Stress and schizophrenia affect each other. Ways to manage stress, like mindfulness, physical activity, support networks, and therapy, can help manage symptoms and reduce the severity of the condition.
While stress doesn’t cause schizophrenia, it can trigger its initial onset in those with a predisposition to the condition. Stress can also trigger psychosis and other symptoms, as well as affect the emotional well-being and overall quality of life in people with schizophrenia. This article discusses how living with schizophrenia can cause stress, how stress can affect schizophrenia management, and how to reduce and manage stress.
Stress and schizophrenia have a reciprocal influence on each other. This means that stress doesn’t just influence schizophrenia, but schizophrenia can influence stress as well.
While stress doesn’t cause schizophrenia, high levels of stress may contribute to episodes of psychosis, especially in individuals with a genetic predisposition to the condition. Stress can also make these individuals more prone to other symptoms that affect emotional well-being, social life, work, and education. All of these can reduce a person’s overall quality of life.
On the flip side, the symptoms of schizophrenia can be overwhelming. These symptoms can create stress in and of themselves. In addition, people with the condition have a heightened risk of being exposed to high-stress situations. This can, in turn, lead to an increased sensitivity to stress and difficulty in coping with tense situations.
Schizophrenia affects a person’s thoughts, feelings, and behaviors. Neely Meyers, Professor of Anthropology at Southern Methodist University and author of Breaking Points: Youth Mental Health Crises and How We All Can Help, explains, “Schizophrenia is usually thought of as a cluster of three kinds of symptoms.”
It can cause hallucinations, delusions, and a disrupted view of reality, which are known as positive symptoms. Negative symptoms can include things like loss of social drive and a lack of motivation. Then, there’s the cognitive aspect, such as difficulties with concentration, memory, and attention.
Symptoms associated with schizophrenia can be disorienting and overwhelming. They can cause a person to become socially isolated and potentially result in them missing long periods of work or school.
Meyers notes, “Psychosis is very disruptive to typical everyday life experiences like being able to maintain your place in school and maintain employment.”
Because of schizophrenia’s disruption to one’s daily life, living with the condition can be quite stressful.
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Meyers adds, “Schizophrenia is really like a hypersensitivity to stress. For some of us, when we get stressed out, our mouth gets dry, or our palms get sweaty, or our brain might freeze up.” For individuals with schizophrenia, however, their symptoms get more pronounced, she says. “The more stressed they become, the voices get louder, they become more frequent, their erratic thoughts get to be more frequent and intense.”
Studies have also found a positive correlation between stress and an increased risk of a psychosis episode. As Meyers puts it, when living with schizophrenia, “there’s an extra special need to protect oneself from stress… The ‘stress cascade’ is important in considering the effects of stress on schizophrenia, which is the body’s reaction to stress. In persons with schizophrenia, they have a more sensitive stress response, and their response involves psychotic symptoms.”
Stress can trigger the initial onset of schizophrenia in those with risk factors, such as genetic predisposition. A 2019 study found that stress during critical periods of development, such as childhood trauma, could increase an individual’s vulnerability to psychosis later in life.
When the body experiences stress, the hypothalamic-pituitary-adrenal (HPA) axis becomes activated, and cortisol levels increase. In people with schizophrenia, dysregulated HPA activity results in too much cortisol being released, according to a 2018 study. This can affect cognitive function and contribute to the severity of psychosis symptoms.
Additionally, stress alone can negatively affect cognitive abilities like memory, attention, and executive functioning. Individuals with schizophrenia may already experience challenges with these things, but stress can worsen them, making daily life more challenging. Lack of motivation or forgetfulness can make it harder for individuals to stick to medication regimens. In some cases, exacerbated paranoia may lead to distrust in medical professionals or treatment plans entirely.
More severe symptoms due to stressful life events can also cause individuals with schizophrenia to
Because stress can be a precursor to episodes of psychosis or
There are techniques and methods that people with schizophrenia can follow to help reduce and manage stress. Here are a few examples, including at-home techniques and outside support.
- Mindfulness and relaxation: Practices like meditation, yoga, and deep breathing can help during times of acute stress.
- Incorporating physical activity: Regular exercise may help reduce cortisol levels and boost mental health. Getting outside for physical activity can further improve mood and decrease stress.
- Time management: Feeling overwhelmed can play a big role in stress. Working on time management skills and breaking tasks down into smaller chunks may help reduce feeling overburdened.
- Building a social support network: Friends, peer groups, and family can provide emotional support and tangible, practical help during periods of intense stress.
- Adding routine and structure: A consistent daily routine may help create a sense of stability and minimize unexpected stressful disruptions. Structured routines that include physical activity, mindfulness, relaxation, and support like therapy may be helpful.
- Psychotherapy: Therapies, such as cognitive behavioral therapy (CBT), can teach stress management skills and help individuals recognize and address negative thought patterns.
- Medication adjustments: In some cases, your doctor may recommend adjusting your medications during periods of heightened stress. They may also suggest adding anti-anxiety medications or mood stabilizers to help manage stress-related symptoms.
- Work and school accommodations: Many people with schizophrenia may also experience extremely stressful conditions, such as unemployment, low-income housing, and social stigma. These can exacerbate their symptoms. Making accommodations for people with schizophrenia at work and in school can help reduce stress levels and make life easier for them.
According to Meyers, many mainstream relaxation techniques like walking or meditating can be a “bit superfluous if you can’t take care of your basic needs.” By contrast, she says, providing accommodations, such as “flexible hours, the ability to take mental health days, good mental health insurance attached to your job, and for school things like flexible assignments and due dates, and, really, the ability to be transparent with people and say ‘I have a serious mental health condition’ as someone with cancer would,” could go a long way in reducing stress for those living with schizophrenia.”
Managing stress is a critical component of living with schizophrenia, as it can significantly affect symptom severity and overall quality of life. Although stress doesn’t directly cause schizophrenia, it plays a significant role in triggering episodes and worsening symptoms. A deeper understanding of how stress and schizophrenia affect each other allows individuals, caregivers, and healthcare providers to take preventive action to reduce their effects.
Mindfulness, exercise, supportive routines, and professional interventions are some of the many ways to reduce stress and promote stability. Increased accommodations and a reduction in stigma can significantly contribute to a more supportive environment for mental health. By addressing both personal and systemic factors, individuals with schizophrenia can better manage stress, reduce the risk of psychosis, and improve their emotional and functional well-being.
