What Are the Early Warning Signs of Psychosis?

If you or a loved one is experiencing the signs of a psychotic episode it can be an extremely frightening experience. Psychosis refers to a loss of contact with reality, when perceptions are altered to the point that it is difficult to know what is real or a figment of the imagination. A psychotic break often constitutes an urgent psychiatric event that necessitates acute stabilization within a hospital setting.

Psychosis is a symptom of a mental or physical illness, trauma, or substance abuse, and not an illness itself. In most cases, there are symptoms that precede the psychotic episode. There might be gradual changes in the individual’s usual behavior or demeanor that foretell the onset of the psychosis. So, what are the early warning signs of psychosis?

What Are the Early Warning Signs of Psychosis?

In most cases, psychosis does not just appear out of the blue one day. There are certain warning signs, although non-specific at first that usually precede a psychotic episode or psychosis. These include:

• Depressed mood
• Sleep disturbance
• Inattentive to personal hygiene
• Social withdrawal, isolating behaviors
• Decline in functioning at work, at school, or in self care
• Anxiety
• Difficulty concentrating
• Mood swings
• Feeling uneasy around others
• Difficulty communicating thoughts
• Having strong inappropriate emotions or no emotions at all
• Fatigue, decreased motivation
• Difficulty managing daily stress

While these symptoms are not necessarily specific to the onset of psychosis, they do provide an opportunity to see a doctor so further evaluation can be conducted. If wondering what are the early warning signs of psychosis, and recognizing them here in this list, it is appropriate to be assessed.

The next level of early warning signs of psychosis include:

• Acquiring odd beliefs or expressing magical thinking. This can include claiming to experience déjà vu frequently, thinking that others can read their thoughts, or thinking that a dream is actually reality.
• Being suspicious and mistrustful of even of friends, family members, teachers, thinking they are out to get you or are watching you
• Going off on tangents in conversation, odd speech patterns, talking in circles, talking to self
• Perceptual incongruence. This includes claiming to see shadow people, sounds seeming louder that usual

When these “attenuated” symptoms worsen over the course of a year there is a possibility that the person is at risk of developing psychosis.

Symptoms of Psychosis

While psychosis encompasses a wide range of symptoms, two primary characteristics define it. These include

Hallucinations: A hallucination is the experience of hearing, seeing, or feeling something that is not actually there. This can include hearing voices, seeing glimpses of people or objects that are not really there, or feeling strange sensations.

Delusions: Delusional thinking involves having strong convictions and beliefs that are inconsistent with the individual’s cultural identity, and are likely to be false. This includes such things as thinking some external power or force is controlling behaviors and thoughts, or that the individual him or herself has special powers, or believes that they are God.

Psychotic Disorders

When a mental health condition has psychosis as a primary symptom, it is then classified as a psychotic disorder. About 3.5% of the population will experience psychosis at some point, according to an article published in JAMA Psychiatry. Although psychotic disorders are among the most complex mental health disorders to treat, with a comprehensive approach to treatment, an individual with a psychotic disorder can learn to manage many of the symptoms in day-to-day life.

The different types of psychotic disorders include:

• Schizophrenia, which may involve hearing or seeing things that are not there, delusional thoughts, erratic behavior, angry outbursts, moodiness.
• Schizophreniform disorder is like schizophrenia but is a temporary disorder lasting one-six months in duration, and tends to affect teens and young adults.
• Schizoaffective disorder, which combines features of schizophrenia with a mood disorder involving depressive or manic episodes.
• Delusional disorder is characterized by false beliefs that the individual truly believes are true, such as thinking someone is out to murder you or your spouse is having an affair, for example, which lead to impairing behaviors.
• Brief psychotic disorder is a short-lived disorder that is sometimes triggered by a traumatic event, such as the death of a loved one or a car accident that lasts less than one month.
• Shared psychotic disorder is one that involves two people who both believe in a delusional situation, such as a husband and wife who both believe the same absurd delusion.
• Substance induced psychotic disorder is the presence of hallucinations or delusions occurring as a withdrawal symptom for several drugs, including alcohol, LSD, opioids, cocaine, benzodiazepines, amphetamines, and PCP.

What Causes Psychosis?

Psychosis is still being studied therefore the exact cause of the condition is still unknown. However some factors are thought to increase the risk of developing psychosis, including:

• Mental illness. Psychotic features are present among the mental health disordered listed above.
• Health conditions. Some illnesses, such as Parkinson’s disease, Alzheimer’s disease, brain tumors, strokes, HIV, and traumatic brain injuries may cause psychosis.
• Substance abuse. Hallucinogenic substances such as LSD, marijuana, and PCP can cause psychotic reactions and may increase the risk of psychosis in some individuals. Amphetamines and some prescription medications can also have these side effects.
• Trauma. Some traumatic events, such as a sudden death, sexual or physical assault, or military combat can possibly contribute to developing psychosis.

A psychotic episode or psychotic break refers to the onset of the prevailing symptoms of psychosis, such as delusions and hallucinations.

How is Psychosis Treated?

Treatment for psychosis is multidimensional. If the individual experiences a severe psychotic break, hospitalization will be necessary in order to subdue the individual with acute stabilization procedures. In this event, the patient is segregated from other patients and may need to be restrained initially to reduce the risk of harm to self or others.

Most individuals with the symptoms of psychosis will likely be treated through their mental health provider. Private practice interventions include medications, such as antipsychotic drugs. These include risperidone, olanzapine, ziprasidone, zotepine, sertindole, clozapine, aripiprazole, and amisulpride. These medications help to tame the overt symptoms of the condition.

The individual will also benefit from outpatient therapy that focuses on managing thoughts and behaviors. Psychotherapy might include cognitive behavioral therapy, family therapy, and psychoeducation efforts.

Living with psychosis can be challenging, as it impacts relationships, daily functioning, and the quality of life. There are some specialized services available, such as Early Psychosis Intervention Clinic (EPIC) that can significantly improve functioning.

Residential Treatment for Mental Illness

If outpatient treatment options have not managed the symptoms adequately, or the symptoms continue to worsen, it is appropriate to consider a higher level of care. This becomes evident when the individual is struggling to perform even basic functions, has become isolated, has developed a co-occurring substance use disorder, or is vulnerable to exploitation, abuse, or suicide. Residential treatment provides the more intensive and targeted treatment protocols within a safe, structured setting.

Residential treatment encompasses the following interventions:

Medication management. Medication will be prescribed depending on the specific diagnosis. In many cases medication will include antipsychotics, benzodiazepines, antidepressants, and mood stabilizers. For some individuals with a psychotic disorder, these medications will necessary to help manage the disorder on a daily basis, and will likely be prescribed for a lifetime.

Psychotherapy. While in a residential treatment the individual will be involved in various types of psychotherapy. The focus for therapy involves helping the individual recognize irrational thoughts and behaviors and to replace those with healthy thought-behavior patterns. Types of psychotherapy suited for psychosis include:

• Cognitive behavioral therapy
• Cognitive enhancement therapy
• Social recovery therapy

Family psychoeducation. Family-focused therapy can assist family members by guiding them toward forming healthy boundaries, learning more effective communication techniques, and generally teach the family how to resolve conflicts and solve problems together.

Holistic therapy. Holist therapies are often utilized as complementary treatment for psychosis or other mental health disorders with psychotic features. Activities such as yoga, mindfulness training, guided meditation, acupuncture, and massage therapy are helpful in controlling stress and promoting relaxation. Patients can learn how to initiate mindfulness exercises on their own at any time of day, which is helpful when sudden symptoms emerge.

There are intensive case management programs that offer community support and transitional housing to help individuals with a psychotic disorder to integrate back into the community following residential treatment. Coordinated Specialty Care (CSC) is a treatment approach that uses a team of mental health professionals and specialists who help the individual in a variety of areas. Another approach that also provides assistance for individuals with mental illness is called Assertive Community Treatment (ACT). Services include:

• Case management
• Psychotherapy
• Family support and medication
• Support groups
• Help with education and employment
• Teach patients how to manage daily problems proactively
• Help encourage patients to take their medications

CSC can offer someone a well-rounded source of adjunctive support over and above medication and psychotherapy for the best possible outcome for living with a psychotic disorder. Early detection and intervention will lead to a more positive clinical outcome, so if you or a loved one are experiencing the early or attenuated symptoms of psychosis, make an appointment with your doctor to be evaluated.

Elevation Behavioral Health Residential Mental Health Treatment

Elevation Behavioral Health is an upscale, private residential mental health treatment center serving Los Angeles, California. In this luxury, intimate setting, individuals experiencing psychosis will receive the most effective therapeutic interventions within a compassionate and nurturing environment. Elevation Behavioral treats all forms of mental health disorders, including psychotic disorders, using a proven integrated approach. If you are wondering what are the early warning signs of psychosis, contact our compassionate team at Elevation Behavioral today at (888) 561-0868.