Elderly woman eating breakfast and talking with a younger relative.A symptom of many medical and mental health issues, psychosis occurs when a person’s perceptions do not match up with reality. People with psychosis may experience frightening hallucinations or delusions which sometimes cause them to endanger themselves or others. 

As psychosis can indicate that a more severe medical or mental health issue is present, diagnosis and prompt treatment is crucial. Psychosis treatment often combines a variety of approaches, including antipsychotic medication, inpatient care, and therapy.

Inpatient Treatment for Psychosis

Because psychosis causes disrupted thought patterns, people experiencing psychosis can sometimes be a danger to themselves or others. Inpatient treatment is temporary treatment that ensures the safety of a person who has psychotic symptoms. It involves the person with psychosis staying in a treatment facility such as a psychiatric hospital until they are no longer a danger to themselves or anyone else.

During hospitalization, a person might:

  • Receive a diagnosis
  • Get help managing both medication and its side effects
  • Develop a course of treatment

Treatment may involve therapy, medication, and/or behavior management to deal with the effects of psychosis. Some residential treatment facilities offer longer-term strategies to those in treatment, teaching things such as life skills, conflict management, stress management skills, and other tactics for coping with psychosis.

Medication for Psychosis

Medication is commonly incorporated into treatment plans for psychosis. Psychiatric drugs often used include:

Antipsychotics and similar medications do not “cure” psychosis or prevent it from recurring, but they can be effective for managing psychosis over time. 

In some cases, electroconvulsive therapy may also effectively treat psychosis. Recent research indicates that early medical intervention can effectively prevent severe psychosis and ongoing episodes of psychosis.

Unfortunately, the false beliefs associated with psychotic episodes can often act as barriers to treatment. People with psychosis may refuse medication or stop taking their medication, and in some cases they must be hospitalized before treatment can continue.

Therapy for Psychosis

Therapy for psychosis often works best when combined with medication, but this is not always the case. A therapist can help a person who is experiencing psychosis recognize their condition, find and use coping strategies, and stick to a treatment plan.

Psychosis often takes a heavy toll on a person’s self-image and social life, and a therapist can help them navigate the aftermath of a psychotic episode, repair damaged relationships, and develop coping skills for future episodes. Group therapy or support groups may also offer people with psychosis an opportunity to relate to and support others who have been through similar experiences.

Family interventions, where families participate in therapy sessions along with the person experiencing psychosis, have been found to reduce the relapse of psychotic episodes. This type of therapy aims to improve family relations, and the family is encouraged to become a type of therapeutic agent to the person in treatment. Family members may have the opportunity to see the therapist in individual sessions as well.

Treatment for Medical Causes of Psychosis

Treatment for psychosis depends on its cause. When there is an underlying medical cause, treatment may focus on that illness instead. Infection-related psychosis requires broad-spectrum antibiotic treatment, usually through an IV. 

Some medical conditions may also mimic psychosis; illnesses that cause delirium are a prime example. Medical professionals are often trained to differentiate between medical issues causing symptoms of psychosis and psychosis related to a deeper mental health issue.

References:

  1. Burns, T. (2010). Early intervention in psychosis. The British Journal of Psychiatry, 197(5), 415-415. doi: 10.1192/bjp.197.5.415
  2. Freudenreich, O. (2012, December 3). Differential diagnosis of psychotic symptoms: Medical “mimics.” Psychiatric Times, 12(27). Retrieved from http://www.psychiatrictimes.com/forensic-psychiatry/differential-diagnosis-psychotic-symptoms-medical-mimics 
  3. Garety, P. (2003). The future of psychological therapies for psychosis. World Psychiatry, 2(3), 147-152. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525111
  4. McCarthy, J. (n.d.). Talk therapy for psychosis recommended. Retrieved from http://www.irishhealth.com/article.html?id=13951
  5. Velligan, D. I. (n.d.). Cognitive behavior therapy for psychosis: Where have we been and where are we going? Retrieved from http://www.medscape.com/viewarticle/708327