withdrawal. Lucemyra works by reducing the release of norepinephrine, a neurotransmitter believed to play a role in withdrawal symptoms.

Because it does not contain an opioid agonist, Lucemyra treatment can begin immediately after your last dose of Suboxone. It is currently approved to treat healthy adults for a maximum of 14 days following opioid cessation. 

Lifestyle Changes

If you are struggling with Suboxone withdrawal it may help to drink more fluids than usual to prevent dehydration. It’s also important to eat a well-balanced diet to keep vitamin and electrolyte levels up.

Work closely with a doctor, counselor, or physical therapist to develop new ways of coping with pain during and after withdrawal. Practice relaxation techniques (meditation, listening to music, etc.,) to help you deal with anxiety and agitation. Try mild to moderate exercise to help you deal with restlessness.

Find something else to focus on during withdrawal, such as a television show, book, or hobby. Get support and encouragement from a local community group or Narcotics Anonymous (NA) meeting. 

Recap

Following the tapering schedule recommended by your doctor is the best way to minimize or avoid Suboxone withdrawal. In some cases, your doctor may prescribe other medications to help you with your withdrawal symptoms.

Suboxone Relapse Potential

Opioid withdrawal is often unpleasant, but it is very rarely dangerous. When it comes to Suboxone, complications are even more unlikely. Still, it is important to work closely with a medical professional during your Suboxone taper.

The biggest threat to people withdrawing from Suboxone is the risk of relapse. 

Relapse is common among people with opioid use disorders and is generally considered a normal part of the recovery process. But people who have been taking Suboxone are typically further along on the path to recovery.

A relapse at this point can be both discouraging and dangerous because your tolerance will have dropped substantially. Relapsing after your tolerance has decreased can lead to a dangerous or potentially fatal opioid overdose.

Overdose Help

If you are in immediate danger or experiencing severe medical symptoms, please get to your nearest emergency room immediately.

Quitting Suboxone During Pregnancy

If you are quitting Suboxone because you’re pregnant or breastfeeding, you should definitely talk to a doctor.

Suboxone is not recommended during pregnancy, but buprenorphine without naltrexone is. Depending on your situation, your doctor may recommend an accelerated taper or a switch to buprenorphine or methadone, which have been proven safe during pregnancy.

Long-Term Treatment for Opioid Use Disorder

If you have been using Suboxone to treat your addiction, you are already ahead of the game. Suboxone allows you to develop a long-term treatment strategy without being distracted by the discomfort of withdrawal. 

Treatment Plan

After Suboxone, a long-term treatment plan should focus on preventing future relapse. Talk therapy plays a very important role in relapse prevention. Once you come off Suboxone, you will have beaten your physical dependence on opioids, but not the psychological aspects of addiction. 

Talk therapy can help you figure out why you began using drugs in the first place. You can learn to identify specific situations and feelings that have led you to use in the past. Identifying these triggers helps you recognize and eliminate the negative thought patterns that cause you to make poor decisions. 

Research shows that combining talk therapy with medication management is more effective at treating opioid addiction than medication alone.

There are many ways to explore talk therapy. You might consider working one-on-one with a psychologist or mental health counselor in private practice. You can meet with a mental health or addiction counselor at a local community clinic. Or you can explore group therapy programs, which are offered at many hospitals, clinics, and addiction treatment facilities. 


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The Pros and Cons of Online Therapy

Key Takeaways

  • Online therapy can be just as effective as in-person therapy for many mental health conditions.
  • The internet makes mental health treatment more approachable and helps overcome stigma.

Are you considering online therapy? While the internet has opened up new avenues for mental health treatment, there are some pros and cons you should consider before you decide if online therapy is right for you.

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This episode of The Verywell Mind Podcast shares the pros and cons of online therapy. Click below to listen now.

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What Is Online Therapy?

Online therapy refers to psychotherapy or counseling services conducted over the internet. In contrast to in-person therapy, online therapy allows you to connect with a licensed therapist or counselor from the comfort of your own home using any device that has an internet connection, such as a computer, tablet, or smartphone.

Other terms that are often used interchangeably with online therapy are teletherapy or e-therapy.

Pros of Online Therapy

There are many reasons people opt for online therapy over in-person therapy. The following are some of the biggest advantages of online therapy.

Online Therapy May Be as Effective

Research shows that online therapy can be just as effective as in-person therapy for various mental health conditions.

One literature review of studies found online cognitive behavioral therapy (CBT) to be just as effective as in-person therapy in treating moderate depression. Another review found that online CBT was equally effective as a face-to-face treatment for panic disorder, social anxiety disorder, and generalized anxiety disorder. Online therapy is even shown to be effective in reducing problem gambling behaviors.

Good Option for Remote Areas

Online therapy offers access to mental health treatment to people in rural or remote areas. Those who live in rural areas simply might not have access to any other form of mental health treatment because there are few or no mental health practices in their area – these are known as “therapy deserts.”

Having to drive long distances and take significant time out of a busy schedule to seek in-person therapy can be a burden for people in need of help. If you have reliable internet access, online therapy gives you relatively quick and easy access to treatment that might not have been readily available to you otherwise.

Accessibility for People With Physical Limitations

Online therapy provides accessibility to individuals who are disabled or housebound. Mobility can be a big issue when it comes to accessing mental health care. A therapist practicing out of their own home, for example, may not be set up to accommodate clients of all abilities.

People who are unable to leave their home for various reasons, such as physical or mental illness, may find online therapy a useful alternative to traditional in-person psychotherapy settings.

Convenience and Affordability

Online therapy is usually fairly affordable and convenient. Since you will be attending therapy sessions online in the comfort of your own home, you can often schedule your therapy sessions for times that are the most convenient for you.

Today, many states require insurance providers to cover online therapy just as they would traditional therapy sessions. Contact your insurance company to learn more about how e-therapy treatments will be covered by your policy.

Therapists who only treat patients online likely have fewer overhead costs, such as renting office space. Online therapists, therefore, can often offer affordable treatment options for those who are not covered by health insurance.

Verywell Mind’s Cost of Therapy Survey found that many Americans currently in therapy face issues with accessing mental health treatment, or additional costs associated with therapy:

  • 31% have to pay for either childcare or adult/elder care in order to attend their sessions
  • 30% say they’ve encountered a lack of appointment availability or flexibility of the mental health professional
  • 27% have had difficulty finding a mental health professional who is taking new patients

Treatment Can Be More Approachable

The internet makes mental health treatment more approachable. People may feel comfortable talking to friends and family about physical health care issues, but may not feel the same discussing mental health concerns that are just as important. Online access makes it easier to overcome the stigma that has historically been attached to mental health issues – you won’t be seen at a therapist’s office or have to explain to someone why you’re taking two hours out of your day to attend therapy in person.

Teletherapy can be an important tool to help people learn more about mental health. Even if you feel like your mental well-being is strong, online therapy can help you become psychologically stronger. You can learn more about health behaviors and coping strategies that will lead to better psychological health.

You don’t need to have a clinically diagnosed condition to benefit from talking to a professional, and online therapy can provide an easy avenue for getting started.

Cons of Online Therapy

While online therapy can potentially be very helpful for people in certain situations, it does not come without some risks and disadvantages over traditional therapy options.

Insurance Companies May Not Cover It

Insurance coverage for e-therapy can depend upon the state where you live and the insurance that you have. Some insurance policies don’t cover online therapy and some online mental health professionals don’t accept insurance as payment. Paying for psychotherapy services out-of-pocket can add up quickly.

Some States Don’t Allow Out-of-State Providers

Many states do not allow out-of-state psychologists to provide services. In such cases, your provider would need to be licensed in both their home state as well as your home state.

In an article for the APA’s Monitor on Psychology, Deborah Baker, a legal expert for the American Psychological Association, explained that some states allow psychologists to provide out-of-state mental health services for a limited amount of time. This usually consists of only 10 to 30 days per year.

This can especially pose problems for those living in therapy deserts, who might not be able to find services in their area or even far beyond it.

Confidentiality, Privacy, and Unreliable Technology

Keeping your personal information private is a major concern in psychotherapy, but online treatment adds a layer of complexity. Confidentiality is just as important in online therapy as it is in more traditional forms of treatment delivery.

Since information is being transmitted online, the situation makes privacy leaks and hacks more of a concern. Technology problems can also make it difficult to access treatment when you really need it.

Lack of Response to Crisis Situations

Since online therapists are distant from the client, it can be difficult for them to respond quickly and effectively when a crisis happens.

If a client is experiencing suicidal thoughts or has suffered a personal tragedy, it can be difficult or even impossible for the therapist to provide direct assistance.

Not Appropriate for Serious Psychiatric Illnesses

E-therapy can be useful for a variety of situations, but not when it comes to people that require close and direct treatment or in-person intervention.

For example, if you have a serious addiction or have more severe or complex symptoms of a mental health condition, such as psychosis, online therapy may not be recommended unless other in-person therapies or treatments are also involved in your plan. The scope of online therapy can be limited, so it may not be effective for more serious situations.

Overlooks Body Language

On a video call, most of your body is obscured; and especially if using text-based therapy, your therapists cannot see facial expressions, vocal signals, or body language. These signals can often be quite telling and give the therapist a clearer picture of your feelings, thoughts, moods, and behaviors.

Some delivery methods such as voice-over-internet technology and video chats can provide a clearer picture of the situation, but they often lack the intimacy and intricacy that real-world interactions offer.

Some people may feel more comfortable undergoing therapy in a digital setting, especially younger people who are more familiar with such methods of communication, but others—therapists and patients alike—may get more out of therapy that utilizes more direct human contact.

Ethical and Legal Concerns

Online therapy eliminates geographic restraints, making the enforcement of legal and ethical codes difficult. Online therapists can, theoretically, treat clients from anywhere in the world, but they have to be licensed in both the state in which they are and the state in which you are. Many states have different licensing requirements and treatment guidelines. It is important to confirm your therapist’s qualifications and experience before you begin the treatment process.


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Definition, Signs, and How to Cope


Key Takeaways

  • Persecutory delusions are false beliefs that others intend to harm you.
  • These types of delusions can occur in serious mental illnesses such as schizophrenia, schizoaffective disorder, bipolar disorder, psychotic depression, and post-traumatic stress disorder (PTSD).
  • Cognitive behavioral therapy can help reduce persecutory delusions by addressing anxiety and worry.

Persecutory delusions occur when someone believes others are out to harm them despite evidence to the contrary. It’s a type of paranoid thinking that can be part of several different mental illnesses.

Whether people with this condition think co-workers are sabotaging their work or they believe the government is trying to kill them, persecutory delusions vary in severity. Some people with persecutory delusions believe they have to go to great lengths to stay safe—and consequently, they may struggle to function in everyday life.

While everyone may experience some false beliefs about people being “out to get them” at times, for people with persecutory delusions, their beliefs take a serious toll on their lives. Their delusions are usually a symptom of a mental illness that requires professional help.

Types of Persecutory Delusions

People with mental illness may experience persecutory delusions. These delusions are most commonly associated with schizophrenia, but they also may appear during manic episodes of bipolar disorder or with severe depression with psychosis.

Conditions that can cause persecutory delusions include:

Schizophrenia

A condition that involves distortions in thinking and perception. People with this condition often experience hallucinations and delusions, including persecutory delusions.

Bipolar Disorder

A condition that causes extreme shifts in mood, activity levels, and behavior. A person may shift rapidly between periods of excess energy and grandiose mood (mania) to periods of very low mood (depression). Persecutory delusions most often occur during manic episodes.

Major Depression with Psychotic Features

Sometimes known as psychotic depression, this condition involves having both depressive symptoms and episodes of psychosis.

Schizoaffective Disorder

Schizoaffective disorder is a condition that involves symptoms of schizophrenia along with mood symptoms such as mania or depression.

Post-Traumatic Stress Disorder (PTSD)

A condition that can occur after a person has experienced a traumatic event, which can lead to symptoms including flashbacks, nightmares, hallucinations, and delusions.

Dementia

It’s also common for people with dementia to develop delusions. It’s estimated that 27% of people with dementia experience persecutory delusions at one time or another.

Delusional Disorder

They may also signal a delusional disorder, an illness that is characterized by at least one month of delusions but no other psychotic symptoms.

Persecutory delusions are one of the most common types of delusions.

Delusional disorders are far less common than other mental illnesses that may involve psychosis. It’s estimated that only 0.2% of the population experiences delusional disorder.

Less common types of delusions include:

  • Somatic delusions: The fixed false belief that one has a physical defect or medical problem
  • Erotomanic delusions: The conviction that someone is in love with them

Signs of Persecutory Delusions

People with persecutory delusions believe that harm is going to occur and that other people intend for them to be harmed.

People experiencing persecutory delusions may say things such as:

  • “My neighbors break into my house at night and steal my clothes out of my closet.”
  • “The police are following me because they want to torture me.”
  • “An evil spirit is trying to kill me.”
  • “The government is poisoning me through the drinking water.”
  • “The people up the street are spying on me and are going to steal my stuff.”

People reporting persecutory delusions may also talk in vague terms by saying things like, “They’re out to get to me,” without being able to articulate who “they” are.

Sometimes, people with persecutory delusions report their concerns to the authorities. When nothing happens, they often grow suspicious that the authorities are somehow involved. They also grow frustrated when no one will help them. They may be confused about why friends and family members don’t seem to share their concerns, or they may become angry that no one will take action.

Causes of Persecutory Delusions

There are several causes linked to psychosis, including childhood trauma as well as societal, genetic, and biological factors.

  • Biological factors: Brain abnormalities or an imbalance of chemicals in the brain as well as alcohol and drug use can contribute to persecutory delusions.
  • Childhood trauma: Some studies have specifically linked childhood trauma to paranoia.
  • Genetic factors: Delusional disorders are more common in people who have a family member with a delusion disorder or schizophrenia.
  • Societal factors: Movies, books, pop culture, and other societal factors may increase or fuel persecutory delusions.

Factors Associated With Persecutory Delusions

People who experience persecutory delusions tend to have several factors in common in terms of the way they think, feel, and behave. However, it’s unclear whether these factors cause persecutory delusions or whether persecutory delusions cause these things to occur.

Here are six things most people with persecutory delusions have in common.

Worry and Rumination

People who experience persecutory delusions are likely to spend a lot of time worrying. Several studies have found that rates of worry in people experiencing persecutory delusions are similar to the rates of worry that people with anxiety disorders experience.

Time spent imagining implausible outcomes and catastrophic ideas may go hand-in-hand with persecutory delusions. A 2014 study found that a period of worry often precedes persecutory delusions.

Treating the underlying anxiety has been found to be effective in reducing persecutory delusions. People who learn skills to reduce their worrying may be able to better manage their symptoms.

Negative Thoughts

People who feel different, apart, inferior, and vulnerable are more likely to be paranoid. A 2012 study assessed 301 patients with psychosis three times over the course of a year. The researchers found that negative thoughts about one’s self predicted the persistence of persecutory delusions.

People with persecutory delusions also tend to be overly critical of themselves. Researchers suggest that cognitive biases, including negative thinking, play a role in the onset and maintenance of persecutory delusions.

Interpersonal Sensitivity

People with persecutory delusions tend to be high in interpersonal sensitivity, meaning that they feel vulnerable in the presence of others due to fear of criticism or rejection.

People with persecutory delusions also are more likely to interpret neutral events as containing hostility from others. Interpersonal sensitivity is also positively associated with higher levels of anxiety and depression.

Abnormal Internal Experiences

People with persecutory delusions sometimes misinterpret external events. However, some research has found that this is only true when the person is experiencing an unsettled internal state.

Unexplained anxious arousal, feelings of depersonalization, or perceptual disturbances can cause a person to look for answers from the external environment.

For example, a person who has experienced a negative life event or poor sleep may feel “off.” Consequently, they may place blame on the environment for why they feel bad. Someone might think, “I feel anxious because someone is spying on me.”

Insomnia

A 2012 study found that having insomnia increased the odds of developing paranoid ideation by threefold. Poor sleep also has been found to be a predictor of the persistence of existing paranoia.

Insomnia is a treatable condition. Helping people improve the quantity and quality of sleep may be key to reducing persecutory delusions.

Irrational Reasoning

One study found that people who experience persecutory delusions are more likely to jump to conclusions. People who jump to conclusions gather little information before making decisions and can be quite impulsive.

For example, people who jump to conclusions may assume a stranger who is holding up a phone is taking a picture of them. They also may believe that a group of people who are laughing must be laughing at them. 

The study also found that people who jumped to conclusions had a poorer working memory of performance, lower IQ, lower intolerance of uncertainty, and lower levels of worry.

Diagnosing Persecutory Delusions

Persecutory delusions are a symptom of some types of mental health conditions. To treat them effectively, it is important to first determine what might be causing them 

To make a diagnosis, a doctor will perform a physical exam, take a medical history, and perform a psychiatric assessment. They may also screen for substances or order brain imaging tests to better understand what might be causing these symptoms.

Once they understand a person’s current symptoms, history, and health status, they can use the diagnostic criteria in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR) to help diagnose their condition.

Treatment for Persecutory Delusions

Treatment varies greatly depending on the type of mental illness someone is experiencing. Sometimes underlying issues, like insomnia or past trauma, must be addressed. At other times, reducing anxiety can be a helpful intervention.

Therapy

A 2014 study found that cognitive behavioral therapy (CBT) can be an effective intervention. When therapists helped patients reduce worry and rumination, persecutory delusions decreased. CBT also led to significant reductions in other psychiatric symptoms and general levels of paranoia.

The results of one clinical trial found that a specific treatment called the Feeling Safe program was an effective intervention for people experiencing persecutory delusions. The program focuses on helping people develop new memories focused on safety. Results suggest that half of people participating in the program significantly improve their symptoms.

Medication

Depending on the illness, antipsychotics, antidepressants, or other mood-stabilizing medications may be used. The specific medications that may be effective depend on an individual’s specific diagnosis. For example, research suggests that antipsychotics can be effective for the treatment of delusional disorders.

Support Services

People who are experiencing delusions also may struggle with everyday tasks, like going to work, running errands, and paying bills. They may require professional in-home support services to assist them with daily tasks.

Inpatient Hospitalization

However, sometimes people with delusions distrust professionals, which can make treatment even more complicated. Inpatient hospitalizations may be required at times to help a person gain better control over the symptoms.

Coping With Persecutory Delusions

Supporting a person who is experiencing persecutory delusions can be hard. You might have to spend a lot of time listening to them explain how they’re being persecuted—even though there’s no evidence that it’s true. Or, there may be times when they insist that you’re out to get them too.

Have Empathy

While you might be tempted to tell the person that they’re delusional and their thoughts are irrational, your efforts may do more harm than good.

A better approach is to focus on how your loved one is feeling. Say things like, “I know this is really stressful for you.” Express concern by saying things like, “I notice you’re overwhelmed.”

Seek Support for Yourself

A support group could help you learn about the struggles, strategies, and resources other people in similar situations have found helpful. Whether the person experiencing persecutory delusions is your partner, sibling, parent, or child, consider seeking therapy for yourself also. A mental health professional can help you gain a better understanding of your loved one’s illness and the strategies that can help you cope.

If appropriate, they may even be able to coach you on conducting some reality testing with your loved one. This practice involves gathering facts that support the delusion as well as facts that refute the delusion.

Rather than telling the person that their beliefs aren’t true, reality testing helps the person draw their own conclusions based on the evidence.

Consider Family Therapy

Family therapy also can help you determine how to best respond to a person who is experiencing delusions. Knowing what to say and how to support someone can be very beneficial to their treatment.

Keep in Mind

Watching someone you love experience persecutory delusions can be overwhelming at times. But with intervention and support, you can help your loved one find ways to cope.


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4 Predictors of Divorce and What to Do About Them


Key Takeaways

  • The “Four Horsemen” that predict divorce are criticism, contempt, defensiveness, and stonewalling.
  • You can improve relationships by using “I feel” statements and appreciating your partner’s positive qualities.
  • Taking responsibility and finding ways to calm down can help reduce conflict.

Marriage isn’t always easy, and all relationships have ups and downs. According to relationship experts, there are certain signs to watch for that serve as important predictors of divorce.

John and Julie Gottman are psychologists, relationship experts, and the founders of the Gottman Institute. Based on their years of extensive research, they have identified four primary predictors of divorce. They have termed these four main predictors the “Four Horsemen of the Apocalypse,” and they are criticism, contempt, defensiveness, and stonewalling.

Criticism

Some criticism is unavoidable in a relationship, but it becomes unhealthy when you do it in a way that implies something is inherently wrong with your partner. You may also be attacking your partner’s personality or character.

The intent is to win the argument or prove your spouse wrong. For instance, saying, “you always…,” “you never…,” or “you’re the type of person who …” or “why are you so …” will make the spouse feel attacked and is likely to elicit a defensive response. 

These harmful patterns cause you both to not feel heard. You both may start to feel bad about yourselves when you are around each other.

It is critical to make a specific complaint about your partner’s behavior and not attack their personality. Using “I feel” statements can help frame the situation around your response and minimize the risk of making your partner feel attacked, criticized, or defensive. For instance, saying, “When A happened, I felt B,” or “I need C.”

Contempt

Contempt is perhaps the most serious of the four predictors of divorce. It concerns any statement or behavior, verbal or nonverbal, that asserts superiority to your partner. 

Examples of such behaviors include:

  • Mocking your partner
  • Name-calling
  • Eye-rolling
  • Showing hostility
  • Insensitive joking
  • Hurtful sarcasm
  • Sneering in disgust

Contempt attacks your spouse’s sense of self. It is also intended to put down or emotionally abuse or manipulate them.

Contempt doesn’t just hurt your relationship; it also takes a toll on your health. Research has also found that experiencing feelings of contempt can lead to increased illness and worse well-being.

Couples must work to eliminate such behaviors completely. A culture of respect, appreciation, tolerance, and kindness is a basic requirement in marriage.

Defensiveness

Defensiveness arises from a perceived attack with your own counter-complaint. It is another way to act like a victim or not to take responsibility for your mistakes. Such behaviors include making excuses or saying things like, “It’s not my fault.”

It can also involve cross-complaining. This is when you match your partner’s complaint or criticism with one of your own. You then ignore what your partner said.

Other defensive behaviors are “yes-butting” or gaslighting, where you deny your partner’s reality. It can also involve simply repeating yourself without really paying attention to what your spouse is saying.

Aim to slow down and try to listen to your partner’s perspective.

You do not have to be perfect. Consciously communicate by speaking honestly and listening well. Don’t forget to validate your partner by letting them know you get what they are feeling.

Stonewalling

Complete withdrawal from communication (and essentially the relationship) as a strategy to avoid conflict is called stonewalling. It may take the form of physically leaving or completely shutting down. Stonewalling might be giving the “silent treatment,” monosyllabic mutterings, changing the subject, or storming out.

This might be an unsuccessful attempt to calm oneself when overwhelmed, but it conveys disconnection, disapproval, distancing, and arrogance.

The antidote to stonewalling is to learn to identify the signs that you or your partner is starting to feel emotionally overwhelmed. It’s a good idea to verbalize that you feel overwhelmed. You can both agree to take a break and that the conversation will resume when you are both calmer.

Other Factors That Contribute to Divorce

Researchers have also found that people report several other factors that contribute to divorce. Commonly cited reasons include:

  • Communication
  • Willingness to work on the relationship
  • Moods and tempers
  • Lack of trust
  • Jealousy and infidelity
  • Unrealistic expectations
  • Lack of quality time
  • Personal habits
  • Money conflicts
  • Division of workload

How to Deal With Predictors of Divorce

All of these behaviors tend to affect relationships at some point or another. On their own, one issue is unlikely to derail your marriage. When you have a combination of these predictors that continue to undermine your relationship, it may be time to talk to a couples therapist.

An unhealthy or toxic relationship can seriously harm your health and well-being, so it is important to take steps to address the problem. 

The Gottoman’s research suggests that each of the four predictors of divorce can be dealth with in the following ways.

  • Criticism: The Gottman Institute suggests you can resolve arguments and conflicts by softening how you begin your discussions. Rather than launching into a complaint or criticism, start the debate gently. Research has found that observing the first three minutes of a conflict discussion accurately predicts whether a couple will eventually divorce.
  • Contempt: The Gottmans suggest that cultivating an appreciation for your partner’s positive qualities can help reduce contemptuous feelings and behaviors. Rather than focusing on the things that irritate you, try reminding yourself about the characteristics that you are grateful for.
  • Defensiveness: If you feel defensive, focus on taking responsibility instead of avoiding blame. 
  • Stonewalling: Since this behavior is often rooted in trying to avoid anxiety or stress, finding ways to self-soothe can be beneficial. Grounding activities, visualization, deep breathing, and thinking kind thoughts are a few ways to soothe feelings of anxiety that might arise.

There are ways to better control these behaviors in your relationship. After an argument, claim responsibility for your piece in the escalation. What can you learn from it and what can you do about it?

De-Escalate

There are many things you can do to help reduce tension or de-escalate an argument. For instance, apologize, express your understanding, or demonstrate your concern. There is no good reason to push buttons or purposely escalate the argument.

Virtually all negative interactions with your partner are really a self-perpetuating cycle that, thankfully, you can exit from. When one of you gets triggered, the other reacts, there is a reaction to the reaction, and so on and so forth.

Reflect

Slow things down and self-reflect by figuring out what you might actually be feeling underneath. For instance, are you really hurt when you yell in anger? You need to get comfortable expressing that deeper part of yourself.

All of us have a lot to learn and to benefit from the Gottmans’ research. But, if you still find the “Four Horsemen” are ruining your relationship, it’s time to seek out a skilled marriage therapist.


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What to Do If You Feel Stuck in a Rut


Key Takeaways

  • Look for ways to treat yourself a little better to ensure you have the energy to stay focused and excited about your life.
  • Talk to new people, engage in fun activities, try new things, and be spontaneous to add excitement and variety to your routines.
  • Pick a new activity you’d like to try, start with small steps, and reward yourself to build motivation and interest.

Many of us go through periods where we’re stuck in a rut. You feel like you’re going through the motions at work, treading water in your relationships, or jogging in place in your social life. Things that used to excite you no longer do and, instead of moving toward your goals, you remain stagnant—stuck where you are.

Being stuck can lead to feeling both disinterested and dissatisfied. It may even cause you to want to give up on your goals altogether. Fortunately, there are a few things you can do to not only figure out why you’re stuck but also to get motivated and excited about life once again.

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Signs You’re Stuck in a Rut

If you’re stuck in a rut, you may not even notice at first as these feelings often build slowly over time. You might follow your same routines day after day, only to one day realize that it feels less like you are working toward something and more like you’re just killing time.

Here are some signs that suggest you might be stuck in a rut:

  • Every day seems the same. You might even have trouble remembering what day of the week it is. Is it Monday, or is it Friday? It doesn’t matter because your days feel indistinguishable from one another.
  • You feel like you’re just trying to get through another day. Your goal is to keep putting one foot ahead of the other until the day is done. You don’t feel excited or inspired.
  • You feel unmotivated. You might want to take on new projects or engage in creative tasks, but it feels like your motivation has run dry. You just can’t seem to get started.
  • You feel unfulfilled. Life feels dull and boring. You want to try new things, but you don’t know where to begin.
  • You want to change, but fear discomfort. You know that changing things up will make you happier in the long run but stick with the status quo because it means you don’t have to risk failure or pain.

When a Rut Is More Than a Rut

Sometimes these feelings may be more than being stuck in a rut. They could also be signs of something more serious, such as persistent depressive disorder (PDD). This mild but chronic mood disorder is characterized by low mood, decreased energy, loss of interest, and loss of pleasure. If you suspect that you may be experiencing PDD, talk to your healthcare provider.

Reasons You Might Feel Stuck in a Rut

Some ruts are caused by a human tendency to make the same decision over and over again when faced with similar scenarios. You choose to drive the same way to work every day, for example. You could take another route but don’t because you’re naturally biased to avoid the uncertainty of the different path.

Fear of stepping outside your comfort zone can also cause you to feel stuck in a rut. You want to do something different but a fear of the unknown or a fear of failure is stopping you from taking action. To ease your fears, you do nothing at all and, instead, remain where you are.

Figuring out what’s causing your discontentment is important to finding ways to get out of your rut. If you are struggling to understand the reasons behind your feelings, working with a licensed counselor or a therapist specializing in cognitive behavioral therapy (CBT) can help.

CBT works by changing negative or unhelpful thought and behavior patterns.

When working to discover the cause of your rut, one thing to keep in mind is that not all ruts are the same. Some people might feel like they are in a rut with a romantic partner while, for others, it is their job. Even your health, family situation, friendships, hobbies, or home can contribute to these feelings.

It’s important to not criticize or berate yourself once you understand the root cause. Also, don’t try to minimize the issue. You might think “I have a great life” or “I don’t have a right to feel this way,” but these thoughts are counterproductive and can keep you trapped in a rut. While things may be “just fine” as they are, if you’re not satisfied, it’s time to make changes and regain your spark.

How to Get Out of a Rut

Once you’ve acknowledged what you’re feeling, it’s time to start looking for ways to get unstuck. There are a number of things you can do to break the negative cycle and move forward. Here are a few ideas to consider.

Take Care of Yourself

When you feel stuck in a rut, combat it by taking care of yourself. Self-compassion is critical to mental wellness. Start with a quick assessment of how well you’ve been taking care of you. Have you been eating well? Are you sleeping enough? Have you been spending time with people who care about and support you?

If something is lacking in the self-care department, now is the time to address it. Healthy food, adequate sleep, daily exercise, and social support are all essential to your physical and emotional health and wellness.

Look for ways to treat yourself a little better. Taking care of yourself ensures you have the energy to stay focused and excited about your life.

Change Your Routine

It’s hard to move forward or branch out if you’re engaged in the same routines day after day. People are creatures of habit and sometimes being stuck stems from boredom or feeling like you’re on auto-pilot.

Look for ways to add different experiences to your day, such as:

  • Strike up a conversation. Talking to new people is a great way to expand your social connections. Plus, you will learn interesting things about the people around you.
  • Have some fun. Spending time engaged in an activity you love is good for your health. Whether it’s hanging out with friends or pursuing a hobby, set aside time each week and focus your energy on having a good time.
  • Try something new. Take a new route to work, watch a new show, or sign up for a class. Exploring the world around you can add zest to your life.
  • Be spontaneous. If you’re bored with your life, live in the moment. Do things that are not pre-planned, say yes to new experiences, and don’t be afraid to do the unexpected.

Head Outdoors

Researchers have discovered that being in nature has a positive impact on the brain. For example, one study found that taking a walk outside reduced self-referential rumination, a behavior that can increase depression risk. Another connected nature walks with decreased depression, lower stress, and improved mental well-being.

The next time you’re feeling bogged down, try going for a walk outdoors. Let go of the thoughts circling around in your brain and simply take in the world around you. Not only can being outside increase your mental wellness, but it can enhance your creativity as well.

While walking, allow yourself to relax, think of new things, and enjoy the beauty you see. This helps you return to your everyday life with a renewed sense of wonder.

Give Yourself Something to Look Forward To

Looking forward to an upcoming event or activity has a way of pulling you out of a rut and creating some excitement in your life. It puts a little pep in your step as you anticipate the fun that lies ahead.

You might look forward to the release of a movie or your favorite holiday, but you also can create these moments intentionally. Call or text friends and make plans for Friday night. Plan a vacation, even if it’s just taking a day trip to a local spot. Give yourself things to look forward to and get excited about.

Even small daily and weekly rewards such as being able to go to your favorite place for lunch or tuning into your favorite TV show are great ways to build a sense of anticipation for the future.

Find Your Purpose

It’s easy to fall into a rut when it feels like you’re not working toward anything. Change this by setting goals related to your career or relationships. This helps you feel a sense of purpose, which is also good for boosting motivation.

Another way to develop a sense of purpose is by helping others. Look for ways to contribute to your community. Participate in your church, volunteer with a local organization. or engage in political activism. You could also help friends or loved ones with a project. Such activities give you a sense of greater purpose and meaning and are good for your mental well-being, too.

Boost Your Motivation

Sometimes getting out of a rut happens spontaneously. You might feel stuck in a rut one day, for example, then something suddenly clicks into place and the feelings vanish. In other cases, you might need to take a more active approach. One action you can take is to focus on your motivation.

Here are some ways to get motivated, even when you don’t feel particularly interested or excited about what you are doing:

  • Take small steps. Pick an activity you would like to pursue, such as a new hobby or workout program. Start small with something you know you can accomplish. Don’t wait for motivation or inspiration to strike—just get going. Take the first step, then another, then another. Eventually, going through the motions will be a thing of the past and you will feel involved, excited, and interested in learning more.
  • Reward yourself. Positive reinforcement is helpful when you’re struggling to get motivated. Promise yourself a reward for starting a task. Then, continue to reward yourself after completing each step. Eventually, pull back on the rewards but promise yourself a larger reward once you’ve reached your goals. Rewards can get you started and help generate greater interest in what you are working on.

Squash Perfectionism

If you struggle with perfectionism, this can keep you stuck in the same place. No matter how hard you try, it seems like whatever you’re working on is never good enough.

Squash your tendencies toward perfectionism right away and recognize that ‘done’ is better than perfect. In other words, rather than trying to make a project perfect, be satisfied with the fact that you completed it.

If left unchecked, perfectionism can keep you spinning your wheels for a very long time. Instead, focus on completing projects and moving forward rather than striving for perfection.

Let yourself make mistakes. Embrace the fact that you’ve given your best effort and move on. In time, you will be much more productive and creative when you’re no longer tethered to perfectionism.


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How Big Is a Human Brain? Learn About Brain Size and Brain Weight

Key Takeaways

  • The average adult human brain weighs about 3 pounds and is fully formed by age 25.
  • Men tend to have larger brains than women, but size doesn’t always mean more intelligence.

The human brain is an amazing organ. It’s capable of surprising feats of memory and learning. It’s susceptible to damage, and yet remarkably adaptable to change. Considering all of its many capabilities, you may begin to wonder, how big is the human brain?

While the human brain has a structure similar to that of other mammals, what makes it different is it’s size in relation to the rest of the human body.

Compared to the size of our bodies, humans have much larger brains than many other mammals—but not the largest. The brain makes up 2% of a human’s body mass, while the shrew’s brain is about 10% of its body mass.

In terms of sheer size, sperm whales and elephants take the top spots for weight at 18 and 11 pounds, respectively. But since even small elephants weigh 6,000 pounds or more, their brains are just 0.2% of their body weight. For the sperm whale, the brain is only about 0.06% of body weight.

Human Brain Size Stats

The average adult human brain weighs about 3 pounds (1300 to 1400 grams). A newborn baby’s brain weighs approximately three-quarters of a pound (350 to 400 grams). On average, the human brain measures about 5.5 x 6.5 x 3.6 inches (140 x 167 x 93 mm).

The brain is considered fully formed at age 25. It develops from back to front, ending at the prefrontal cortex; this is the part of the brain that’s responsible for decision-making and reasoning.

Men tend to have bigger brains than women. After taking overall body weight into account, men’s brains tend to be approximately 100 grams larger than women’s.

In women, parts of the frontal lobe and limbic cortex (areas associated with problem-solving and emotional regulation) tend to be bigger than those of men. In men, the parietal cortex (associated with the perception of space) and amygdala (involved in the processing of memory and emotional responses) tend to be larger than those in women.

Neurons are the building blocks of the brain and nervous system – they transmit and carry information, thus allowing different parts of the brain and body to communicate with one another. Researchers currently estimate that there are around 86 billion neurons in the human brain.

Does Brain Size Matter?

All humans do not have the same size brain. Does that mean that highly intelligent people have bigger brains? In some cases, there might be a link.

Researchers have found brain size can be linked to certain diseases or developmental conditions.

Autistic children tend to have bigger brains (and earlier disproportionate brain growth) than non-autistic children. The hippocampus (an area of the brain strongly associated with memory) tends to be smaller in older adults with Alzheimer’s disease.

What about intelligence? It depends on who you ask. According to an analysis done by Dr. Michael McDaniel, a professor at Virginia Commonwealth University, many studies have found a correlation between bigger brains and higher intelligence.

However, not all researchers agree with McDaniel’s conclusions. Such studies also raise important questions about how intelligence is defined and measured, whether relative body size is taken into account when making such correlations, and which parts of the brain should be looked at when evaluating intelligence.

It is also important to note that variations in brain size between humans are relatively small. Other influences that could play a pivotal role in determining intelligence include the density of neurons in the brain, social and cultural factors, and other structural differences inside the brain.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Herculano-Houzel S, Avelino-de-Souza K, Neves K, et al. The elephant brain in numbersFront Neuroanat. 2014;8. doi:10.3389/fnana.2014.00046

  2. Herculano-Houzel S. The human brain in numbers: a linearly scaled-up primate brainFront Hum Neurosci. 2009;3:31. doi:10.3389/neuro.09.031.2009

  3. McDaniel M. Big-brained people are smarter: A meta-analysis of the relationship between in vivo brain volume and intelligence. Intelligence. 2005;33(4):337-346. doi:10.1016/j.intell.2004.11.005

Additional Reading

Kendra Cherry

By Kendra Cherry, MSEd

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the “Everything Psychology Book.”


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What It’s Like to Have Schizophrenia

Key Takeaways

  • Schizophrenia is a serious mental illness that creates disturbances in a person’s thoughts, behaviors, moods, and perceptions.
  • Treatment with antipsychotic medications and therapy can help manage schizophrenia symptoms.

If you don’t have schizophrenia, it is probably difficult to understand the internal experience of schizophrenia. People with the condition often experience thoughts that do not align with reality or exhibit symptoms such as disorganized behavior and speech. Understanding what it is like to have schizophrenia can provide some insight into how these symptoms may feel and how they might affect a person’s daily life.

Schizophrenia is a condition that affects how the brain functions and results in problems with thoughts, feelings, and behaviors. The condition affects less than 1% of adults in the U.S. and tends to be misunderstood. While the condition is serious and can be very damaging if left untreated, there are effective medications and treatments that can help.

How People Experience Schizophrenia

Normally, when we describe our experiences to one another, we assume there’s a shared understanding of what it feels like to think and to perceive the world with our senses. We expect that we can talk about what we’re thinking—without having to describe the ways in which our brains connect different pieces of sensory information and memory to make a thought.

In someone with schizophrenia, the most basic processes of perceiving and thinking are affected by the illness.

Every person with schizophrenia will have a unique experience of the world, but there are common themes. Some schizophrenia symptoms that a person might experience include illogical thoughts, hallucinations, delusions, and unusual movements.

So what does it really feel like to have schizophrenia? The answer isn’t simple. Each person’s experience is unique and different; people can experience a spectrum of symptoms.

Until the publication of the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) in 2013, schizophrenia was categorized into five different subtypes:

These subtypes were removed from the DSM-5 because symptoms were often inconsistent, which created complications when it came to diagnosing people with the condition.

Types of Symptoms

Symptoms of schizophrenia can include:

  • Positive symptoms: These are symptoms that are not part of normal, everyday experience. The term “positive” means they are added or excessive. Such symptoms include things like hallucinations and delusions.
  • Negative symptoms: These are normal behaviors that are absent in someone with schizophrenia. Examples include loss of emotion, pleasure, or the ability to initiate plans.
  • Disorganized symptoms: These are problems with thinking and behavior, such as confused thinking, abnormal movements, and bizarre behavior.

What Symptoms of Schizophrenia Feel Like

One way to try to understand what it’s like to have schizophrenia is to understand the experience of each of the basic symptoms of schizophrenia. An individual’s personal and unique experience, of course, won’t be broken into these neat categories.

Symptoms of schizophrenia usually first appear sometime between the late teens and mid-30s. The symptoms typically appear gradually and increase in severity over a period of time.

Because the onset of symptoms is gradual and progressive, it can make it harder to detect until more severe psychotic symptoms emerge.

Sadness and Loneliness

People who experience psychosis, which includes hallucinations and delusions, can also experience true sadness as well as isolation. Having schizophrenia can be a scary experience. Sadness is often a natural response to being trapped in a terrifying and isolating situation.

A stunning first-person account of schizophrenia, “Autobiography of a Schizophrenic Girl,” describes very clearly the sadness and loneliness the young author felt when gripped by psychosis.

Delusions

To have a delusion is to be obsessed with an idea, and to have absolute certainty that the idea is correct. The person’s thinking may be clear in other ways, with an otherwise logical ability to reason, starting with the absolute conviction of the incorrect premise.

Delusional ideas have a lot of power to preoccupy thoughts. Sometimes people with delusions can convince others that their delusions are true. This happens most often when the delusion is in the realm of common human experience, like an unfaithful spouse or a boss who’s “out to get them.”

Some delusions are clearly recognized as abnormal, like when someone is convinced that they’re a famous person or that their thoughts are being controlled by aliens.

Even after responding well to antipsychotic medications, a person with schizophrenia may continue to believe their delusions are true. It’s also possible that someone can develop an insight that other people think the ideas are probably delusions. Psychologists might call this a meta-awareness of the symptom or awareness that exists above the level of the symptom itself.

Hallucinations

Hallucinations are a symptom of psychosis that involves seeing or hearing things that are not there. Hallucinations and delusions can go hand-in-hand.

For example, hearing voices speaking to you from the radio is a hallucination. Being absolutely convinced that the voices are real and the things they tell you are true has a component of delusion.

It is possible to experience hallucinations while being aware that they aren’t real. As with delusions, this would require a meta-awareness of the unreality of what appears to be a real experience.

Human beings usually rely on their perceptions to tell what’s real. We’re often unaware that different people experience the same situation differently because those small differences don’t usually come up in conversation. For example, people can go their entire lives without knowing they’re colorblind because they don’t know what they’ve never experienced.

Likewise, at a party, an outgoing person may perceive friendly, receptive faces, while a shy person may perceive the same faces as being indifferent or even critical. Both of these perceptions are within the realm of normal human experience, and neither are pathological.

Perception Distortion

People with schizophrenia may also experience perceptual distortions that make it difficult to distinguish between hallucinations and reality. For example, a person with schizophrenia may actually hear people saying things that are critical or insulting when those conversations aren’t really taking place. That would be a type of auditory hallucination.

Visual hallucinations can take many forms as well. A person with schizophrenia may find their attention drawn to one particular person’s face, notice that the teeth are very white, and then perceive the mouth and teeth growing to fill the room.

This perceptual distortion would feel like a real visual perception, and the person may believe it’s actually occurring. If they’re frightened by the perception, they might try to hide their fear, cry out, or run away.

Some people have persistent visual hallucinations, such as small children or animals that frequently appear or follow them around. They may even hold open doors for these hallucinations to pass through when they leave a room.

Disorganized Speech

People with schizophrenia also experience thought disorder, which leads to problems with organizing speech. The process that disrupts the normal operations of the brain also disrupts the process by which the brain monitors its own operation.

People experiencing disorganized speech are often aware that their thoughts and words aren’t communicating the things they intend. However, they typically don’t understand why.

They may earnestly try to communicate their thoughts in nonsensical, stream-of-consciousness language, and become frustrated when the other person doesn’t understand or the words aren’t coming out right. On the other hand, they may seem to be unaware that the listener doesn’t understand them.

Disorganized Behavior

There are many kinds of disorganized behavior, and people are usually unaware of these motions and believe the behavior is entirely reasonable. For example:

  • Moving their empty hands as if they’re knitting
  • Making an apparently meaningless hand gesture or body posture
  • Remove clothing in an inappropriate place

Disorganized public behaviors often result in contact with the law. More and more legal jurisdictions are recognizing mental illness and referring people for psychiatric evaluation. However, there are still far too many mentally ill people in jails and even prisons for nothing more than disruptive, disorganized behavior.

People without schizophrenia also perform bizarre and socially unusual behaviors. Relatively healthy people engage in socially inappropriate or unusual behaviors. The difference is that these people are aware that the behavior is unusual and are looking for the attention it attracts.

Negative Symptoms

People with schizophrenia have a particularly difficult time recognizing negative symptoms as being symptoms of an illness or even abnormal. In this way, the experience can be like that of certain kinds of depression.

For example, the person doesn’t express emotions or expresses them only mildly, even when confronted angrily or in a dangerous situation. Or the person may also fail to find significant pleasure in things that were once delightful, called anhedonia.

If you’re experiencing negative symptoms, you often have little energy or motivation, and your mental energy and acuity may also be depressed. Because the mind feels fuzzy or dull, there’s a limited perception that it’s possible to feel differently and little memory of a time when you felt differently. Many people who have experienced depression will understand this feeling of being in a mental fog.

Recap

If you want to understand what it is like to have schizophrenia, it is important to know more about the symptoms of the condition. Loneliness, delusions, hallucinations, perceptual distortions, and disorganized speech and behaviors are common.

Real People, Real Emotions

Psychiatrist Samuel Keith, MD, a professor at the University of New Mexico School of Medicine and former head of the Schizophrenia Research Program at the National Institute of Mental Health (NIMH), expresses the plight of a person with schizophrenia very well.

Samuel Keith, MD

Real people with real feelings get schizophrenia. One should never underestimate the depth of their pain, even though the illness itself may diminish their ability to convey it…As one of my own patients told me, ‘Whatever this is that I have, I feel like I’m a caterpillar in a cocoon, and I’m never going to get the chance to be a butterfly.’

— Samuel Keith, MD

People with this condition may experience feelings of fear about not having control over their own minds. Problems with thinking and sensory disruptions can also make it challenging at times for people to trust their own thoughts and sensory experiences. 

While it can be challenging, supportive care and an effective treatment plan can help people manage their symptoms and experiences. There is no cure for schizophrenia, but there are ways to cope and function effectively in daily life.

Treatment for Schizophrenia

Treatments that can help with schizophrenia symptoms include medication, psychotherapy, and skills training.

Medications

Diagnosis and treatment with antipsychotic medications early in the illness, optimally within the first six months of symptoms, have the greatest potential to reduce the severity of a person’s illness. As such, antipsychotic medications are the first-line treatment for schizophrenia.

They can help reduce the frequency and intensity of psychotic symptoms and are usually taken each day as either a pill or liquid. Some antipsychotic medications can be administered by injection once or twice each month.

Psychotherapy

Therapy can also be helpful for managing the symptoms of schizophrenia.

  • Cognitive behavioral therapy (CBT) may be helpful for some of the negative symptoms or cognitive symptoms of the condition.
  • Family therapy can also be beneficial for addressing issues with family dynamics and relationships.
  • Some people may find that group therapy can be helpful for practicing skills and getting encouragement from other people who are facing the same problems.

Psychosocial Treatments and Skills Training

Supportive psychosocial treatments can help people learn coping skills that will help them live with some of the day-to-day challenges they may face while living with their condition.

Schizophrenia Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor’s appointment.

Mind Doc Guide

Recap

Schizophrenia is a progressive illness and treatment with antipsychotic medications along with therapy can decrease symptoms and potentially stop or slow the progression of the disease. It is absolutely essential for people to get help, and insist on an evaluation by a psychiatrist when psychotic symptoms occur.

Ways to Cope With Schizophrenia

While having schizophrenia presents a number of obstacles, there are things that a person can do that can improve their ability to cope. Having an understanding of how their individual symptoms affect them and the areas where they seem to have the greatest difficulty provides a solid foundation. 

The next step is finding strategies that can help them function and live their best. If your loved one has schizophrenia, encourage them to:

  • Seek out social support: Encourage them to talk to you or their close friends or family members about their condition. Sharing their challenges can help their loved ones learn to notice when their symptoms might be worse and when they could use additional support. 
  • Join a support group: In addition to leaning on their loved ones, joining a support group can be a way to learn new skills and get encouragement from people who share their experiences.
  • Practice self-care: Caring for yourself is important. Encourage them to take steps to make sure that they are treating themselves with kindness and caring for their physical and mental health. 
  • Participate in skills training: Skills training can help them with both daily living skills as well and social skills. They can explore ways to manage some of the daily challenges they face and build coping skills that will help both now and in the future.

Recap

In addition to seeking treatment, it is also important for people with schizophrenia to care for themselves. If your loved one is living with schizophrenia, encourage them to look for strategies that can help them cope with their symptoms such as finding social support, joining a support group, and attending skills training.

Keep in Mind

While it is not a treatment per se, family support is an important part of coping with schizophrenia. Supporting a loved one with schizophrenia means more than just learning about symptoms and treatment; it’s about understanding what it’s really like to live with these symptoms day in and day out. This way, you can give your loved one the empathy and support they need to better manage their condition.


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