Schizophrenia and CBT/DBT

[not_so_insig]

Has anyone here that has a diagnosis of schizophrenia ever had CBT or DBT? I keep on reading about how NHS guidelines say that people with schizophrenia should be given CBT, yet I havent had either DBT or CBT.

I just feel that I should be doing more for my recovery than just taking meds (and I feel atm I am on too high a dose). Also I feel as though that CBT may help me with my SI urges (though I havent SIed for over 2 1/2 years).

[Morpheus]

I have recieved CBT however that was before i was diagnosed with schizophrenia. I was wrongly diagnosed with avoidant personality disorder which i got treatment for. Though it was aimed at personality disorders i did find it helpful.

However like you, after i got my schizophrenia diagnosis, almost all of my treatment has been medication. I am against meds for me as they have never really helped me and given me a lot of serious side effects and i spent about two years argueing with my psych about how we should go about treatment. I wanted therapy, she insisted i had to be stabilized with medication before recieving that. That meant two and a half years where my only treatment was medication and hospitalisations because the medication did not stabilise me at all.

Two and a half months ago though, i started refusing to take my medication. I have been on almost every kind of antipsychotic, mood stabilizer and antidepressive over the past ten years with absolutely no effect. I still have several hospitalizations a year where they then drug me to the point of not being able to tie my shoe laces and then send me home. It is not helpful.

So i came right out and said, your methods are clearly not working, now we are doing it my way. No meds, my psychiatric nurse visits me more often and i have been referred to a psychologist for the first time in many years. For me it is tricky with medication because they never really did much for me. I can see that it helps other people, it just never helped me. When i am in crisis, having a psychosis i have found out that PRN helps with my symptoms when i get overwhelmed but more long term antipsychotics doesnt lessen my psychotic episodes, make them shorter or occure less. I have to sit through these psychotic episodes which varies in length and intensity. Sometimes i manage at home, other times i need hospital and sometimes i need PRN. However i think it would be helpful for me to learn skills to cope with episodes like these. I know they will come, several times a year and i know they dont last forever. What i need now are skills so that i can sit through them without getting hospitalised.

Personally, i have gotten better without meds. I am no longer drowsi or have side effects. I am far more present in conversations, many people including professionals have said that. I can feel more. I get more sad, more angry, more happy which was, i admit, overwhelming to begin wi cause i havent felt that for years however, i quickly learned how to cope with it and after all. These are healthy feelings i want to feel.

I am not telling you to stop taking your meds. Doing what i did can be very dangerous however sometimes you need to do drastic things to get through to your professionals. Personally, i think people with schizophrenia often get far too little therapy. We are mostly just drugged up and sometimes that is necessary yea, but there are cases where is is not and therapy should always be offered as well. Medication is not gonna cure you. It might treat your symptoms but wouldnt it be better to learn how to cope without meds? Souldnt that be our goal?

[Aubergine]

I've been diagnosed with the depressive type of schizoaffective disorder and have been for about 5(?) years. It's not schizophrenia, but there are similar symptoms involved.

I was seen by the Early Intervention team for three years (a team who specialise in young people with psychosis - they will see people for three years following their first episode of psychosis). I had CBT fortnightly for the last two and a half years I was with them, with a few breaks due to being in hospital. I was not well enough to form a sentence, let alone engage in therapy properly, so I know they weren't fobbing me off with that excuse - in my case it was a genuine need to get me stabilised on meds (which fortunately have a positive effect on me.)

I found the therapy incredibly helpful. Probably as effective as the medication. It helped with challenging difficult beliefs about various things. I still get the beliefs, but as long as I practice CBT when I'm well, I am quite good at maintaining the challenges when things slip. CBT is also good for helping me challenge what the voices I hear say. They're there, yes, but I don't have to buy into everything they're telling me anymore. Just like visible people, they're not always truthful, and CBT has helped me to acknowledge that.

I also did some work around self-esteem and confidence, as being unwell had knocked me back in that regard. It was effective for this also and I view myself in a more positive light since therapy ended.

Whilst is was a really helpful experience for me, and has paid a part in keeping me out of hospital for over two years, it was hard. Certainly not the easy option. You have to be willing to try all of the exercises and work with your therapist, by being honest with yourself and him/her. Sometimes, strongly held difficult beliefs can be difficult to work through, and there was often a lot of tears and anger on my part. It can work if you work it though.

If you have any questions, feel free to ask away. I'm not an expert, but might be able to give you an idea. :)

[Bear]

Hey. I have a diagnosis of schizophrenia and found CBT very helpful. Even more so because my psychologist was lovely.
I really think you should tell your psychiatrist about how you'd like some form of therapy ( someone please correct me if I'm wrong, but I don't think they use DBT very often for schizophrenia?) and really push for it.
I know it's expensive and that the CMHTs have had a lot of cut backs, but that doesn't mean you have to suffer and if it's going to improve your quality of life then they should definitely offer it to you.
Take care x

[tamobhuuta]

before I was diagnosed with schizophrenia, but while I had lots of symptoms, I did DBT individual and group, and some CBT-style exercises. I didn't find either helpful but I don't know if they would have been better if my symptoms were under control. now I am on good meds and symptoms are largely gone I don't really feel the need to SH (and I can control the SI thoughts) so CBT seems a bit pointless because it's used for tackling unhelpful behaviours.

[out_of_here]

Hey,

I have been diagnosed with both schizophrenia and schizoaffective, (they haven't really decided on one yet) and I have done both DBT and CBT whilst in hospital. DBT wasn't particularly helpful and I would have to agree with Bear that it isn't a recommended treatment. CBT is however. CBT was really helpful (when I had insight into my experiences) in challenging my perceptions. If you think it would be beneficial I would say definitely ask your psychiatrist/psychologist if you can have access to some sort of CBT therapy. I'd definitely recommend it for the schizophrenic spectrum.