Optimizing Your Schizophrenia Care With Symptom Trackers

With schizophrenia, minimizing symptoms and maintaining stability are important, but “doing okay” may not feel enough like recovery. Having limited time with your provider can make it difficult to get the treatment adjustments and support you need to thrive.

Symptom tracking is one way you and your therapist can work together for more effective schizophrenia treatment. By creating a framework in which you note key variables like energy, focus, social functioning, and potential medication side effects, you can make more efficient use of your time with your therapist and give them concrete data they can use to help you.

“Using a symptom tracker is useful for identifying patterns, which can be particularly helpful when communicating with your therapist or psychiatrist,” explains Nissa Keyashian, MD, a psychiatrist in private practice in San Jose, California. “That’s because it allows them to make medical recommendations to hopefully address any symptoms not being treated, side effects with medications, or other medical problems that need to be addressed.”

When you move from initial treatment into long-term maintenance, you may only have quick “check-in” visits, as short as 15 minutes, to review your symptoms and update your prescriptions. It’s almost impossible to assess functional recovery in that timeframe, says Anna Costakis, MD, psychiatrist and director of psychiatry residency training at Northwell Health’s Staten Island University Hospital in New York.

“Anyone can present themselves a certain way and contain certain symptoms for 15 minutes,” she adds. “How they are in a short appointment can be entirely different than how they’re living and functioning every day.”

Symptom trackers can help your provider see the bigger picture.

NAMI says that your treatment plan needs to be tailored to address both schizophrenia and any co-occurring conditions. Recognizing them is a crucial step.

Over the past few years, new apps have been developed that can track a number of variables, says Dr. Costakis. Some options include:

• Health Storylines
• eMoods
• Bearable
• 90health
• Daylio

Physical journals — using good old-fashioned pen and paper — can also be useful, according to Christina Kantzavelos, LCSW, a social worker in San Diego, who specializes in trauma and chronic illness.

“For some, a simple written journal feels less overwhelming than using an app, and also more personal,” she says. “That said, there’s no single best tool. The most effective tracker is one that you’ll actually use regularly, because what matters most are consistency and accessibility.”

Any type of data that you find meaningful can be included, says Dr. Keyashian. Some possibilities are:

• Episodes of depressive symptoms, including disinterest in everyday activities and hobbies, and reluctance to socialize with friends and family
• Mood changes that happen quickly or seem out of proportion to a situation, such as anger, irritability, sadness, or mania
• Side effects from medication that may include drowsiness, constipation, weight gain, loss of libido, dry mouth, frequent headaches, and other issues
• Sleep quality, including trouble falling asleep, sleeping too much or too little, and difficulty staying asleep
• Symptoms that indicate schizophrenia is not being well managed, such as paranoid thoughts, hearing voices, visual hallucinations, jumbled speech, and repetitive movements

“Daily tracking does not need to be complex,” says Kantzavelos. “Brief notes are often more sustainable than trying to write long entries.” With that in mind, a few days of tracking might look like this:

Including caregiver perspectives can also be helpful, because they could notice symptoms or patterns that someone with schizophrenia may be missing, says Keyashian.

“Friends and family can help tremendously in providing better care for those with schizophrenia,” she adds.

Once you’ve collected the data, you can use what it reveals to guide your conversations with your mental health provider. Here are some examples of questions that may come up:

• Based on this tracker, do you see any patterns that seem like a concern?
• Are there lifestyle changes I should focus on most for achieving better emotional and physical regulation?
• My energy seems to fluctuate quite a bit from day to day — how can I address that?
• Do you see any triggers here that I should be keeping in mind?

Overall, schizophrenia symptom tracking for treatment recovery can help you not only identify patterns and make provider appointments more helpful but also give you a sense of agency, says Keyashian.

With schizophrenia, that’s crucial, because the condition can often come with feeling overwhelmed or helpless rather than in control, she adds. Using a tracker lets you take an active role in managing your schizophrenia care, which can help you feel more empowered to reach your goals.

• Schizophrenia management includes a focus on functional recovery, which means optimizing energy, focus, work, and socialization — but it’s challenging when check-in appointments are short.
• Using a symptom tracker can help make conversations with your provider more effective, and can also give you a sense of control over your condition.
• Symptom trackers can include whatever factors you find meaningful, such as sleep, ability to focus, socializing, stress levels, caregiver opinions, and work challenges.