What can I do to minimize the relapses experienced by my loved one?

Schizophrenia and bipolar disorders are by definition cyclical illnesses. Symptoms may increase or decrease often with no apparent reason or, may be due to stopping medication, stress, lack of sleep, big life changes, drug abuse, etc.  Recognizing this fact can help you feel less responsible and less likely to tiptoe around your relative out of fear of triggering an episode.

Acute episodes or relapses may include an increase in psychotic symptoms or extreme negative symptoms such as apathy, isolation, hyperactivity or inactivity, neglect of personal hygiene etc.  Behaviors that are a threat to self or others are also strong indicators of relapse.  As symptoms worsen, early warning signs often appear.  These tend to be idiosyncratic to each individual, so you must learn what your particular relative does when he is getting worse. Is he more agitated and hallucinating more?  Is he more untrusting and guarded?  You may even notice seemingly routine behaviors like wearing a particular color or a dramatic change in hairstyle, often precede a relapse.  Once you have experienced several relapses you will be more likely to recognize a pattern.

The best way to prevent relapse is to plan ahead for the possibility of it happening and to respond as soon as possible if there are signs of deterioration. You and the person who is ill should make a plan (while they are in the stable phase) for avoiding relapse and decide what to do if it should happen.  For example, discuss the triggers and agree that they will let someone know if they are not feeling well. Reassure them that you will not abandon them if they relapse and will intervene in their best interest by seeking the appropriate help.

This can be an occasion to learn and develop awareness for the future and thus result in a better management of the illness.