Recovery, not progressive deterioration, should be the expectation in schizophrenia

Since the time of Kraepelin, schizophrenia has been considered to be a progressive deteriorating illness [1]. This perspective has been bolstered by a generation of studies demonstrating deficits in brain volumes on magnetic resonance imaging (MRI) scans and in performance on a broad range of cognitive tasks in individuals with schizophrenia [2].

Despite the introduction of effective pharmacological treatments and evidence-based psychosocial interventions, fewer than one in seven people affected are considered to meet criteria for recovery [3]. The possibility that the pathophysiology of schizophrenia involves mechanisms that progress over the longitudinal course of the illness is often assumed to explain the poor outcomes observed [2]. Advocates for early intervention have embraced this paradigm as it implies that early treatment has the potential to arrest a disease process that would otherwise continue on an unrelenting march to severe mental deterioration.

While progression of an active disease process would provide a compelling explanation for the poor outcomes so commonly observed, it is not consistent with what we have learned from modern studies of the longitudinal course of structural brain abnormalities, cognitive deficits and clinical outcomes associated with schizophrenia [4]. Rather, schizophrenia appears to be associated with stability of these measures over the longer term. It is time to consider the possibility that clinical stability and recovery rather than progressive deterioration should be the expected outcomes from schizophrenia.


I feel and see myself getting better and not worse. I think on that level it’s all about lifestyle. If you maintain the life that drive your brain to sz then you will deteriorate. If learn and grow and change things like your supposed to things will get better.


i feel i am in the the residual schizophrenia category right now

Was it not life changes like staying away from drugs that helped you?

not really, it was changing and re-evaluating my belief system that helped the most. and heavy research into the symptoms and exploring it.

I’ve smoked weed and gotten drunk in recent times, i even tried coke which was a dangerous thing to do., was just looking to escape my current symptoms… and the fact that i havnt really had any positive symptoms in recent i decided what the hell why not. Yeah wheres the logic in that one? lol
I’m just being honest about it.
with weed i had more of a handle on my thoughts due to having a far more rational mindset, but both weed or alcohol no matter how little i have of it makes me extremely lethargic and further unmotivated afterwards for up to a full week.

so i have decided to do away with it all. none of it is a positive thing for me. alcohol is a tricky one as its so ingrained in social activity since i am still young but im sure as time goes by ill get better with just saying no alltogether.

from my experience recreational drugs seem to exasperate current symptoms and de-stabilises you further. which would obviously lead to bad news…

I would say i have low impulse control. i need to work on that!!


I was gonna say something about belief systems as well as part of a lifestyle but didn’t want to complicate things or go out on a limb. I’m done with drugs but I am having a few beers at the moment. Drugs were fun but they seem more like a youthful activity to me. It’s stupid for adults to do that ■■■■.

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yeah I hired this one guy to work for me, he was 43, and he previously had a drug problem (meth or coke im not sure) but had said he was good now, later he tells he had recently tried DMT , and then after a couple paychecks, one morning when i pick him up for work his eyes are like pins and hes just raring to go totally hyped at 4am. work all went downhill after that. had to fire him. I keep that in my mind as a reminder to not end up like that.

Yeah man, sucks that addiction is so possible. You gotta fall in love with being sober.


I don’t feel that I have progressive deterioration. I’m pretty sure I’ve reversed that with therapy, self-help books, medication, and a change in lifestyle.

I do not use drugs, other than in the process of not smoking weed anymore. I’m not sure if weed is beneficial or harmful to it. The thing is, my brother used to smoke but quit. I think his experimentation in college may have helped him balance his state of mind. He wanted to see what it was like, and said psychedelics made him understand schizophrenia from my perspective when he was at a rave and tried LSD.

I don’t do LSD. I’ve tried it and ironically it had no effect on me. It didn’t bother me. It actually made me feel somewhat more in the moment. My cousin said Acid makes your brain bleed. I’m doing my best to avoid situations and people who use drugs. I have no addictions other than cigarettes. I don’t like weed, occasionally for anxiety, but not that much. It seems to make me depressed and irritable.

Recovery for me was about learning from experiences and how to adapt to them. I feel that a small exposure to drugs may have not harmed me at all. The only thing is opiates do help me tremendously, I just avoid them for that reason. If I was prescribed them for say, a nerve disorder, I think it would make more sense.

I don’t even know or think I have schizophrenia anymore. When I’m off Abilify I don’t have horrible experiences anymore. I stopped getting sleep paralysis and I’m not sure why. I used to have horrible night terrors and couldn’t explain them. Weed may have been what helped. But I noticed that holy basil is supposed to help with that, and that’s when it stopped when I got that stuff.

Do people look into Chinese Medicine and holistic treatments because they really do work!

The idea of homeopathy is that there is a disease and a cure, but to break it into parts. A disease of speech could be cured by an herb that affects the mouth and certain remedies to activate the immune system whole body, to train the body to know how to heal.

i took niacin for 3 years. it is a controversial treatment. i recovered from my positive symptoms this year, I think it worked because when I took it I was desperate for something to work, I needed to believe in something that would help me, I was at my last straw…I believed niacin was the absolute key to getting better I believed very strongly in it. So i took it and took it consistently, I think it gave me time to work on all my beliefs and thought processes during that time. I quit taking it about almost 3 months ago and I am fine in that respect.

So placebo or medical treatment I have no idea which one it was. but it doesnt really matter at this point because it worked. I stopped taking it because I was getting a bad rash. and my liver values had progressively risen.

My thoughts are we need a treatment to believe in.

I have a SZ sister-in-law that has just gotten worse while on treatment. She relapsed while she was taking her meds religiously, and that makes me a bit anxious about my own prospects. However, reading and discussing this with my husband who also reads a lot about the illness, I got to the conclusion that taking medication is only one step of the way, and that I should also change my lifestyle completely in order to avoid the brain deterioration Kraepelin announced.

Sure thing, every psychosis affects your brain, every relapse brings you closer to deterioration. I’ve seen scans of my own brain however, and I know that there is still hope for me. So I’ve decided, after learning about thes findings a few days ago, that I will do everything I don’t feel like doing, every day, until my stubborn brain gets on the track again: physical exercice, cleaning the house, learning new languages, reading and listening to real, useful information I can later put to use. I don’t have access to therapy in my country, so I guess this is my own alternative: to force my brain activate the areas where I tend to lose gray matter while on psychosys. Will this work? I am 30 and I wish to remain lucid until at least 80

Will it work?

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