Psychosis Treatment: How to Handle Drug-Induced Psychosis

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Psychosis is a frightening phenomenon that occurs when you lose contact with reality and experience delusions or hallucinations. It’s a symptom of bipolar disorder and schizophrenia, but several other causes exist. 

Psychosis has the ability to affect how someone thinks as well as their perceptions. Their senses will pick up on things that don’t exist, and they may find it challenging to distinguish the difference between truth and fiction. 

Someone with psychosis can experience the following:

  • See items or people that aren’t there.
  • Hear voices.
  • Smell odors others can’t detect.

The individual could also believe they’re in trouble, that someone is chasing them, or they’re very important in a situation when that’s not the case. The person is often unaware they have psychosis because the delusions seem real. Psychosis can be confusing and overwhelming. Sometimes, the symptoms will cause the individual to harm themselves. In rare cases, they could hurt someone else. 

Psychosis is one of the key symptoms associated with schizophrenia.

Symptoms of Psychosis

The signs of psychosis include the following:

  • Delusions: The person has a deep belief things are false, and they might have unfounded suspicions or fears.
  • Hallucinations: The individual hears, smells, tastes, sees, or feels things that don’t exist.
  • Catatonia: The individual becomes unresponsive. 
  • Disorganized speech, thinking, and behavior: The individual might jump between unrelated topics in thought and speech, making connections that seem illogical to other people. Their speech might make no sense to others. 
  • Unusual psychomotor behavior: The individual makes unintentional movements, such as tapping, pacing, or fidgeting.

The person could also experience:

  • Sleep problems
  • Mood changes
  • Difficulty focusing

Psychosis could appear quickly or slowly, depending on the cause. It might also be mild or severe. In some cases, it might show up mild but intensify with time. 

Early Signs

Earlier symptoms that indicate mild psychosis might include:

  • Depression
  • General anxiety
  • Problems focusing
  • Social isolation
  • Mild or moderate disturbances in thinking, energy levels, and language
  • Neglecting self-care
  • Sleep problems
  • Inability taking initiative 
  • Lower tolerance to stress
  • Ideas and thoughts that are strange to others
  • Feelings of suspicion

Hallucinations can affect all senses—smell, sight, sound, taste, and touch—in a person dealing with psychosis. 

Hearing Voices

Auditory hallucinations are considered the most common type of hallucination someone with schizophrenia will experience. The individual hears things they believe are real, even when they don’t exist. It’s common for the person to hear voices, and there may be several voices that sound exactly like a real voice. 

Hearing voices is often very confusing and could affect someone’s actions. It can also lead to the person harming themselves, and in some cases, others. 

Treatment can prevent psychosis and manage the symptoms, but it can also return if the person stops using their medication. There is also a heightened risk of suicide. 

Delusions During Psychosis

During a psychotic episode, it’s not out of the ordinary for a person to experience delusions. Paranoid delusions might cause someone to be suspicious of individuals or organizations, and the individual feels deeply that they’re being plotted against.

Delusions of grandeur involve strong feelings that the individual has extraordinary power or authority. For example, they might believe they’re a political leader.

Diagnosis of Psychosis

Anyone who experiences psychosis must seek urgent medical attention. Treatment will provide assistance in both the long- and short-term and could prevent any of the worst-case scenarios from occurring. If you notice symptoms in a loved one, you should reach out for help immediately. 

Early Diagnosis 

Bipolar disorder and schizophrenia typically appear in someone’s teenage years or during early adulthood. Early treatment will likely improve the long-term outcome, but it might take time for a healthcare professional to establish an accurate diagnosis. Psychiatrists will recommend the possibility of a psychotic disorder if a young person displays the following:

  • Changes in mood
  • Increased social withdrawal
  • Agitation or distress without an explanation
  • Increased social withdrawal

There isn’t a biological test for psychosis available, but laboratory tests can rule out medical problems that cause other symptoms. 

Diagnostic Tests

For a doctor to diagnose psychosis, they must carry out a clinical examination and ask several questions. They will ask about the following:

  • Family history of psychiatric illness
  • The person’s thoughts, experiences, and daily activities
  • Any recreational or medical drug use
  • Any other symptoms

They might also do tests to rule out other factors that include:

  • A head injury
  • The use of drugs or any other illicit substances
  • Other medical conditions, including a brain tumor or multiple sclerosis (MS)

Potential tests might include:

  • Urinalysis
  • Blood tests
  • An electroencephalogram (EEG) to record brain activity

If any of the signs indicate a psychiatric cause, doctors will refer to the criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), for a diagnosis.

how-to-handle-drug-induced-psychosis

Causes of Psychosis 

The specific causes behind psychosis aren’t well-understood but could include:

  • Hormones: Some individuals might experience postpartum psychosis after birth. Because of this, and that early signs of psychosis occur in adolescents, experts weighed in and said hormonal factors could play a role for those with genetic susceptibility. 
  • Genetic factors: Bipolar disorder and schizophrenia might share a common genetic cause. 
  • Changes in the brain: Those with psychosis might have differences in brain chemicals, specifically the activity of dopamine

A lack of sleep can also trigger psychosis. 

Treatments for Psychosis

Psychosis is often disruptive, and getting treatment is the only way someone can manage their symptoms. 

Antipsychotic Drugs

Antipsychotic drugs are the primary means of treating someone with a psychotic illness. Antipsychotics may reduce symptoms in those with schizophrenia, but they do not cure or treat the underlying condition. 

Examples of the medications used include:

  • Clozapine (Clozaril)
  • Haloperidol (Haldol)
  • Chlorpromazine (Thorazine)

You can only use these drugs under the guidance of a doctor since they can have adverse effects. The treating physician will also treat underlying conditions that are responsible for psychosis. When people, family support is also helpful.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy means regularly meeting with mental health counselors to change thoughts and behaviors. The approach is effective in helping individuals with these conditions achieve permanent changes and manage their illness. It’s helpful for psychotic symptoms that don’t completely resolve with medication. 

Rapid Tranquilization

A person experiencing severe psychosis will become agitated and at a much higher risk of hurting themselves or others. In this case, it’s necessary to calm them down quickly. The method is called rapid tranquilization. An emergency responder or doctor will administer fast-acting medication to relax the patient. Getting these situations under control before they escalate is imperative for the person’s safety with the condition and others around them. The consequences could be deadly.

Complications of Psychosis

If left untreated, it’s challenging for those experiencing psychosis to take care of themselves, which might lead to other illnesses going left untreated. Most individuals who experience psychosis can recover with the right treatment, even in the most severe cases. Fortunately, medication and therapy help as long as the person continues getting treatment. 

Recognizing the Symptoms of Psychosis

If you’re concerned that a loved one might be experiencing symptoms of psychosis, look for the following symptoms:

  • Delusions
  • Hallucinations
  • Not sleeping enough or sleeping too much
  • Depressed mood
  • Inability to concentrate
  • Suspiciousness
  • Withdrawal from friends and family
  • Anxiety
  • Depression
  • Disorganized speech – switching topics erratically 
  • Suicidal thoughts

Risk Factors for Developing Psychosis

The exact causes of who will develop psychosis are still not identifiable. However, we do know that genetics play a significant role. Individuals with family members like parents or siblings with a psychotic disorder are more likely to develop the condition. Children born with the genetic mutation 22q11.2 deletion syndrome are at an elevated risk of developing a psychotic disorder, particularly schizophrenia. 

What Are Delusions and Schizophrenia? 

Schizophrenia is a lifelong disease that’s accompanied by psychotic symptoms. The individual experiences distortions of reality and hallucinations or delusions. Some people believe it causes a “split personality,” but that’s not true. Schizophrenia can occur in women and men of all ages, and men often develop symptoms in their late teens and early 20s. Women exhibit signs in their late 20s and early 30s. 

Delusional disorder, previously called paranoid disorder, is a severe mental illness when a person can’t tell the difference between what’s real and imagined. The primary feature is the presence of delusions, which are beliefs that something is untrue. 

Sources

NIMH (February 2021) What Is Psychosis? from https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml

NHS (February 2021) Psychosis Symptoms. from https://www.nhs.uk/conditions/psychosis/symptoms/

NIMH (February 2021) Bipolar Disorder. from https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml

NAMI (February 2021) Schizophrenia. from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizophrenia

NCBI (August 2010) Early Signs, Diagnosis, and Therapeutics of the Prodromal Phase of Schizophrenia. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2930984/

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