What can happen when schizophrenia goes untreated?

Schizophrenia is a chronic mental health condition that can have several serious complications, particularly if a person does not receive treatment.

Though treatment can help people with schizophrenia live typical lives, several barriers may prevent a person from seeking or sticking with therapies.

Schizophrenia affects less than 1% of the population of the United States. A person with the disorder may experience symptoms such as:

• delusions
• lack of motivation
• hallucinations
• trouble with thinking
• disorganized speech

With treatment, most people can experience symptom relief. However, a person often needs to overcome barriers to treatment, such as:

• lack of access to healthcare
• costs
• difficulty committing to therapy

If a person does not receive appropriate treatment, they may be more likely to develop complications. Compared to people without schizophrenia, people with the condition may have:

• a shorter average lifespan
• a greater chance of suicide

This article reviews the potential risks of a lack of treatment for schizophrenia and the potential barriers to successful treatment.

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Schizophrenia can lead to several potential health complications, including:

• suicidal thoughts or actions
• further decline in cognitive functioning
• lower overall life expectancy
• increased risk of several possible health complications

Increased suicide risk

According to a 2016 review of studies, people with schizophrenia have a higher chance of attempting or dying by suicide within the first year after diagnosis. The risk slowly decreases over the years.

The researchers also note that people with the highest chance of suicide include those who:

• have attempted or thought about it in the past
• lack friends or strong social support
• experience severe psychotic symptoms
• use substances, including alcohol and recreational drugs
• have higher cognitive functioning prior to diagnosis

Decline in cognitive functioning

In a 2020 study of people with schizophrenia in rural China, researchers noted that cognitive decline can continue to progress after initial diagnosis. This can lead to diminished thinking ability and other issues related to declining cognitive function.

The researchers noted that additional studies, particularly in low and middle-income countries, are necessary to help determine the exact effect of schizophrenia on cognitive abilities.

Lower overall life expectancy

In a 2017 meta-analysis of 11 studies, researchers found that the weighted average decrease in life expectancy for people with schizophrenia was about 14.5 years.

They noted that the lowest life expectancy averages came from Asia and Africa. This could imply that access to appropriate care may play a role in life expectancy.

Increased risk of health complications

Lower overall life expectancy may have a link to the development of other health conditions.

For example, according to a 2018 review, most studies indicate that people with schizophrenia have a significantly higher risk of dying from cardiovascular conditions than those who do not have schizophrenia.

This is because antipsychotic medications increase the risk of metabolic disorders and heart disease.

Several factors may prevent a person with schizophrenia from receiving treatment that can help them live an otherwise typical life.

The potential issues include personal choice and difficulty accessing proper healthcare.

Lack of access to healthcare

Modern treatments can help a person with schizophrenia manage their symptoms, but not everyone has access to the appropriate level of care.

Studies suggest that access is limited in low and middle-income countries.

A 2021 study noted that the biggest hurdle for people in the U.S. is the affordability of therapy. However, the researchers also noted that any barrier can prevent proper treatment.

Therapy adherence

There is no cure for schizophrenia, but therapies can help significantly. Treatment typically consists of taking antipsychotic medication and participating in psychotherapies such as cognitive behavioral therapy.

Several factors may prevent a person from consistently adhering to treatment, such as:

• the decision not to take medications
• substance misuse
• the potential for side effects

Anosognosia is also recognized as a major factor for patients not completing or continuing with treatment for schizophrenia.

Personal choice: The decision to take medication

In some cases, a person may choose not to take their medications.

First-generation antipsychotics have a high chance of causing adverse reactions or side effects. Second-generation antipsychotics have a much lower risk of adverse reactions, though some side effects are possible.

The potential side effects may influence a person’s decision to not take the medications at all.

Family and friends may be able to convince or even force a person to take medications, but doing so may be difficult. Additionally, it is unclear whether it is legal to force medications on those who do not want to take them. Some analysis suggests that it may be ethical, even if the laws are not clear.

Other difficulties in taking medication

A person with schizophrenia may have other issues with taking medications or following through on therapy in general. Though everyone is different, potential issues include:

• recurrence of symptoms
• lack of support from family or friends
• lack of consistent psychotherapy sessions
• misuse of substances

Schizophrenia support groups may offer a sense of community, important coping skills, and improved outcomes for people with the condition.

Various organizations offer support, both online and offline, for people with schizophrenia and their families. These include:

• Mental Health America offer their own support group through a platform called Inspire.
• The Schizophrenia & Related Disorders Alliance of America offer a variety of online groups and chats for people with schizophrenia as well as their family and friends.
• 7cups offers online chats and other group resources.
• National Alliance on Mental Illness (NAMI) family support groups.
• The NAMI Connection is a free, peer-led support group for any adult who has experienced symptoms of a mental health condition
• NAMI’s Family-to-Family program is a free, eight-session educational program for family and friends of people with mental health conditions.
• Family and caregiver schizophrenia support forums.

Below are some commonly asked questions about untreated schizophrenia.

Does schizophrenia get worse with age if untreated?

Schizophrenia is a chronic disorder. If left untreated, it can potentially lead to suicidal thoughts, a decline in cognitive functioning, and an increased risk of cardiovascular conditions.

It does not typically worsen with age. However, people may have periods of time when they are less able to manage their condition.

What if a person with schizophrenia refuses medication?

If a person with schizophrenia refuses medication, family and friends may be able to convince them to take it.

However, it is unclear whether it is legal to force medications on those who do not want to take them.

Despite this uncertainty regarding the law, some analysis suggests that it may be ethical.

What are 3 warning signs of schizophrenia?

Three warning signs that point to a person having schizophrenia are:

• delusions
• hallucinations
• disorganized speech

Untreated schizophrenia may increase the risks of complications for the person. Several factors, such as personal choices, lack of support from family or friends, and lack of access to health care, can affect a person’s treatment.

Without proper treatment, a person with schizophrenia may have a lower life expectancy, an increased risk of health complications, and a higher risk of suicide.