See the list of schizophrenia early warning signs.

My first psychiatrist instituted a drug holiday in April 1992.  by July 2, 1992 I was back in the hospital and started taking the meds again.

The prime tip-off was that I was restless and couldn't sleep and I had insomnia.  I would wake up late as a result and get to work late.  I started to wear garish theater makeup again.

Little things would upset me that I shouldn't have gotten upset with.  I lost the ability to recognize fact from fiction and began to believe my paranoid thoughts.

So the loss of being conscious of how your thoughts are irrational was the dividing line that sent me to the hospital.

The paranoia returned in full-force and I was hospitalized against my will.

Luckily: I did not have anosognosia. I started taking the medication again and I've been in remission over 19 years because in 19 years I've taken the medication every day as prescribed and missed only one dose on the day I had a medical procedure.

If your husband has anosognosia and lacks the awareness that he has an illness, he will not want to take his medication because he will think he's not sick, so why should he?  In this case I recommend you buy and read the 2010 edition of Xavier Amador, PhD's book, I Am Not Sick, I Don't Need Help. This esteemed psychologist has coached tens of thousands of family members about how to talk to their loved one so he or she is willing to take their meds.

Because even if someone has anosognosia, he will be able to decide to take his meds if he sees a link between taking the meds and achieving a goal, like staying out of the hospital.

If it gets worse, you might have to admit your husband involuntarily to the hospital if you can make the case he is an immediate danger to himself, the criteria for admission to a psych ward in the U.S.

You don't want to delay if he had an episode three weeks ago.  Left untreated, his condition will worsen-and there's no guarantee it will get better.

Please: take whatever action you feel you need to take.  The fact that he won't take his medication is the one true signal that all is not well.  As this is the case, brace yourself for the worse.

Let him know you're concerned and will work together will him to get him help so that he'll feel better like his old self.

Because if you say he had an "episode" the fact is my dear he's had a relapse.  Call it an episode, call it a relapse, we're not going to quibble over the definition when immediate treatment is called for.  And an episode does signal a relapse is on the way.

Christina.