Schizophrenia Without Medication: Can Any Non-Medication Treatment Options Manage Symptoms?

Schizophrenia is a serious chronic disorder typically associated with a range of symptoms, including symptoms of psychosis. Psychosis is a medical term that can be used to describe a state in which a person is not sure what is and isn’t real. The most common psychotic symptoms present in schizophrenia tend to be hallucinations, in which a person perceives sensory stimulation that doesn’t actually exist (i.e., hearing voices no one else can hear), and delusions, or false and illogical beliefs that often aren’t physically possible (i.e., believing members of one’s family are being controlled by aliens).

Treatment for schizophrenia can include a combination of medication and therapy. Although some people may be interested in focusing on non-medication options, symptoms like hallucinations and delusions often do not fully resolve without antipsychotic medication for many people. Still, therapy and lifestyle changes can be effective in maximizing the effects of pharmaceutical treatment.

An overview of schizophrenia symptoms

While psychotic symptoms are potentially the most well-known (and most misunderstood) aspect of schizophrenia, the disorder can be associated with a variety of other symptoms as well.

• Positive symptoms are symptoms added to a person’s experience, such as hallucinations, delusions, disorganized speech, or abnormal motor behavior.
• Negative symptoms involve reductions in typical emotional expression, motivation, speech, or social engagement.
• Cognitive symptoms typically refer to difficulties with executive function that may impact people with schizophrenia, such as memory issues or problems with decision-making.

What role can antipsychotic medications play in treating people with schizophrenia?

While antipsychotic medication may not cure schizophrenia, medication can reduce symptoms, particularly psychotic symptoms like hallucinations and delusions. These medications usually accomplish this reduction by specifically targeting and regulating the brain neuro-chemicals associated with symptoms of schizophrenia.

*Medication is prescribed only when clinically appropriate and is not guaranteed. Pricing, availability, insurance coverage, and copays vary by plan, location, and provider availability are not guaranteed.

The side effects of antipsychotic medication

Antipsychotic medication may produce several potential side effects. Older forms of antipsychotic medication, now often referred to as first-generation antipsychotics, were usually associated with different and in some cases, more movement related side effects in people with schizophrenia. Mental health research has developed a newer generation of antipsychotic medications for schizophrenia treatment, often called second-generation antipsychotics, that may be associated with less movement related side effects and can help manage symptoms of psychosis. However, side effects can still be common, such as metabolic side effects and other risks.

Short-term side effects of transitioning onto antipsychotic medications

Short-term side effects associated with transitioning onto antipsychotic medication may include the following:

• Restlessness
• Blurred vision or dizziness
• Muscle spasms and twitching
• Drowsiness and fatigue
• Trembling
• Dry mouth
• Constipation
• Agitation
• Muscle stiffness

Long-term side effects of antipsychotic medication use

Long-term use of antipsychotic medication may also result in chronic side effects.

• Weight gain: Some people on antipsychotic medication may gain weight to the point of experiencing obesity and related health challenges, such as type 2 diabetes. Individuals can manage medication-associated weight gain through nutritional counseling and an exercise routine, both of which may have positive impacts on other psychiatric symptoms.
• Cardiovascular complications: Some antipsychotic medications are associated with cardiovascular risks, including arrhythmias, and certain agents such as clozapine have also been linked to myocarditis. Doctors typically carefully monitor individuals using antipsychotic medication for these risk factors.
• Hormonal imbalances: Antipsychotic medication can cause the body to develop elevated levels of prolactin, which can have a variety of impacts, including affecting menstrual cycles in women and causing complications with sexual arousal and fertility in people of all genders.
• Cognitive function: While antipsychotics can alleviate psychotic symptoms, some people report cognitive dulling or mental fog while taking antipsychotics, though cognitive difficulties can also be part of schizophrenia itself.
• Tardive dyskinesia: Tardive dyskinesia can be defined as a condition resulting in involuntary movements, usually limb movements or facial expressions.
• Emotional blunting: Some people report emotional blunting, which can reduce emotional intensity but also negatively affect quality of life

Why do people with schizophrenia explore alternative mental health treatment?

Because of the amount and potential severity of side effects associated with antipsychotic medication, many people with schizophrenia may be interested in alternative treatment options. However, while other forms of treatment can be helpful in reducing some symptoms and improving mental health and quality of life, psychotic symptoms like hallucinations and delusions often require medication support for many people.

If you are experiencing negative medication side effects, talk to your doctor before making any changes to your routine. Medical providers may be able to adjust the medication type or dosage to alleviate some side effects. Always speak to your doctor or psychiatrist before starting, stopping, or changing the way you take medication.

Recovery from schizophrenia without medication: Medication-free treatment options to address schizophrenia symptoms

As noted above, psychotic disorders are often treated with medication to address specific symptoms. However, that does not mean medication is the only effective form of intervention for schizophrenia. Combining some of the below techniques with a medication routine may help improve functioning, coping, and overall recovery.

Lifestyle changes can reduce mental illness symptoms

A variety of lifestyle adjustments may be helpful for symptom management.

• Eating nutritious food: Consuming balanced and well-rounded meals can promote overall health in people with schizophrenia. There is some evidence that specific choices related to eating habits, like eating foods with fewer carbohydrates, may have an impact on symptom presentation, though evidence is limited and more research is needed, so remember to consult with your doctor.
• Keeping a regular sleep schedule: For many individuals with schizophrenia, sleep disruption can worsen symptoms or increase vulnerability to relapse for some people. Keeping a regular sleep schedule can play a significant role in maintaining stability.
• Avoiding recreational substances and alcohol: Substance use may trigger psychosis or worsen other symptoms in people with schizophrenia.
• Maintaining a social support system: Schizophrenia can cause symptoms that may lead people to withdraw or isolate themselves from others, but meaningful social support is usually associated with greater overall well-being and more positive long-term outcomes.

Cognitive behavioral therapy for mental health

Cognitive behavioral therapy normally focuses on the interaction between a person’s thoughts and their behaviors. Cognitive behavioral therapy for schizophrenia can involve helping individuals understand their symptoms and developing strategies to manage them effectively. These strategies can include the following:

• Examining distressing beliefs and experiences in a structured therapeutic way
• Building social skills
• Using techniques for stress management and anxiety reduction
• Altering negative or unhelpful self-talk
• Identifying ways to check what is real
• Developing coping mechanisms for emotional challenges

One variation of cognitive behavioral therapy that may be helpful for people with schizophrenia is cognitive enhancement therapy, which usually focuses on helping individuals build cognitive and social skills to improve day-to-day function. Examples of skills taught in this type of therapy can include those related to memory, language, and information processing.

Finding support for schizophrenia and other mental health conditions

The lack of surety associated with schizophrenia and other psychotic disorders can lead to anxiety and nervousness at the thought of interacting with other people. This fear may make it difficult to access traditional in-person therapy appointments to receive cognitive behavioral therapy or cognitive enhancement therapy. Some research suggests online therapy may be a beneficial option in some cases, especially when symptoms are stable and not during an acute psychotic episode. Additionally, BetterHelp now offers psychiatry services through UpLift as an additional care option alongside therapy, and medication management may be available when clinically appropriate based on a licensed psychiatric provider’s evaluation. In-person care may still be necessary during acute psychosis. However, online therapy can be a helpful supplement to other forms of schizophrenia treatment.

Some research suggests online therapy may be a helpful supplement for some people with psychotic disorders, especially when symptoms are stable, but in-person care may still be necessary during acute episodes. One study found that engaging in a course of online therapy (combined with antipsychotic medication) usually helped reduce psychotic symptoms associated with schizophrenia in a group of patients.