This section covers what psychosis is and how you can get treatment. You might find this information useful if you experience psychosis. Or if you are a carer, friend or relative of someone who does. Show
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Overview
Need more advice?If you need more advice or information you can contact our Advice and Information Service. AboutWhat is psychosis?Psychosis is a term used to describe when a person interprets or perceives reality in a different way to those around them. If you experience psychosis, you may process the world around you differently to other people. You might see or hear things that others do not. Or believe things other people do not. Some people describe psychosis as a "break from reality". There are different terms used to describe psychosis. Such as “psychotic symptoms”, “psychotic episode” or “psychotic experience”. If you are experiencing psychosis for the first time, this can sometimes be called “first-episode of psychosis”. Traditionally psychosis has been seen as a symptom of mental illness. But this isn’t necessarily the case. Psychosis is not always because of a mental illness. There are many theories about what causes people to experience psychosis. You may not find it helpful to think of your experiences as symptoms of a mental illness. You may have a different reason as to why you experience psychosis. For example, due to traumatic experiences you may live with psychosis. The way you experience psychosis may be different to the way someone else experiences psychosis. Some people make a complete recovery from psychosis. This page will use the word ‘experiences’ to describe what you may go through if you have psychosis. In mental healthcare, your experiences may be referred to as ‘symptoms of psychosis’. Common symptoms of psychosis are:
These symptoms are described in further detail below. HallucinationsThese are when you see, hear, smell, taste or feel things that other people don’t. For example:
Hearing voices or other sounds is the most common type of hallucination. For example, voices may be:
You might hear voices sometimes, for example only for a few minutes, once a month. Or you may hear voices everyday that last for hours at a time. DelusionsThese are unusual beliefs that other people within your community do not share, even though they feel real to you. For example, you may worry:
There are different types of delusions that people experience. For example, you may think you are a very powerful person or that you’re God. These kinds of thoughts are called 'delusions of grandeur'. You may not always find delusions or your unusual beliefs distressing, although people often do. You may be able to stay in work and function well even if you have these worries. Cognitive impairmentsCognitive impairments are ones that relate to mental action. Such as learning, remembering and functioning. Some cognitive impairments associated with psychosis are:
CausesWhat causes psychosis?Nobody knows exactly what causes psychosis, researchers have not identified one single cause. There are different reasons why you may experience psychosis. It is thought that most people who experience psychosis, it is due to their life experiences. Which are largely out of their control. , Psychosis can be:
Some people also experience hallucinations if they are very tired. Research shows men from Black, Asian and Minority ethnic (BAME) backgrounds are more likely to experience psychosis. In addition to this, research also suggests that voice hearing experiences are different across different cultural backgrounds. Below we have described in further detail about how life experiences, genetics and brain chemicals may lead to psychosis. Life experiencesThere is evidence that stressful life experiences can cause psychosis. In particular, abuse or other traumatic experiences. A review found that over ½ of clients that were in hospital for mental health problems had either been physically or sexually abused as children. As stated, research suggests there are many different types of life experiences that can trigger psychosis or make you relapse. These include:
Genetic causesResearch suggests that mental illness can run in families. But at the moment it isn’t possible to separate genetics and life experiences to work out the cause of mental illness. Brain chemicalsResearch suggests that changes to your brain chemistry can cause psychosis. But it’s not known why the chemicals in your brain change. For more information see our webpages on the following:
Linked conditionsWhat mental health conditions are linked with psychosis?Psychosis can be a one-off experience or part of a mental health condition. Some conditions psychosis can be related to are:
Below we have explained how psychosis can be linked to these mental health conditions in further detail. For more information about psychosis linked to neurological conditions or brain injuries, please look at the “Useful Contacts” section at the bottom of this page. SchizophreniaYou may get a diagnosis of schizophrenia if you experience a mixture of what medical professionals call ‘positive symptoms’ and ‘negative symptoms’. You may experience both negative and positive symptoms as described below. Positive symptoms
Negative symptoms
Bipolar disorderBipolar disorder can be a life-long mental health problem that mainly affects your mood. Your mood can change massively. You may experience episodes of mania and depression. If you experience manic symptoms, you may also experience psychosis. For example, you may experience grandiose delusions. This means that you may believe that you are able to achieve something which can’t be achieved. For example, you may believe you have special powers or are on a special mission. Not everyone with bipolar will experience psychosis. And you may feel well between episodes of mania and depression. When your mood changes, you might see changes in your energy levels or how you act. Schizoaffective disorderSchizoaffective disorder is a mental illness that can affect your thoughts, mood and behaviour. You may experience symptoms of both bipolar and psychosis. Drug induced psychosisPeople who use or withdraw from alcohol and drugs can experience psychosis. In rare situations side effects of medication can cause psychosis. Also taking too much medication can cause psychosis. Depression with psychotic symptomsYou may experience symptoms of psychosis if you live with severe depression. Severe depression means that your symptoms are more severe than someone who has mild or moderate depression. If you have a diagnosis of depression, you may:
Postpartum psychosisIf you experience symptoms of psychosis after giving birth, this is known as postpartum psychosis. This can also be known as puerperal psychosis. This is a rare condition and it’s most likely to happen suddenly within 2 weeks of giving birth. If you experience postpartum psychosis, you may:
This is a serious mental health condition and should be treated as an emergency. If you don’t get treated quickly there is a risk that your mental health could deteriorate fast. You are likely to make a full recovery as long as you get the right treatment. You may be admitted to a mother and baby unit for support. Delusional disorderYou may have a delusional disorder if you have a firmly held belief or beliefs that other people within your community do not share. These are likely to be constant and lifelong beliefs. You are unlikely to hear voices with this disorder. Brief psychotic episodeYou will experience psychosis for a short period of time. Often this is linked to extreme stress. But this is not the case all of the time. Your experience of psychosis will usually develop gradually over a period of 2 weeks or less. You are likely to fully recover within a few months, weeks or days. For more information see our webpages on the following:
Help & treatmentHow do I get help if I am experiencing psychosis?You may decide to get help for your experiences. The earlier you seek help, the better the chances of getting effective treatment. You can get help from:
How can the NHS help me?You can speak to your GP about your concerns. They will be able to talk to you about treatment options and coping strategies. You don’t have to do what your GP thinks that you should do, but you should listen to their advice. Make sure that you understand the pros and cons of your treatment options before you make a decision. Your GP should not give you antipsychotic medication without first talking to a psychiatrist. Your GP should refer you to a secondary mental health team if this is the first time that you have asked for help. You should be assessed quickly. A secondary mental health team will usually be called the:
You or your carer can often make a self-referral to a secondary mental health team if this is the first time that you have experienced psychosis. EIT’s specialise in helping people who experience psychosis for the first time. But they aren’t available in all areas of England. To find your local secondary mental health team you can try the following.
Please look at the following section, ‘What treatment should the NHS offer me?’ for more information. Support under the care programme approach (CPA) Support for physical health Because of the increased risk you should have regular physical health checks. Such as a full health check including weight, blood pressure and other blood tests when you start antipsychotic medication. It could also include:
How can adult social services help me?Your local authority is responsible for your social care and support. The social services team are part of the local authority. If you need help and support to look after yourself then you can have an assessment by social services. For example, you may need support so that you can:
What other help is available?Charities You can look on our website www.rethink.org to see if we have any support groups or services in your area. Click on ‘Help in your area’ at the top of the webpage. Some of the other national mental health charities are:
You can look on their websites to see what support they offer in your area. If you would like us to look for you, please contact our advice line on 0808 801 0525. Self-help
What treatment should the NHS offer me?The National Institute for Health and Care Excellence (NICE) recommend that you should be offered antipsychotic medication and talking therapy if you experience psychosis. If you decide not to take medication you should still be offered talking therapy. NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at www.nice.org.uk. Your GP may refer you to a specialist mental health team such as the early intervention team (EIT), community mental health team (CMHT), or crisis team. MedicationAntipsychotic medication can help with psychosis. Your doctor should give you information about antipsychotics including side effects. You and your doctor should choose the medication together. Some people find they do not start to recover until they get the right medication. It is important to take the medication every day to help your symptoms. Try not to be too upset if the first antipsychotic that you try doesn’t help. There are lots of different antipsychotics to try because people respond better to different medications. Some may not improve your symptoms and may cause side effects. You can discuss your medication with your doctor if your medication is not working. Or you are finding the side effects hard to deal with. There might be another medication that will suit you better. Doctors should check that your medication is working. They should also give you a physical health check 12 weeks after the start of medication and then at least once a year. Some antipsychotic medication can make you put on weight. So, your weight should be monitored each week for the first 6 weeks. There is a high risk of relapse if you stop taking medication within the first 1 to 2 years, following your first episode of psychosis. Talking therapiesThere are different types of talking therapies recommended for people who have psychosis. Cognitive behavioural therapy for psychosis (CBTp) What is CBTp?
CBTp aims to:
Family intervention The support that you and your family and friends are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions. Your family should get support for 3 months to 1 year and should have at least 10 planned sessions. Family intervention could help you and loved ones to:
Art therapy You will have art therapy with a therapist which usually takes place in a group. It is there to mix different communication techniques with creativity. Art therapy aims to help you to:
Therapy for trauma For more information see our webpages on the following:
What if I am not happy with my treatment?If you are not happy with your treatment you can:
There is more information about these options below. Treatment optionsYou should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try. Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you. Second opinionA second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis. You don’t have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion. AdvocacyAn advocate is independent from mental health services. They are free to use. They can be useful if you find it difficult to get your views heard. There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. You can search online to search for a local advocacy service. If you can’t find a service you can call our advice service on 0300 5000 927. We will look for you. But this type of service doesn’t exist in all areas. The Patient Advice and Liaison Service (PALs)PALs are part of the NHS. They give information and support to patients. You can find your local PALs details through this website link: www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363. ComplaintsIf you can’t sort your problem, you can make a complaint. This is where your concerns are investigated in further detail. You can ask a member of your health team to explain how to make a complaint You can ask an advocate to help you make a complaint. Advocates that do this are called Independent Health Complaints Advocates. They are free to use and don’t work for the NHS. For more information see our webpages on the following:
Managing psychosisWhat can I do to manage psychosis?People deal with their experience of psychosis in different ways. You might need to try different things before finding something that works best for you. Support groupsYou could join a support group. A support group is where people come together to share information, experiences and give each other support. Hearing about the experiences of others can help you feel understood. This may help you feel less alone and boost your self-confidence. You might be able to find a local group by searching online. The charity Hearing Voices Network have face to face support groups in some areas of the country. Their contact details are in the ‘useful contacts’ at the bottom of this page. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area, or get help to set up your own support group if you follow this link: www.rethink.org/about-us/our-support-groups. Or you can call our advice service on 0808 800 0525 for more information. Recovery CollegeRecovery colleges are part of the NHS. They offer free courses about mental health to help you manage your experiences. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college. But please note the recovery college may tell your care team that you have been in touch. Unfortunately, recovery colleges are not available in all areas. To see if there is a recovery college in your area you can use a search engine such as Google. Or you can call our advice service on 0808 800 0525 for more information. Peer support through the NHSYour doctor may refer you to peer support. Peer support is when you work with someone who has lived experience of psychosis and are now in recovery. Your peer supporter should be able to offer advice and support with:
Self-management techniquesManaging your condition on your own is called self-help. Health professionals may offer you help to manage your condition on your own. They may call this a self-management programme. You can try some of the suggestions below to manage or cope with upsetting experiences.
Taking control of the voicesIf you hear voices, you could:
Talk back to them You could set a time each day to listen to and answer the voices. If the voice you hear is distressed and angry, you could try speaking to it in a calming voice. Some people find it helpful to visualise the voices. If you are worried about talking back to your voices in public, you could pretend you are speaking to someone on the phone. Some people have found that wearing a face mask when they’re outside is also helpful when responding to voices. If you start to talk back to the voices, you may find that they don’t like the change. Standing up to voices that frighten or bully you can be tough. You may find it helpful to have talking therapy to help you to take the power away from the negative voices. Distract yourself Concentrating on a task such as a household chore or hobby may also help to distract you from the voices. Keep a diary
Keeping a diary may help you to notice patterns and if anything, you are doing is making them worse. This may help you to find new ways to cope with them. For example, some people who spend a lot of time alone may hear voices. You could therefore try spending time with others to stop the voices for a period of time. A diary may also help you to talk about your voices with your therapist and help you identify any triggers. Use a mobile app www.hearingvoicescymru.org/hearing-voices-app-a-guide-to-understanding-helping-and-empowering-individuals/ For more information see our webpages on the following:
Information for carers, relatives and friendsInformation for carers, friends and relativesIt can be very distressing if you are a carer, friend or relative of someone who experiences psychosis. You can get support. How can I get support for myself?You can do the following.
What is a carers assessment? The CMHT or the early intervention in psychosis team (EIT) should tell you about your right to have a carers assessment through your local authority. To get a carer’s assessment you need to contact your local authority. How do I get support from my peers? How can I support the person I care for?You can do the following.
What is a care plan? A care plan should always include a crisis plan. A crisis plan will have information about who to contact if they become unwell. You should be given information about what to do in a crisis. You can use this information to support and encourage them to stay well and get help if needed. Can I be involved in care planning? What can I do if my friend or family member is
in crisis? If you think that your friend or family member is a risk of harm to themselves or others you can:
Nearest relative is a legal term under the Mental Health Act. It is different to ‘next of kin.’ Your nearest relative has certain rights. What is a Mental Health Act Assessment? How do I ask for a Mental Health Act assessment? An AMHP works for social services but can often be found through the community mental health team (CMHT) or mental health crisis team. It is best if the request comes from your friend or family members nearest relative. The only way to give someone treatment who doesn’t want it is through the Mental Health Act. Your friend or family member will only be detained under the Mental Health Act if they are assessed as a high risk to themselves or other people. There is no definition for what high risk means. It could include:
Think about the following questions:
Because of the stress involved in detaining someone it is usually the best option if your friend or family member can be encouraged to get the help for themselves, such as through their GP. There is no extra care available whilst detained, compared to in the community. For more information see our webpages on the following:
Further readingBack to Life, Back to Normality: Cognitive Therapy, Recovery and Psychosis by Douglas Turkington et al. (Cambridge University Press, 2009) This is a self-help guide for people who experience psychosis and their carers. It helps readers use Cognitive Therapy techniques to control their symptoms and delay or prevent becoming unwell again. The First Episode of Psychosis: A guide for patients and their families by M. Compton & B. Broussard (OUP USA, 2010)
Website: www.meandmymind.nhs.uk/ Rufus May Website: www.rufusmay.com Caring for someone with psychosis or schizophrenia Website: www.futurelearn.com/courses/caring-psychosis-schizophrenia Useful contactsThe Royal College of Psychiatrists Telephone: 0208 618
4000 The Hearing Voices Network (HVN) Address: National Hearing Voices Network (HVN), 86-90 Paul Street, London, EC2A 4NE Action on Postpartum Psychosis Phone: 020 33229900 Intervoice Address: Barnes House, 9-15 Camden Road, London, NW1 9LQ Headway Telephone: 0808 800 2244 Alzheimer’s UK Telephone:
0333 150 3456 Need more advice?If you need more advice or information you can contact our Advice and Information Service. How long does it take for brain to heal from psychotic break?Psychosis involves experiencing something that is not really happening and having a difficult time distinguishing what is real. The three stages of psychosis are prodome, acute and recovery. Psychotic disorders can last for a month or less and only occur once, or they can also last for six months or longer.
How do you recover from a psychotic break?There are several possible psychological treatments.. 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. ... . Family intervention. ... . Self-help groups.. How long does it take psychosis to resolve?In about 60% of cases psychotic symptoms resolved within one month of terminating illicit drug use, in about 30% of cases the psychotic symptoms persisted for 1 to 6 months after stopping illicit drug use and in about 10% of cases psychotic symptoms persisted for more than 6 months after stopping illicit drug use.
Can a psychotic break be permanent?Psychosis is a symptom and therefore temporary; however, if not treated early, it may develop into more intense experiences, including hallucinations and delusions. Psychosis can also be a sign of a mental health condition, such as schizophrenia or bipolar disorder.
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