What caused her relapse?

Family
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We live in the UK. Our daughter has had schizophrenia since she was 15 years old. After she was diagnosed, the psychiatrists tried several medication cocktails, but Abilify and Venlofaxine proved to be the most effective. Over the last 14 years, she’s had lots of wobbles of anxiety/paranoia/delusion/halucination, and we’ve needed to seek professional help from CPNs, crisis team, A&E, and managed to guide her back to being able to cope with life. She’s had a couple of jobs, got herself a gaming art qualification, and started University about 6 months ago.

About 4 months ago, things started to deteriorate. She became obsessed that she was pregnant, spent a fortune on pregnancy tests, even persuaded doctors to send her for scans. She finally gave up the paranoia, then dumped her boyfriend. She then started going to a social group for mental illness sufferers, where she made some new friends. She got herself a new boyfriend, but then started to find the University work hard going and her work was being criticised quite harshly, so she began to explore a host of different ideas, from leaving Uni altogether, to changing course, getting a part-time job, getting a full-time job, her head was just spinning, as was ours. She then started going to church, suddenly wanted to get baptized, and then a couple of weeks ago, announced she was God, and could heal people.

We’ve been monitoring her for a while as we were concerned about some of the ideas she had and the things she was saying. We’ve been in contact with her mental health support team for a while, as we could see her getting worse. They recently decided she should be hospitalised, and that’s where she is now, with lots of delusions. We’re being told she will recover, but it could be a long haul.

So now we’re questioning, what caused this? We saw the deterioration, but didn’t see she was heading for a relapse. Was it the worry about Uni, the crticism of her work, the new boyfriend? Was going to church a really bad idea, since her delusions are now all based on religion and satanism, where this wasn’t the case when she was first diagnosed? We want to try to prevent another relapse, to protect her from whatever caused it. Does anybody else have any experience of this, is relapse inevitable, so in effect there is no specific cause?

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Stress is always the main environmental factor in a relapse. It seems that maybe if she wants to do school she would need less classes than the average person and a more flexible schedule so that she can rest, if not her brain is going to “boom” from all the work and thought processing she has to do. Having a relationship can always increase stress as well. I think schizophrenics should always avoid any religious doctrines because they get crazy with it. I remember my fiancé saying he was God and God was telling him to do things and then there was the “Blood God,” etc, etc. If he tries to talk about religion I automatically shut him down and tell him I don’t want him to start thinking he’s God or that God’s telling him to do things and hospitalize him like he was telling me a year ago. It terrifies me that something like that happens. It’s bad enough that he already has malicious spirits and sometimes feels a “divine presence” in the room.

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I agree with @Doctor. Stress.

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Yes - stress is a major trigger for relapse. By far the most common I think - not sure of many others, but sometimes things like medicine changes also trigger relapse.

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It doesn’t sound like this is a problem for your daughter, but insomnia & isolation are big triggers for my son in addition to stress & anxiety.

Sometimes, both are triggered by anxiety.
Sometimes, the insomnia starts because the meds aren’t working

It doesn’t help that my son can get anxious without a known trigger - he’s just kind of stuck in flight mode most of the time.

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Some general early Signs of Relapse - for everyone to be aware of:

In-depth Early Signs of Relapse and what to do:
http://www.schizophrenia.com/pdfs/earlysigns.relapse.pdf

and other web resources:

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Many thanks for all the advice, it is much appreciated.

Looking back we can see a huge amount of stress in my daughter’s life, from troubles with her boyfriend, to a suspected pregnancy, worry about taking on a big loan for Uni tuition fees, difficulty of Uni work etc. All this caused her anxiety to rocket.

One major downturn for her was when the government took away a lot of her income as part of their austerity program (she lost DLA and was not awarded PIP). It had a big impact on her as she was left with no money to buy food. We all had many sleepless nights fighting government bureaucracy over that, and thankfully common sense prevailed, but the cost is that she has relapsed, and it also caused my wife to seek treatment for stress.

So to the future, hopefully our daughter will make a reasonable recovery to good cognitive function, and then we’ll work with her to reduce the stress she has in her life, although some things are very difficult to resolve.

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