Early Psychosis Intervention
In the “What is Psychosis?” section, we go into more detail about the causes and treatment of psychosis. In this section, we concentrate on the importance of identifying the early warning signs of a developing psychoses, getting an assessment and initiating treatment to reduce the impact of the episode.
Let’s begin with a brief overview of psychosis.
What is Psychosis?
Psychosis describes a treatable medical condition that affects the mind and can result in some loss of contact with reality. People who suffer from psychosis often have prodromal and acute phases to their illness.
The early stage prior to a full-blown episode of psychosis is known as the prodromal stage. Symptoms of this phase are often subtle; they develop gradually and can be mistaken as “normal” behaviour, particularly in adolescents.
The duration of the prodromal stage can vary from person to person, however it commonly lasts for several months.
Prodromal symptoms can include:
- Withdrawal from friends and family
- Sleep disturbances
- Anxiety and/or suspiciousness
- Mood swings (extreme happiness to anger)
- Reduced ability to focus and feelings of disorientation
- A dislike to being touched by anyone
- An extreme sensitivity to noise, light, colours, textures
If the prodromal stage is not recognized (or in some cases, does not occur) and treatment is not initiated, an individual’s condition will develop into an acute episode of psychosis. In this phase, a person will exhibit symptoms that are severe enough to impair day to day function.
They may include symptoms such as:
- Increased confusion – The person feels like their thoughts are racing around, speeding up or slowing down uncontrollably;
- Delusions – Otherwise called false beliefs, delusions range from paranoia to feelings of grandeur. For example, an individual believes he is being followed, his thoughts are being manipulated, or that he is able to control other peoples’ minds;
- Hallucinations – The individual sees, hears, smells or tastes things that are not present;
- Altered emotions – A person experiences greatly enhanced mood swings, “flat” mood or feelings of being disengaged;
- Behavioural changes – The individual acts differently than usual, exhibiting bouts of high and low energy, inappropriate laughter and sudden, unexpected bouts of anger.
An acute episode of psychosis is frightening for both the person suffering from the condition and for the people around them. It is a confusing, disruptive and potentially devastating time, particularly for young people who are just developing their self-image, their relationships and their view of a positive, productive future.
In most cases, psychosis will not go away on its own – detection and treatment are required before recovery can occur.
What is Early Psychosis Intervention?
We talk about treatment approaches in our pamphlet “What is Psychosis?” so we won’t repeat them here. However, we do want to talk about the critical importance of assessment and treatments as early as possible when a psychotic episode is developing.
Research has discovered that the sooner an intervention begins (in other words, the earlier identification, assessment and treatment start), the better the results. Once a psychotic episode is identified, the professionals who make up a treatment team can organize medications, education and support for the individual, as well as friends and family.
We refer to this as early psychosis intervention or EPI. EPI has been found to be so effective that the seriousness of a psychotic episode can be greatly reduced, and possibly even avoided, if treatment is started quickly and appropriately.
EPI reduces the impact of psychosis on a person’s activities, relationships and self-esteem. It reduces the risk of depression, suicide, substance use problems, hospitalization and relapses as well as helps with a faster, more complete recovery. All in all, EPI assists individuals in maintaining the life they have planned for themselves and reducing the effects of the illness.
Obstacles to EPI
With all the benefits of EPI, why isn’t it used all the time? Early detection is the key; if early identification is not made, then treatment is delayed and the benefits of EPI are decreased.
The prodromal symptoms of psychosis are often not recognized as early warning signs. Sometimes people – including the person afflicted, family friends, and even the support professionals – do not identify behavioural changes as red flags to an impending psychotic episode. The individual who is undergoing the episode may feel “different”, but without the necessary awareness of prodromal symptoms, he may not understand the significance. Indeed, there may not be any significance to these feelings however if they continue, a medical assessment is required to rule out psychosis.
Even if an individual, or their loved ones, recognize that “something is wrong”, the prejudice and discrimination associated with mental illness can discourage people from seeking help. The misguided hope of a “wait and see” attitude leads people to delay treatment and in the process, only serves to prolong the disease process.
Don’t Delay – Act Today
If you, or someone you care about, suffer from psychosis, what can you do?
First, learn all that you can about psychosis, including the signs and symptoms of both the prodromal and acute stages. It is particularly helpful if you increase your knowledge about the subtle changes that occur in the early stages of a psychotic episode; learn to recognize them and act without delay. In the initial stages, it may only be the person with psychosis who actually notices small changes in the way they feel, and it is not until the psychosis develops that family and friends see the more obvious signs.
If you are part of the support network for a person with psychosis, be sure to encourage them to seek help if you see signs developing in their behaviour. Help them to see their family doctor or mental health professional for an assessment. Ensure that the professionals they see are experienced in early psychosis, identification and treatment.
Finally, do all you can to shatter the stigmaaround mental illness. Our society tends to discriminate against those with any disease of the mind at the same time as we try to help those with physical ailments. Why? Fear and ignorance play a big role; dispel them by learning the facts and sharing that knowledge.
Put the Brakes on Psychosis.
Early psychosis intervention has been proven to be effective in reducing – even preventing – the symptoms of a psychotic episode. The sooner assessment and treatment are begun, the better the results of medication, counseling and support in helping a person cope with a psychotic episode.
If left unchecked, the symptoms of a psychotic episode will gather speed and a train wreck of tangled relationships, disrupted work or school activities and damaged self-esteem can result.
Learn all you can about early psychotic intervention and put the brakes on psychosis. Remember – psychosis is treatable.