• Times where you feel OK
• Times where you suddenly feel worse and experience psychosis: this is an acute episode

An acute episode of schizophrenia involves psychosis – a change in your perception of reality. It can make it really difficult to work out what is real and what isn’t.

In an acute episode, people are most likely to experience the positive symptoms of schizophrenia. These include:1-3

• Hallucinations – hearing, seeing or feeling things that no-one else can
• Delusions – strong beliefs that no-one else believes
• Paranoia – concerns that people are plotting against you or watching you, or that people around you can hear your thoughts

If you need help NOW, you can call:

• Your GP surgery
• The 111 service
• Your healthcare team if you have one
• Your local NHS urgent mental health helpline (England only) – find yours on the NHS website
• 999 if you or anyone around you is in any danger

• Talk to someone you trust – ask if they have noticed any changes in you 4
• Check you’ve been taking your medications if you have them at home
  1. Look at the packets – have you taken all the doses you were prescribed?
  2. If you use a divided pill box, do any of the days have tablets still in them?
• If you have a mental health care team: Get in contact with your healthcare team – this could be your psychiatric nurse, home worker, therapist, counsellor, doctor or acute care worker.1
  1. Explain what has been happening. The healthcare team should have an individualised care plan for you, saying what to do in these situations4
  2. Tell them about your medication – if you’ve been taking the prescribed dose or if you’ve missed any doses or stopped taking it
• If you don’t have a mental health care team: contact your GP surgery urgently for a same-day appointment. 1 If it is the weekend or evening, call the 111 service

It’s a good idea to learn about and become aware of the kind of symptoms you experience at the prodromal phase and at the beginning of the acute stage. When you’re aware of any changes, it can help you recognise early signs of an acute episode. You can then take action, by accessing medical help or therapy.4

Taking your medication as prescribed can help prevent an acute episode 4,6

Each time you go into the acute phase (i.e. have an acute episode) it’s called a relapse.

Some people only ever have one episode of schizophrenia and never have another.⁷ The majority of people with schizophrenia, though, will experience cycles of recovery (periods of time with no or manageable symptoms) and relapse (periods of time when symptoms become overwhelming).8

It’s not clear exactly why some people completely recover after one episode and why others experience relapses. But, research has shown that getting treatment early and having a good support network can help prevent relapses to some extent.7

The single most effective thing you can do to prevent relapsing into an acute episode is to stick with antipsychotic medication.6 If you’re struggling to take your medication for whatever reason, it’s always better to speak to a healthcare professional about it than to just stop taking it.4 A doctor or nurse prescriber can talk you through any problems you’re having with your medication and find ways to help you either stay on it or change to something else.