Understanding Psychosis: Symptoms, Treatment, and Management

Psychosis symptoms, including hallucinations and delusions, affect approximately 3.5% of people and commonly occur in conditions like schizophrenia, though evidence-based therapeutic interventions combined with professional support can help individuals effectively manage symptoms and maintain daily functioning.

Have you ever worried about a loved one losing touch with reality? Understanding psychosis can feel overwhelming, but with proper support and treatment, there's hope for managing symptoms and rebuilding connections. Let's explore the facts behind this complex condition and discover the path forward together.

Is Psychosis A Lifelong Illness? Understanding The Facts

Psychosis isn’t considered a mental health disorder on its own. Rather, it’s a term used to describe a category of symptoms found in conditions like schizophrenia and other psychotic disorders. Psychosis may also occur in substance use and mood disorders like bipolar disorder or major depression with psychotic features. Individuals experiencing psychosis might have hallucinations, delusions, and disordered thoughts, speech, and behavior. Episodes often make it difficult for individuals to distinguish between what is real and what is not.

Psychotic disorders are relatively uncommon, with studies estimating a prevalence rate of roughly 1.5% to 3.5%. As such, scientists still have questions, and research on psychosis etiology, characteristics, and neurological underpinnings is ongoing. Psychotic conditions like schizophrenia spectrum disorders tend to be chronic and benefit from lifelong treatment. However, psychosis symptoms may be managed or reduced with appropriate intervention, often including therapy and medication when prescribed by appropriate medical professionals.

Psychosis treatment and management

Treating psychosis typically involves a combination of methods tailored to the needs of the individual. With treatment adherence and support from loved ones and healthcare professionals, reducing or completely eradicating symptoms of psychosis may be possible.

Therapeutic approaches

There are many types of psychosocial treatments that can help individuals manage symptoms and navigate the challenges associated with them. Cognitive-behavioral therapy (CBT) and other forms of psychotherapeutic treatment can help individuals with psychosis better understand their thoughts and behaviors and learn coping strategies to manage symptoms.

ReachLink’s licensed clinical social workers are trained to provide therapeutic support for individuals experiencing various mental health challenges, including those recovering from psychotic episodes. Our therapists work within their scope of practice to help clients develop coping strategies and build resilience.

Family therapy

Psychotic disorders typically affect every aspect of an individual’s life, but for many people, family life and relationships can be the most impacted. Family therapy is often an integral part of helping individuals with psychosis by working with their family members to learn coping, conflict resolution, and communication skills. Family therapy can cultivate greater empathy and understanding of mental illness so members can better support each other.

ReachLink offers comprehensive family therapy services that can help families navigate the challenges of supporting a loved one with mental health concerns, including psychosis. Our licensed clinical social workers create a supportive environment where families can learn effective communication strategies and develop a deeper understanding of their loved one’s experiences.

Supportive services

Case management, supported employment, and housing assistance can help individuals with psychosis live and manage their symptoms more independently. While ReachLink focuses on providing therapeutic services, our therapists can connect clients with appropriate community resources and provide guidance on accessing additional support services.

Education and skill-building

Psychoeducation programs can provide individuals with comprehensive information about the development of psychosis, how to manage a psychotic episode, treatment options, and more. Such programs typically teach individuals skills to manage symptoms and improve their quality of life.

Strategies for long-term management

For some people, psychosis symptoms subside on their own with short-term interventions. However, some individuals may work closely with a mental health professional to establish a long-term treatment plan. There are some supplemental ways that individuals with psychosis may manage symptoms on their own as well.

Self-care practices

Individuals with psychosis are often encouraged to prioritize self-care and cultivate a healthy lifestyle, including regular exercise, nutrient-rich eating habits, and adequate sleep. Because stressful situations can exacerbate psychosis symptoms, therapists may teach individuals stress management techniques to prevent relapse and support overall mental health and well-being.

ReachLink therapists emphasize the importance of self-care as part of a comprehensive approach to mental wellness. Through our telehealth platform, clients can access guidance on developing personalized self-care routines that complement their formal treatment.

Social support

Building a solid network of friends, family, and community can provide emotional support, encouragement, and understanding. Many individuals with psychosis find that peer-led group therapy tends to be a beneficial part of ongoing management. In group treatment, individuals can share experiences, successes, and tips for living with psychosis.

Psychoeducation

Staying informed about treatment options and self-management strategies through educational programs and resources can be helpful for individuals with psychosis. Psychoeducation can also be vital for reducing the stigma and misunderstanding often surrounding mental illnesses like psychotic disorders.

Routine monitoring

Regularly monitoring symptoms and overall mental health status may help individuals detect any notable changes or signs of impending relapse. Daily journaling and other reflective activities can be excellent ways to stay present and aware.

Goal setting

Setting realistic goals for personal growth, recovery, and well-being can be a productive supplement to treatment. Individuals may track their progress over time to stay motivated and focused.

Understanding psychosis

Psychosis symptoms often present differently between individuals. However, they typically emerge in the late teenage to early adult years. There tend to be core symptoms that arise in psychotic disorders, usually referred to as “positive” symptoms, because they tend to involve the acquisition of abnormal mental states that can be outwardly expressed. These include, but aren’t limited to, the following:

• Delusions: Delusions can be defined as false beliefs that are not reality-based. Delusions can be paranoid (believing others are conspiring against you), grandiose (believing you have special abilities or powers), or neutral. Individuals with psychosis typically continue to hold delusional beliefs despite evidence that they aren’t true.
• Hallucinations: Hallucinating generally refers to seeing, hearing, feeling, smelling, or tasting stimuli that are not actually there. Common hallucinations can include hearing voices (auditory), seeing what others don’t (visual), or feeling sensations on the skin (tactile).
• Disorganized thoughts and speech: Disorganized symptoms usually refer to difficulty organizing thoughts, constructing coherent sentences, or connecting ideas logically. In many cases, this symptom can emerge in the form of speech that is incoherent or difficult to follow. Colloquially, this is sometimes referred to as “word salad.”
• Disorganized behaviors: When a person displays disorganized behavior, they may act in an unusual, unpredictable, or inappropriate way for the situation. This behavior can include agitation, catatonia (absence of movement or response to outside stimuli), or unusual mannerisms.

Some psychotic disorders also feature “negative” symptoms labeled as such because they represent a decrease in activity, unlike the core “positive” symptoms. These symptoms can include a loss of motivation (avolition), social withdrawal (asociality), reduced emotional expression (blunted affect), and a reduced ability to experience enjoyment or pleasure (anhedonia). Often, individuals experiencing psychosis symptoms also have cognitive impairments associated with executive function, memory, problem-solving, and concentration.

Psychosis diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides diagnosis criteria for mental health disorders. Criteria for psychotic disorders can vary between conditions, but there are a few critical criteria that apply to most of them:

• Two or more positive or negative symptoms must present for a significant portion of time during a one-month period.
• Symptoms must impact an individual’s function in one or more primary areas, such as work, relationships, or self-care.
• Symptoms must persist continuously for a period of at least six months, including at least one month of active-phase symptoms (including prodromal or residual symptoms).
• The effects of a substance, medication, or a medical condition cannot better explain symptoms.

Portions of these criteria may not apply to some psychotic disorders. For example, schizophreniform and brief psychotic disorders often have different onset criteria. In addition, some psychotic disorders can be characterized by additional symptoms that must be present for diagnosis. For instance, schizoaffective disorder can also feature symptoms of major depression or mania.

Psychotic disorders

The DSM-5 lists several conditions under the category of disorders characterized by symptoms of psychosis.

Schizophrenia

Schizophrenia can be defined as a severe mental health condition featuring psychotic symptoms and the breakdown of one’s relationship with reality. Individuals with schizophrenia may experience isolation and withdraw from daily life and relationships as symptoms worsen. Schizophrenia symptoms typically present in stages:

• Prodromal: Marked by the emergence of negative symptoms, individuals in this phase might become depressed, lose interest in previously enjoyed activities, and avoid social interaction.
• Acute: People often experience psychosis symptoms during this phase, including delusions and hallucinations. Individuals in this phase might display unusual speech and behaviors.
• Residual: Negative symptoms tend to reemerge during this phase as positive symptoms recede.

Schizophreniform disorder

Schizophreniform disorder tends to be similar to schizophrenia, but symptoms are typically milder. The condition usually features positive and negative symptoms in the prodromal, acute, and residual phases. While two or more core symptoms must be present over one month for schizophreniform disorder, clinicians might reassess the possibility of schizophrenia if symptoms persist for six months or longer.

Schizoaffective disorder

This disorder typically features symptoms of psychosis similar to schizophrenia with the addition of severe depression, mania, or both. The disorder is normally categorized into two types:

• Schizoaffective bipolar type: This disorder usually features extreme “highs” and episodes of mania, often alternating with episodes of major depression in addition to psychosis symptoms.
• Schizoaffective depressive type: This disorder may only feature major depressive symptoms along with psychosis.

Delusional disorder

Delusional disorder features the presence of “non-bizarre” delusions defined as those involving conditions that could realistically occur. For example, one may experience delusions that they’re being stalked or followed, have been betrayed by a loved one, or are living with a chronic disease. In delusional disorder, one or more delusions must be present for one month or more. Hallucinations aren’t usually the most prominent symptom, and sensory experiences tend to be associated with a corresponding delusion.

Brief psychotic disorder

Brief psychotic disorder tends to be characterized by shorter episodes of psychosis, usually lasting for at least one day but less than one month.

Other psychotic disorders

Substance or medication-induced psychosis and psychotic disorder due to another medical condition can fall under the category of psychotic disorders, as can unspecified schizophrenia spectrum and other psychotic disorders.

Finding support for psychosis

Though psychosis isn’t necessarily lifelong, individuals may experience relapse without appropriate treatment. Even with support, challenges associated with accessibility, scheduling, and affordability may present barriers to essential treatment for people with psychosis and their families.

While ReachLink’s licensed clinical social workers can provide valuable therapeutic support for individuals recovering from psychotic episodes or managing ongoing mental health challenges, it’s important to understand that our services complement rather than replace comprehensive psychiatric care. For individuals experiencing active psychotic symptoms, a combination of psychiatric services (for evaluation and possible medication) and therapeutic support often provides the most effective approach.

Virtual therapy through ReachLink can be particularly helpful during prodromal and residual phases, or as part of a maintenance plan developed in collaboration with psychiatric providers. Our telehealth platform offers greater accessibility, flexible scheduling, and affordability while connecting clients with experienced licensed clinical social workers who can provide evidence-based therapeutic interventions.

Important Note: ReachLink does NOT provide prescription medications or pharmaceutical services of any kind. Our licensed clinical social workers are qualified to provide therapeutic counseling but do not prescribe or manage medications. Clients requiring psychiatric medications should seek those services from qualified medical professionals such as psychiatrists or primary care physicians.

Takeaway

Psychosis can create significant challenges in every aspect of an individual’s life. While disorders like schizophrenia, which feature symptoms of psychosis, are typically chronic, meaning they are lifelong and require ongoing treatment, eliminating or effectively managing psychotic symptoms with various interventions may be possible. A comprehensive approach often includes psychiatric care for evaluation and possible medication, regular therapy sessions with qualified professionals like ReachLink’s licensed clinical social workers, lifestyle changes, and support groups. With the right combination of treatments and support, many individuals with psychotic disorders can lead fulfilling, meaningful lives.

FAQ

• What are the early warning signs that someone should seek professional help for potential psychosis?

  Early warning signs that warrant seeking professional help include significant changes in thinking patterns, difficulty distinguishing reality from non-reality, social withdrawal, declining performance at work or school, and changes in self-care habits. It's important to connect with a mental health professional as soon as these signs appear, as early intervention through therapy can lead to better outcomes.

• How does therapy help in managing psychosis symptoms?

  Therapy, particularly Cognitive Behavioral Therapy (CBT), helps individuals develop coping strategies, identify triggers, manage stress, and improve reality testing. Therapeutic approaches can help people understand their experiences, develop stronger problem-solving skills, and build resilience. Therapy also provides a safe space to process experiences and work toward recovery goals.

• What role do family members play in supporting someone experiencing psychosis?

  Family members play a crucial role in the support system. Through family therapy, they can learn effective communication strategies, understand how to provide appropriate support, and develop skills to help their loved one maintain stability. Family involvement in therapy can improve outcomes by creating a more supportive and understanding home environment.

• How can online therapy support ongoing psychosis management?

  Online therapy provides convenient, consistent access to mental health support from the comfort of home. Virtual sessions can help maintain regular therapeutic contact, practice coping skills, and address challenges as they arise. This ongoing support is valuable for long-term management and recovery, especially when in-person visits might be challenging.