Early intervention in schizophrenia and other psychotic disorders may be helpful in slowing the progress of the illness and in minimizing the risk of relapse and long-term effects. Each individual is unique, thus no two individuals will have exactly the same symptoms or warning signs, but one or more common warning signs is likely to be evident. Listed below are several common warning signs of psychosis. Some of these symptoms, such as withdrawing from family and friends, may occur in other mental disorders, such as depression. Other symptoms may be a normal part of a phase, such as wearing strange clothing during adolescence. If you suspect someone you know to be exhibiting some of these warning signs, you should seek assistance from a mental health professional:

• Change in sleeping habits - sleeping too little or too much.
  
• Withdrawal from family and friends.
  
• Speech becoming more disorganized and hard to understand.
  
• Lack of speaking, not having much to say about anything.
  
• Expression of emotions diminishing, behavior becomes "robot-like".
  
• Motivation diminished.
  
• Decreased ability to concentrate or focus.
  
• Behavior becoming strange and not make sense, for example
  
• Hoarding objects or
  
• Wearing strange clothing.
  
• Suspiciousness or hostility.
  
• Development of strange or unbelievable ideas, such as "My parents are poisoning my food."
  
• Hearing voices or seeing visions that others can't see or hear.

One of the best ways to manage relapse is to identify the early warning signs and to develop an action plan to manage relapse. People who have schizophrenia or other psychotic disorders should try to identify the first changes that indicate they may be experiencing a relapse. Relapse symptoms may be subtle. Warning signs of relapse include:

• Change in sleeping habits - sleeping too little or too much.
  
• Decreased compliance with treatment.
  
• Tension or agitation.
  
• Irritability.
  
• Change in eating habits - problems with eating, lack of appetite, or greatly increased appetite.
  
• Decreased ability to concentrate or focus.
  
• Depression - especially as evidenced by apathy, sadness, hopelessness, uncontrollable crying.
  
• Anxiety - especially as evidenced by restlessness, increased feelings of fear or apprehension, or anxious habits such as nail biting.
  
• Social withdrawal.
  
• Other signs that have preceeded previous relapses.
  
• Worsening of personal hygiene.
  
• Unusual, disturbing, or recurring thoughts.

1 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 represent an overall worsening compared to behavior exhibited previously. Remember that schizophrenia tends to impair thinking, thus the individual may not be able to recognize the return of symptoms or the signs of relapse. Family members can be very helpful in recognizing and preventing relapse by keeping communication lines open. If signs of relapse seem evident, meet as soon as possible to discuss your concerns, and call the health-care providers to discuss changes that you are observing. When discussing concerns, be as specific as possible. Identify any stressors that may be present and evaluate mechanisms that can be used to decrease the stressor or increase the individual's ability to cope. Seek out support systems, including the local Mental Health Association or chapter of the Alliance for the Mentally Ill, friends and other family members, for help and assistance.