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Although I take large dosages of antipsychotics and have done this since the mid nineteen eighties, I continue to have some level of "breakthrough symptoms." Despite treatment I can get delusional thoughts, and it is not safe to assume that medication will solve this. I cannot raise dosages of meds every time I get symptoms, because I am already on exceedingly high amounts, and raising the dosages could make things worse, not better. 

This is established in psychiatry: when dosages of antipsychotics and many other medications are too high, or "above therapeutic level" it can worsen symptoms rather than solving them. Additionally, many meds become toxic if raised too high, or could cause other types of damage. 

(In the past twenty years, psychiatrists have raised my dosages at my own request--it was not their idea. Psychiatrists have acknowledged that I have considerable experience managing my condition.) 

I have gone off medications against medical advice about three times, with bad results. I am also older, having so far made it to an age many schizophrenic men don't reach. Due to aging and having stopped medication in my past, the effectiveness of medication could be less. 

You might ask, if the dosages are at their maximum and I still have symptoms, where does that leave me? It means I must seek other methods of getting my thinking and perceptions in order. Being medicated gets me in the ballpark of normal, but it does not do enough by itself. There are options. 

"Reality-checking" is one option. It is imperfect because it requires that either you believe what someone tells you, and/or you believe what your senses are telling you. If excessively paranoid, it is hard to take people at their word. Yet, reality checking should be part of the picture. You can't ask someone whom you do not know whether a thought is real or a delusion, because they will not understand. When asking someone whether a thought seems accurate or delusional, you must tap someone whom you know very well, or whom you know to be a clinical mental health professional. 

Another approach to delusions is to discuss a questionable thought at length with a therapist. You can discuss how you feel about the thoughts--whether they cause you a feeling of importance, a feeling of fear, pleasure, or pain. You can discuss the possible emotional "payoffs" of the delusion. Or the delusion could be painful and could be plaguing you. Usually, a delusion will gain its power over you through generating strong emotions. 

Another exercise is to reinforce the memory of how delusions have occurred in your past, and of how you later discovered that your brain had been generating a falsehood. 

Depression and anxiety, also, can be partly addressed with cognitive techniques. Generally, depression and anxiety are hinged upon a false image in the mind. Your mind is falsely telling you that things are bad. Working to combat this perception helps alleviate these symptoms, albeit partway. 

Sometimes depression is due to circumstances. If you are incarcerated, you're going to be depressed. If you go through a divorce or a death of a close relative, depression is normal. Depression due to living under difficult conditions, such as if you live in a noisy or dangerous neighborhood, is normal. Depression due to a downturn in your stock market portfolio is more subjective and has more to do with expectations--but this is also normal. 

Depression can lend itself to cognitive exercises, but sometimes we may need an antidepressant, if it gets too bad. Anxiety, also, may respond best to some meds. However, benzodiazepines are not advisable to take long-term. They are habit forming, they periodically require upping the dosages, and, if you get in a car accident, having them in your system can entail consequences. There are antidepressants that are not considered "controlled substances" that can address both depression and anxiety. 

You should never drive a car on a new medication until you know how it affects you. 

I suggest that if you have symptoms left over that medication hasn't fully solved, you could investigate cognitive exercises, many of which are taught in the mental health treatment system in California. A popular system taught to smart mental health consumers is called Cognitive Behavior Therapy, CBT. It is taught at a variety of places, or you can study it on your own.