Psychosis is a mental health condition that affects a person’s thoughts, emotions, and perception of reality. Identifying early warning signs can help individuals, friends, and family members recognize the need for professional help. Here, we will discuss key points to look out for and provide guidance on what to do when encountering these signs.
Understanding psychosis
Psychosis is characterised by a loss of contact with reality, including hallucinations, delusions, disorganized thinking, and changes in behavior. Anyone can experience psychosis and early intervention can help improve long-term outcomes. The following explains these terms, and gives examples of each:
Early Warning Signs
- Unusual beliefs (the medical term is delusions):
- Ideas that seem irrational or paranoid, e.g., believing that secret services are conducting surveillance on the person.
- They may hold strong convictions about supernatural experiences, or they may believe they have special abilities, e.g., that they can read other peoples’ minds, or end wars instantly.
- They may speak about the belief that they are an important historical or cultural person, completely at odds with their known identity.
- There are many other types of unusual beliefs, many of them are distressing and inhibit the person’s ability to live the kind of life that they want.
- Perceptual disturbances (the medical term for this is hallucinations):
- Hearing things that others don’t. Examples include hearing music, hearing voices whispering, talking, laughing, shouting, screaming, etc. Importantly, these experiences can be as real as all other everyday hearing is to the person. It is not in their imagination, and it can be very difficult for the person to distinguish between what is real and what is not. This can make it confusing and scary for the person with these experiences.
- Seeing things that others do not, e.g., seeing visions of objects, people, animals, lights or shapes.
- It can happen, but it is less common for people with psychosis to experience hallucinations in the other sensory modalities, e.g., tactile (e.g., feeling insects crawling under the skin), olfactory (smelling odours that others cannot) or gustatory (tasting things others do not).
- Disorganized thinking and speech (often termed formal thought disorder by health professionals). There are more than 20 sub-types, including:
- Poverty of thought: when people give brief, unelaborated responses to questions.
- Circumstantial speech: when excessive, irrelevant detail is included in speaking or writing. The person may stick to their original point but take some time getting to it.
- Derailment: talking in sequences of semi-formed ideas, e.g., jumping from talking about the weather to their favourite secondary school teacher, to the milk in the tea they are drinking.
- Thought blocking: interrupting themselves mid-sentence abruptly. This can last from seconds to minutes. Often, when speech resumes, the subject is changed.
- Neologisms: creating new words.
- Trouble concentrating:
- A decline in the ability to focus and concentrate may occur.
- Simple tasks that used to be manageable can become overwhelming or confusing for the individual.
- They may struggle to maintain attention for extended periods.
- Heightened sensitivity:
- Some individuals experiencing psychosis may become excessively sensitive to light, sounds, or touch.
- They may feel overwhelmed by sensory stimuli or perceive things differently than others.
- Emotional and behavioural changes:
- Sudden mood swings, irritability, or agitation.
- Social withdrawal or loss of interest in previously enjoyed activities.
- Changes in sleep patterns or appetite.
- Onset of new behaviours, or behaviours that would be unusual for that person, e.g., staying up all night online, when this was never a pattern before.
- Decline in functioning:
- Decline in academic or work performance.
- Neglecting personal hygiene or appearance.
- Difficulty carrying out daily tasks or maintaining relationships.
Finally, be mindful:
- Experiencing one or more of these early warning signs does not necessarily indicate psychosis. However, if these symptoms persist or significantly impact daily functioning, please seek professional help for proper evaluation and guidance.
What to DosWhen supporting a loved one during the at-risk, early or active phases of psychosis, it’s important to prioritize their safety and well-being. Here are some practical steps you can take to help keep them safe:
- Safety first:
- If there are any concerns about the safety of the person with suspected psychosis or anyone they have contact with, access crisis and emergency services immediately for advice. You can take the person to the emergency department of Al Amal or Al Rashid hospitals as they have psychiatrists on call 24/7.
- Ensure that the immediate environment is safe and free from any potential hazards. Remove any objects that could be used to harm themselves or others.
- Stay calm and reassuring:
- It’s important to remain calm and composed when interacting with your loved one. Speak in a reassuring and non-confrontational manner to help them feel more at ease.
- Reduce stress and overwhelming stimuli as much as possible. Create a calm and predictable environment by minimizing noise, bright lights, and chaotic situations.
- Recognize the signs:
- Educate yourself about the early warning signs of psychosis to better identify them.
- Trust your instincts and take any concerns seriously – time is a factor, so the earlier someone with suspected psychosis is seen professionally, the better.
- Encourage seeking professional help:
- Approach the individual in a supportive and non-judgmental manner.
- Express concern and suggest seeking help from a mental health professional.
- Help in finding a qualified psychologist or psychiatrist.
- Monitor medication:
- If your loved one is taking medication for their condition, ensure that they are taking it as prescribed. Monitor any side effects and communicate with their healthcare provider about any concerns or changes in symptoms.
- Promote self-care and emotional support:
- Encourage the person to engage in self-care activities, such as exercise, maintaining a healthy diet, and getting enough sleep.
- Encourage them to avoid alcohol or recreational drugs that can worsen symptoms.
- Provide emotional support by actively listening, validating their experiences, and offering reassurance. Instead of trying to help someone by contradicting their beliefs, it might be more helpful to acknowledge the distress caused by their beliefs, whether you share their views or not.
- Maintain supportive social connection:
- Foster an atmosphere of continued connection and empathy within the person’s social circle, if appropriate.
- Formal family work for psychosis (e.g., The Meriden Model of Behavioural Family Intervention) has shown that reducing 3 key communication styles within a family or social setting is shown to reduce the likelihood of further episodes of psychosis.
- Recovery from psychosis takes time and can involve setbacks.
- Offer patience, understanding, and support throughout the journey.
- Remember, supporting someone with psychosis can be challenging, and it’s essential to take care of your own well-being as well. Reach out to support networks, psychologists, or support groups to help you cope with the situation.
A final word
Recognising the early warning signs of psychosis is important for early intervention and improved outcomes. By familiarising ourselves with the signs and taking appropriate action, we can help individuals experiencing psychosis receive the necessary support and treatment needed to regain stability and well-being. Remember, seeking professional help is essential, and no one should face psychosis alone. I hope this has been useful to you.
Dr. James Hurley, Clinical Psychologist, Vivamus.
Call us (04 4403844) or drop us an email (hello@vivamus.me) if you’d like to make an appointment to see Dr. James Hurley.