Before we learn about psychosis treatment, we must first understand what it is. Psychosis is a symptom of mental illness that affects the mind, where there has been some loss of contact with reality. During the period of psychosis, an individual may have difficulty perceiving what is real and what is not. According to the National Institute of Mental Health, approximately 3% of Americans will experience psychosis at some point in their lives. While there is not a specific cause of psychosis, it is thought to be a symptom of mental illness, such as schizophrenia or bipolar disorder. It has also been attributed to sleep deprivation, some general medical conditions, certain prescription medications, and alcohol and drug use.
What are the symptoms of psychosis?
Individuals will typically show changes in their behavior before psychosis develops. A person might experience one symptom of psychosis or multiple symptoms. For example, a slight shift in someone for a few days might be attributed to sleep deprivation or stress but persisting symptoms might warrant a mental evaluation. The following are some of the symptoms of psychosis:
- Hearing or seeing something that other people cannot hear or see
- A persistent feeling of being watched
- Disorganized or bizarre speech or writing
- Inappropriate or unusual behavior
- Strange body movements or positioning
- Feeling indifferent or numb about important situations
- Deterioration of academic or work performance
- A change in personal hygiene and appearance
- A change in personality
- Increasing withdrawal from social situations
- Irrational, angry or fearful response to loved ones
- Inability to sleep or concentrate
- Extreme preoccupation or fears that seem bizarre
Someone suffering from a psychotic episode may also feel depressed, anxious, or have difficulty with overall functioning.
How is psychosis treated?
At Pasadena Villa, 15-20% of our clients have experienced some level of psychosis. Psychosis can be effectively treated, and early intervention increases the chances of a successful outcome. We have found success in starting with medication management as the first step, followed by supportive therapy.
Cognitive Behavioral Therapy (CBT) is typically used because it focuses on thoughts, and psychosis is often associated with thought disorders. Recognizing they are in psychosis often proves to be a challenge for these individuals, as their entire brain is geared towards proving their hallucination or delusion is real or fact. One of the primary skills taught to help counter this way of thinking is reality testing, which teaches an individual to determine between reality and fantasy based on careful examination of the evidence.
Primary Therapist, Bryce Schalk, says, “Treatment can be step oriented, but for individuals with psychosis you need to be free-flowing, because they come into treatment at different points. It is vital to meet the resident where they are when they admit and walk with them in their journey. As treatment progresses it becomes more structured and increasingly based solely in reality.”
Individuals suffering from psychosis often have a difficult time in social situations, making group therapy counterproductive in certain cases. In the beginning, individual therapy tends to be more effective as they learn the behaviors that work successfully in social situations. As someone begins to stabilize, group therapy can be gradually introduced.
Pasadena Villa’s Social Integration Model can be tailored to individuals experiencing psychosis in a variety of ways. Often, the increased stimulation of being in crowded places, such as restaurants or various attractions, can worsen psychotic symptoms. Therefore, treatment strives to create successful situations by carefully choosing and controlling the environment. Low stimulus, high success environments within which residents can participate include parks—Pasadena Villa’s Smoky Mountain Lodge is located just one mile from Smoky Mountain National Park—quiet, uncrowded restaurants, outdoor cafes, hiking trails and other such venues.
Our approach in treating psychosis seeks to be collaborative with the individual. Although someone is experiencing psychotic episodes, they are continuing to develop memories, making a collaborative and compassionate approach vital to recovery. Bryce adds, “These individuals often experience barriers in society. It can be healing for them to be in an environment where someone is not confronting them about their delusions or hallucinations but instead taking an approach to help them where they are in that moment. This healing relationship combined with medication management and therapy helps them work through their psychosis in a healthy, productive manner.”