selfy: i know schiz can cause cognitive issues and his concentration and motivation is at an all time low...

There seems to be two underlying beliefs as related to cognition. The first is that the "illness" itself causes the difficulties; the second is that the medication used to treat the illness causes the difficulties. I think both have their merit.

I didn't and haven't had medication but I certainly did go through a period where it was difficult to concentrate. I would describe this as difficulty organizing my thoughts. A young woman I know who recently had a break and has chosen to forgo anti-psychotic medication reports difficulties with racing thoughts. On the other side of the coin, many people who take medication report that it dulls or slows their thought processes and doesn't always deal with all their positive symptoms, i.e., they may still experience voices.

Proponents of anti-psychotic medication claim that it prevents cognitive dysfunction however there is also evidence that anti-psychotic medication contributes to the loss of gray matter. With no clear answers from the medical camp I think people simply have to determine what works best for them and go with it.

Regardless of whether an individual takes or doesn't take medication, it seems apparent that an individual will require a healing period following their breakdown. During this time, it's probably best to take small steps towards a larger goal as a means of decreasing anxiety while also trying to rebuild confidence. For myself, that meant re-learning to focus on specific tasks and re-learning how to prioritize several tasks at once. A practice that others might find helpful in this vein is mindfulness. That young woman I know has chosen to reduce her work load (studies) and allow more time to complete it. She has also found that a small dosage of an anti-anxiety medication can best help her slow her racing thoughts, thereby reducing her anxiety and allowing her to concentrate. She feels more comfortable having this option available to her when she's facing greater stressers such as a test.

If your mate can identify where and how he's having difficulty concentrating, he can probably come up with some coping skills of his own that will work for him. Alternatively, if he feels his medication is the problem, he can work with his doctor to alter the dosage, switch to a new medication, or withdraw from the medication he's taking.


As for motivation...

I subscribe to a model of 'schizophrenia as a result of ego collapse" -- it's simply the model that makes the most sense to me so it tends to structure my own thoughts in these matters.

As noted above, a period of healing is required post breakdown. I've observed that it must occur on several different levels: physical, emotional, mental, relational and spiritual. Moving through those stages is somewhat incremental although they are also all interrelated. For example, the physical, emotional and mental bodies have to recover to a certain extent before healing can take place on the relational level. This translates as a need for plenty of sleep, good nutrition, exercise, a relaxed and restful environment, time to process thoughts and emotions, etc.

The relational level is particularly important because it's our relationships with others and the larger world that defines our sense of who we are and this is what must be rebuilt in the aftermath of a fragmentation crisis: self-identity; self-esteem; self-confidence, etc.

During these stages we may need to sleep or rest, a lot. We may need to sit and seemingly do nothing for hours while we sort through our emotions and thoughts. We may need to be alone and to carefully choose those people we spend time with. We may benefit from a non-invasive structure. We may find we are hyper-sensitive to the slightest criticism because our sense of self is so fragile. We may need to borrow on the hope and beliefs of others while we (ideally) slowly, slowly, slowly, mend all the fractured parts back into one whole.

All of the above affects what others might call motivation. But we can't get out of bed until we've had adequate rest and we can't take on the world by the horns until we've rebuilt our sense of identity and confidence.

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