How to deal with psychosis

Treatment - Psychosis - NHS

Treatment for psychosis involves a combination of antipsychotic medicines, talking therapies and social support.

Your care team

Your treatment is likely to involve a team of mental health professionals working together. If this is your first psychotic episode, you may be referred to an early intervention team.

Early intervention teams

An early intervention team is a team of healthcare professionals set up specifically to work with people who have experienced their first episode of psychosis.

Depending on your care needs, early intervention teams aim to provide:

a full assessment of your needs
medicine
talking therapies
social, occupational and educational interventions

Antipsychotics

Antipsychotic medicines are usually recommended as the first treatment for psychosis. They work by blocking the effect of dopamine, a chemical that transmits messages in the brain.

However, they're not suitable or effective for everyone, as side effects can affect people differently. In particular, antipsychotics will be monitored closely in people who also have epilepsy, a condition that causes seizures or fits.

People who have cardiovascular disease – conditions that affect the heart, blood vessels, or circulation, such as heart disease – will also be closely monitored.

Antipsychotics can usually reduce feelings of anxiety within a few hours of use, but they may take several days or weeks to reduce psychotic symptoms, such as hallucinations or delusional thoughts.

Antipsychotics can be taken by mouth (orally) or given as an injection. There are several slow-release antipsychotics, where you only need an injection every 1 to 4 weeks.

Side effects

Antipsychotics can have side effects, although not everyone will experience them and their severity will differ from person to person.

Side effects can include:

drowsiness
shaking and trembling
weight gain
restlessness
muscle twitches and spasms – where your muscles shorten tightly and painfully
blurred vision
dizziness
constipation
loss of sex drive (libido)

dry mouth

Tell a GP or mental health worker if you have side effects that are becoming particularly troublesome. There may be an alternative antipsychotic medicine you can take that causes less side effects.

Never stop taking medicine prescribed for you unless advised to do so by a qualified healthcare professional responsible for your care.

Suddenly stopping prescription medicine could trigger a return of your symptoms (relapse). When it's time for you to stop taking your medicine, it will be done gradually.

Talking therapies

Talking therapies can help reduce the intensity and anxiety caused by psychosis. There are several possible talking therapies.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) for psychosis is based on an understanding of how people make sense of their experiences and why some people become distressed by them.

A CBT therapist may encourage you to consider different ways of understanding what's happening to you. The aim is to help you achieve goals that are meaningful and important to you, such as reducing your distress, returning to work, education or training, or regaining a sense of control.

Family intervention

Family intervention is known to be an effective form of therapy for people with psychosis. It's a way of helping both you and your family cope with your condition.

After having an episode of psychosis, you may rely on your family members for care and support. While most family members are happy to help, the stress of caring for somebody can place a strain on any family.

Family therapy involves a series of meetings that take place over a period of 3 months or more. Meetings may include:

discussing your condition and how it might progress, plus the available treatments
exploring ways of supporting someone with psychosis
deciding how to solve practical problems caused by psychosis, such as planning how to manage future psychotic episodes

Self-help groups

If you're experiencing episodes of psychosis, you may benefit from being around other people who've had similar experiences.

For example, the mental health charity Mind has more than 150 local Mind networks, which may be able to put you in touch with a support group in your area, as well as provide a range of other useful services.

Rehabilitation for psychosis

If your treatment for psychosis is not working, you might be offered rehabilitation.

The aim of rehabilitation is to build your confidence and skills so you can cope with your condition and become as independent as possible.

You'll be offered different types of support as your needs change, and you can go through the rehabilitation process more than once if you need to.

Your rehabilitation team will include people from different parts of the health and care system, such as a rehabilitation psychiatrist, mental health nurse, occupational therapist and social worker. Depending on your needs, you might also see other people who can help, such as a dietitian or exercise coach.

Rehabilitation should happen close to where you live, but sometimes the services you need might be outside your local area.

Your team will work with you to decide on the types of care you need for your physical and mental health, which is called your care plan. They'll also help you set goals you want to achieve, such as managing in your own cooking and shopping, or going back to work.

Mental Health Act (1983)

If you're experiencing a particularly severe psychotic episode and it's felt you present a significant danger to yourself or others, you can be compulsorily detained at a hospital under the Mental Health Act (1983).

The mental health charity Mind has more information about the Mental Health Act (1983).

If you're detained under the Act, every effort will be made to obtain your consent to treatment.

However, treatment can be carried out without your consent if it's required.

Violence and aggression

Acts of violence and aggression are fairly uncommon in people with psychosis. They're more likely to be victims of violence than those being violent.

However, there may be times when your behaviour places yourself or others at risk of harm. Mental health staff have been trained to deal with aggressive behaviour.

They will try to help reduce any distress, agitation and aggression, but it may be necessary to hold you down without hurting you. This is known as physical restraint. You may then be moved to a secluded room.

In some cases, you may need to be given medicine that will quickly make you very relaxed.

You'll be offered the medicine voluntarily, in the form of tablets, but you can be treated against your consent if you refuse. This may involve giving you an injection of a tranquilliser (rapid tranquillisation).

It's important to stress that these methods are only used in extreme circumstances and are not routinely used to treat psychosis.

Advance decisions

If you're at risk of having psychotic episodes in the future and there are certain treatments you do not want to have, it's possible to pre-arrange a legally binding advance decision, previously known as an advance directive.

An advance decision is a written statement about what you'd like health professionals and your family or friends to do if you experience another psychotic episode. You may also want to include the contact details of your care team.

To create an advance decision, you need to make your wishes clear, in writing, and ask a witness to sign it. You should include specific details about any treatments you do not want and specific circumstances in which they may apply.

However, an advance decision can be overruled if a person is subsequently detained under the Mental Health Act.

Although doctors will try to take your wishes into account when deciding on treatment, they may decide it's in your best interests not to follow the advance decision.

Yellow Card Scheme

The Yellow Card Scheme allows you to report the suspected side effects of any medicine you're taking. It's run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).

How to Deal with Psychosis: Supporting Yourself and Others

Managing psychosis can mean learning to recognize the early signs, having a crisis support plan, and keeping up long-term healthy habits.

Psychosis is an experience of altered reality, such as delusions, hallucinations, and disorganized thoughts.

“Individuals experiencing psychosis often do not recognize that their perceptions are not reality,” explains Tiffany Freeman, a psychiatric nurse practitioner from Addison, Texas. When you cannot determine what’s real it’s often hard to know when you might benefit from seeking help.

The symptoms can affect your work, school, and social life. You might withdraw socially or develop a sense of unease around people and places, or you may start avoiding hygiene and self-care routines.

Learning how to handle psychosis when it happens — and how to help prevent symptoms in the long term — can help you reduce distress and recover faster. Getting enough sleep, exercise, and social time can help prevent psychosis from happening again.

Psychosis involves false experiences, but there are other warning signs you can look out for too. Heading into an episode of psychosis, you may experience changes that could easily pass as stress, illness, or fatigue.

You might notice a change in your thinking patterns, though they may be hard to describe.

“Recognition of early warning signs is a key aspect here,” indicates Freeman. “Things like shifts in sleep patterns, feelings of unease, distrusting, and urges to isolate are very common early symptoms.”

When you’re able to recognize the early symptoms of psychosis, you can get in touch with your support network and healthcare team right away.

Early warning signs of psychosis can include:

difficulty concentrating
reduced job or school performance
growing suspicion or feelings of unease
paying less attention to personal hygiene
self-isolation
emotions without a clear reason, or a lack of emotion

The early-onset signs of psychosis can be different for everyone. Keeping a daily log of your thoughts, feelings, and experiences can help you keep track of changes that might suggest an emerging psychosis episode.

Is psychosis a mental disorder?

Psychosis is a symptom, not a formal diagnosis. On its own and with short-term effects the symptoms might meet the criteria for brief psychotic disorder.

As a long-term symptom, psychosis may indicate another mental health condition, like schizophrenia or bipolar disorder.

A psychotic episode can be confusing and frightening. If something around you isn’t making sense, or if you’re having a sensory experience that feels out of the ordinary, it can help to do a mental self-check.

“Leaning on past experiences — ‘this has happened before, what was true then?’ — dialogue can be helpful,” says Freeman.

Acknowledging that you may be in an episode of psychosis can help ease initial feelings of panic and can direct you toward your pre-designed plan of action.

Your support network — which might include a life skill coach, mental health professional, or emergency response teams — is there to help keep you safe and calm when psychosis occurs. A friend or family member may be able to contact this support for you.

Immediate contact with this support system can help you receive any care you need sooner rather than later during an episode of psychosis.

If you think you might be experiencing a psychotic episode, waiting somewhere safe and quiet until support arrives can help minimize the chances of psychosis putting you or those around you in harm’s way.

If you’ve experienced an episode of psychosis before, having a “go-to” area free of hazards may help, especially if you’re alone when the symptoms develop.

Family members are often the ones who first notice the changes that mark a psychotic episode.

If you suspect your loved one isn’t perceiving reality accurately, knowing what to do — and what to avoid — can help.

1. Avoid confrontation

When a loved one is acting outside of what’s typical, wanting to correct them can feel like a natural reaction.

During psychosis, however, altered perceptions like hallucinations and delusions can’t be reasoned away. Confrontation or correction might escalate irrational behaviors.

“Caregivers, at times, want to challenge the thoughts of the individual. But depending on the severity of the episode, this can make things worse,” Freeman cautions.

2. Remain calm

Keeping your voice neutral and your gaze soft can help promote calm when a loved one is experiencing psychosis. Being patient, actively listening, and moving and speaking slowly are also ways to help your loved one stay calm.

3. Express concern without focusing on treatment, medication, or hospitalization

It’s okay to express that you’re concerned about your loved one’s behaviors. Non-judgmental comments and questions may help you determine the extent of what’s happening.

Focusing on treatment, hospitalization, or medication may be perceived as threatening during a psychotic episode, which can involve delusions of paranoia and suspicion.

4. Offer non-threatening options

“Would you like it if I called so-and-so? They might like to hear from you,” is an example of feeling out, in a non-threatening way, who might be your loved one’s most accepted resource to call, based on their current mindset.

5. Call the support team or emergency provider

If your loved one doesn’t indicate they can participate in the decision on who to call, or if their behaviors may harm themselves or others, you may want to go ahead and contact the support team or emergency services.

An episode of psychosis can be considered a mental health crisis due to the potential for harm resulting from altered perceptions.

Creating a mental health emergency plan can help guide you and your loved ones when fear, panic, and confusion might prevent actionable thinking.

There’s no right or wrong way to create a mental health emergency plan, but it can be helpful to have your medical information handy in the event you aren’t able to communicate it.

Consider including:

emergency contacts
primary healthcare professionals and their contact information
a list of formal mental and physical diagnoses, if any
physical and mental medical history
known allergies
current medications or supplements and their dosages
any recreational substance use

In addition to your basic medical information, a crisis plan might include:

a list of behaviors that indicate early psychosis and any successful management strategies
a list of behaviors that indicate a need for emergency care
a mental health crisis hotline number
emergency service numbers
where to go while you wait for support (a designated safe place free of hazards)

You might experience psychosis once or twice and then never again, or you may have recurring episodes that coincide with other mental health disorders.

Knowing how to deal with psychosis in the moment is just one piece of the puzzle. Long-term management is often necessary for the best wellness outcomes.

Keep up with your treatment

Successful long-term management of psychosis can hinge on maintaining your treatment.

“Studies show that lack of medication adherence is associated with longer hospital stays, poorer health outcomes, and higher cost burden,” says Freedman.

Avoid substance use

Certain recreational substances like cannabis, amphetamines, LSD, and alcohol may increase the chances you’ll experience psychosis if you’re at risk of symptoms.

Develop stress management strategies

Short-duration psychotic episodes may be brought on by stressful events or trauma. Developing stress management strategies can help prevent it from overwhelming your daily life.

Breathing exercises, meditation, and mindfulness might be useful tools in addition to a:

regular exercise
balanced diet
good sleep hygiene

Use various forms of support

Disrupted reality can be short-term or long-term. While you’re working toward managing your symptoms, having a multi-dimensional support system can help you with everyday responsibilities.

Coordinated specialty care (CSC) is a formal treatment approach to psychosis that incorporates:

case management
services coordination
family education
employment support

With CSC, a team of professionals is there to offer guidance for psychotherapy and medication adherence as well as support for everyday essentials.

Understanding how to deal with psychosis in the moment and the long term can help limit its impact on your life.

Establishing a crisis plan, keeping medical details handy, and educating yourself and loved ones about psychosis can all make a difference.

If you need additional support resources in your community, the National Alliance on Mental Illness (NAMI) offers state-specific guidance through their hotline at 1-800-950-6264 or by emailing info@nami. org.

Are you currently in crisis?

If you feel like you’re having a mental health emergency, you can:

Call the 988 Suicide and Crisis Lifeline at 988 for English and Spanish
Chat with professionals at Lifeline Chat
Text “HOME” to the Crisis Text Line at 741741
Check out Befrienders Worldwide or Suicide Stop if you’re not in the United States and need to find your country’s crisis hotline

If you decide to call an emergency number like 911, ask the operator to send someone trained in mental health, like Crisis Intervention Training (CIT) officers.

Treatment of psychoses at home, effective treatment and prevention of psychoses

Psychoses develop rapidly, the main symptoms of the condition are the occurrence of delirium, hallucinations, aggressive behavior, disorientation in space and time. Such people become potentially dangerous to others, so self-treatment of psychosis is strictly prohibited. If you experience alarming symptoms, you should immediately call a specialist or an ambulance.

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Psychosis has many different forms and is a symptom of many mental illnesses. The most effective treatment of psychosis occurs in inpatient psychiatric hospitals or on an outpatient basis under the supervision of a psychiatrist, but it is not always possible to see a doctor on time. Often an attack in a sick person can begin at the most inopportune moment, at a great distance from the hospital. What to do in such cases? How can psychosis be treated at home?

Treatment of psychosis at home: recommendations

Psychosis can be quite easy to recognize, it manifests itself in the following symptoms:

hallucinations;
illusions;
mania;
phobias;
violation of the process of thinking and logic;
paranoia;
obsessive thoughts;
nonsense.

For example, a sick person suffers from hallucinations. In this case, they can be olfactory, visual, auditory or tactile. A person begins to experience something that does not actually happen. This form of psychosis can be dangerous for a person - he can jump out of the window, because he will see the sea outside the window in his hallucinations, or he will hear voices that will order him to kill himself. As soon as you notice that a loved one:

talking to someone;
sees what is not;
laughs for no reason;
makes incoherent and illogical conversations;
caught fire with some strange idea and is trying to bring it to life;
experiences unpleasant odors or feels something that is not really there, you should first try to contact the nearest hospital and follow the recommendations of the doctors.

Home psychosis prevention

In fact, only a qualified specialist can give advice on the treatment of psychosis at home. However, most psychiatrists will give you initial and general advice to follow when in close proximity with a psychotic person:

if the patient talks about suicide or behaves aggressively towards others, you should immediately call an ambulance;
in no case do not argue with the patient, no matter what he says - he may not be aware of his words, moreover, this can make him angry, and then the consequences will be unpredictable;
listen to crazy ideas, but do not try to enter into a dialogue with your point of view - in this case it is meaningless;

Remember, psychosis can be expressed, in particular, in manic and depressive forms. And the treatment in both cases is very different. For example, if during the course of psychosis in the first form, taking antidepressants is contraindicated, then during the course of the disease in the second form, on the contrary, it is necessary. That is why it is important not to self-medicate and consult a specialist as soon as possible. In particular, you can contact the IsraClinic administration by e-mail.

Effective treatment of psychosis in a psychiatric center

Treatment of psychosis in a psychiatric center will be most effective. Remember, outside of a specialized center it is very difficult to restore the health of a patient who is in psychosis. This is due to the peculiarities of his behavior, the nature of the course of the disease, in addition, only an experienced qualified doctor will be able to choose the right medication and take preventive measures. We offer treatment in the conditions of the clinic "IsraClinic". Our specialists will carry out high-quality diagnostics, help to choose the most effective treatment and, if necessary, conduct a rehabilitation course, which is often required by patients after psychosis.

Psychosis - Hadassah Medical Moscow

Psychosis is a mental illness. Under it, a person cannot adequately behave, he does not perceive the world around him and does not react to it. At the initial stages, psychosis can be recognized by changes in behavior, atypical reactions appear in a person, and the emotional background is disturbed. He cannot control his feelings

and expresses emotions that do not correspond to situations. If you or your loved ones experience these symptoms, you should immediately consult a doctor. The appearance of psychosis may indicate the development of schizophrenia, delirium tremens, senile dementia and other serious diseases.

Full text

Symptoms of psychosis

Psychosis is a group of psychotic disorders. Their manifestations depend on the specific type of violation. However, all of them are characterized by a gradual increase in signs, a change in behavior. You can recognize the symptoms of psychosis by the following manifestations:

Hallucinations - can be auditory, visual, gustatory, tactile, olfactory;
Delusional ideas - there are obsessive thoughts and judgments that do not correspond to reality. A person may feel that he is being watched;
Movement disorders - periods of excitement are replaced by a sharp stupor;
Mood disorders - apathy, melancholy, indifference to everything;
Manic disorders - excessive aggressiveness, building unrealistic plans, a sharp addiction to alcohol, promiscuity;
Emotional disorders - a person cannot express his feelings, he does not correlate his feelings with what is happening.

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Causes of psychosis

Psychosis occurs due to problems in the work of neurons. Due to the violation of bonds in the molecules, they do not receive nutrition, they experience a lack of oxygen. This leads to the fact that neurons cannot transmit nerve impulses - multiple disorders occur in the central nervous system. The type of psychosis that occurs depends on which part of the brain suffered from a hunger strike. The causes of this disease are of 3 types:

Endogenous, associated with internal processes. These can be endocrine, neurological disorders, bronchial asthma, vitamin B deficiency, conditions accompanied by acute pain (ulcer, heart attack, sarcoidosis), electrolyte imbalance, systemic diseases, genetic predisposition, age;
Exogenous, or external: stress, intoxication with alcohol, drugs, drugs, consequences of infectious processes, mental trauma;
Organic, when changes in the brain become the cause of psychosis: tumors, injuries, hemorrhages.

Methods for diagnosing psychosis

Psychologist diagnoses psychosis. At the first appointment, he conducts a pathopsychological examination: he studies human behavior, asks questions to determine the process and course of thinking. It is necessary to understand how the patient reacts to the world around him. Relatives of a sick person are also involved in the diagnosis of psychosis - they will help to collect a complete clinical picture. Further diagnostics include

X-ray of the brain

MRI of the brain

Electroencephalogram

Blood test for hormones

Urinalysis for drugs and alcohol

Methods of treating psychosis

Psychosis is usually treated in a hospital setting. Such patients require hospitalization, as they cannot control their actions, they can harm themselves and others. The basis of therapy is taking medications, including:

Antipsychotics - stop psychosis, relieve delirium and hallucinations;
Atypical antipsychotics - restore neurochemical connections;
Nootropics - restore brain function, improve mental activity;
Normotimics - prevent the development of depressive and manic tendencies;
Antidepressants - relieve symptoms of depression.

Treatment of psychosis necessarily includes psychotherapy. The patient will have to work with a psychologist for a long time in order to successfully return to society. In some forms of the disease, an electroconstrictive effect is shown, in which the current restores the metabolic processes of the nervous system in the brain. A good effect in the treatment gives physiotherapy: acupuncture, exercise therapy, reflexology.

Prevention and treatment programs for psychosis at the Hadassah Clinic

Psychosis is a relapsing disease. With timely and comprehensive treatment, the prognosis will be favorable. However, the patient will have to undergo preventive examinations for several more years. If the patient follows all the recommendations of the doctor, the likelihood of exacerbations in the future will be minimal. To prevent the development of psychosis, you need to monitor your physical and mental health. For this:

Eat right and balanced;
Give up bad habits, especially alcohol and drug use;
Avoid stressful situations;
Avoid physical and psycho-emotional overload;
Seek medical attention for all head injuries;
See a therapist if necessary;
Observe the daily routine;
Communicate more.

Psychosis is a tricky and dangerous problem. And it is very important to notice it in time and start treating it. If you see signs of approaching psychosis in yourself or loved ones, you should immediately consult a doctor. You can make an appointment at the Hadassah clinic in Moscow, where experienced specialists will determine the cause of psychosis and select an effective treatment regimen.

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Published: 21.02.2023

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