Managing psychosis can mean learning to recognize the early signs, having a crisis support plan, and keeping up long-term healthy habits.
Psychosis is an experience of altered reality, such as delusions, hallucinations, and disorganized thoughts.
“Individuals experiencing psychosis often do not recognize that their perceptions are not reality,” explains Tiffany Freeman, a psychiatric nurse practitioner from Addison, Texas. When you cannot determine what’s real it’s often hard to know when you might benefit from seeking help.
The symptoms can affect your work, school, and social life. You might withdraw socially or develop a sense of unease around people and places, or you may start avoiding hygiene and self-care routines.
Learning how to handle psychosis when it happens — and how to help prevent symptoms in the long term — can help you reduce distress and recover faster. Getting enough sleep, exercise, and social time can help prevent psychosis from happening again.
Psychosis involves false experiences, but there are other warning signs you can look out for too. Heading into an episode of psychosis, you may experience changes that could easily pass as stress, illness, or fatigue.
You might notice a change in your thinking patterns, though they may be hard to describe.
“Recognition of early warning signs is a key aspect here,” indicates Freeman. “Things like shifts in sleep patterns, feelings of unease, distrusting, and urges to isolate are very common early symptoms.”
When you’re able to recognize the early symptoms of psychosis, you can get in touch with your support network and healthcare team right away.
Early warning signs of psychosis can include:
- difficulty concentrating
- reduced job or school performance
- growing suspicion or feelings of unease
- paying less attention to personal hygiene
- self-isolation
- emotions without a clear reason, or a lack of emotion
The early-onset signs of psychosis can be different for everyone. Keeping a daily log of your thoughts, feelings, and experiences can help you keep track of changes that might suggest an emerging psychosis episode.
Is psychosis a mental disorder?
Psychosis is a symptom, not a formal diagnosis. On its own and with short-term effects the symptoms might meet the criteria for brief psychotic disorder.
As a long-term symptom, psychosis may indicate another mental health condition, like schizophrenia or bipolar disorder.
A psychotic episode can be confusing and frightening. If something around you isn’t making sense, or if you’re having a sensory experience that feels out of the ordinary, it can help to do a mental self-check.
“Leaning on past experiences — ‘this has happened before, what was true then?’ — dialogue can be helpful,” says Freeman.
Acknowledging that you may be in an episode of psychosis can help ease initial feelings of panic and can direct you toward your pre-designed plan of action.
Your support network — which might include a life skill coach, mental health professional, or emergency response teams — is there to help keep you safe and calm when psychosis occurs. A friend or family member may be able to contact this support for you.
Immediate contact with this support system can help you receive any care you need sooner rather than later during an episode of psychosis.
If you think you might be experiencing a psychotic episode, waiting somewhere safe and quiet until support arrives can help minimize the chances of psychosis putting you or those around you in harm’s way.
If you’ve experienced an episode of psychosis before, having a “go-to” area free of hazards may help, especially if you’re alone when the symptoms develop.
Family members are often the ones who first notice the changes that mark a psychotic episode.
If you suspect your loved one isn’t perceiving reality accurately, knowing what to do — and what to avoid — can help.
1. Avoid confrontation
When a loved one is acting outside of what’s typical, wanting to correct them can feel like a natural reaction.
During psychosis, however, altered perceptions like hallucinations and delusions can’t be reasoned away. Confrontation or correction might escalate irrational behaviors.
“Caregivers, at times, want to challenge the thoughts of the individual. But depending on the severity of the episode, this can make things worse,” Freeman cautions.
2. Remain calm
Keeping your voice neutral and your gaze soft can help promote calm when a loved one is experiencing psychosis. Being patient, actively listening, and moving and speaking slowly are also ways to help your loved one stay calm.
3. Express concern without focusing on treatment, medication, or hospitalization
It’s okay to express that you’re concerned about your loved one’s behaviors. Non-judgmental comments and questions may help you determine the extent of what’s happening.
Focusing on treatment, hospitalization, or medication may be perceived as threatening during a psychotic episode, which can involve delusions of paranoia and suspicion.
4. Offer non-threatening options
“Would you like it if I called so-and-so? They might like to hear from you,” is an example of feeling out, in a non-threatening way, who might be your loved one’s most accepted resource to call, based on their current mindset.
5. Call the support team or emergency provider
If your loved one doesn’t indicate they can participate in the decision on who to call, or if their behaviors may harm themselves or others, you may want to go ahead and contact the support team or emergency services.
An episode of psychosis can be considered a mental health crisis due to the potential for harm resulting from altered perceptions.
Creating a mental health emergency plan can help guide you and your loved ones when fear, panic, and confusion might prevent actionable thinking.
There’s no right or wrong way to create a mental health emergency plan, but it can be helpful to have your medical information handy in the event you aren’t able to communicate it.
Consider including:
- emergency contacts
- primary healthcare professionals and their contact information
- a list of formal mental and physical diagnoses, if any
- physical and mental medical history
- known allergies
- current medications or supplements and their dosages
- any recreational substance use
In addition to your basic medical information, a crisis plan might include:
- a list of behaviors that indicate early psychosis and any successful management strategies
- a list of behaviors that indicate a need for emergency care
- a mental health crisis hotline number
- emergency service numbers
- where to go while you wait for support (a designated safe place free of hazards)
You might experience psychosis once or twice and then never again, or you may have recurring episodes that coincide with other mental health disorders.
Knowing how to deal with psychosis in the moment is just one piece of the puzzle. Long-term management is often necessary for the best wellness outcomes.
Keep up with your treatment
Successful long-term management of psychosis can hinge on maintaining your treatment.
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Avoid substance use
Certain recreational substances like cannabis, amphetamines, LSD, and
Develop stress management strategies
Short-duration psychotic episodes may be brought on by stressful events or trauma. Developing stress management strategies can help prevent it from overwhelming your daily life.
Breathing exercises, meditation, and mindfulness might be useful tools in addition to a:
- regular exercise
- balanced diet
- good sleep hygiene
Use various forms of support
Disrupted reality can be short-term or long-term. While you’re working toward managing your symptoms, having a multi-dimensional support system can help you with everyday responsibilities.
Coordinated specialty care (CSC) is a formal treatment approach to psychosis that incorporates:
- case management
- services coordination
- family education
- employment support
With CSC, a team of professionals is there to offer guidance for psychotherapy and medication adherence as well as support for everyday essentials.
Understanding how to deal with psychosis in the moment and the long term can help limit its impact on your life.
Establishing a crisis plan, keeping medical details handy, and educating yourself and loved ones about psychosis can all make a difference.
If you need additional support resources in your community, the National Alliance on Mental Illness (NAMI) offers state-specific guidance through their hotline at 1-800-950-6264 or by emailing info@nami.org.
Are you currently in crisis?
If you feel like you’re having a mental health emergency, you can:
- Call the 988 Suicide and Crisis Lifeline at 988 for English and Spanish
- Chat with professionals at Lifeline Chat
- Text “HOME” to the Crisis Text Line at 741741
- Check out Befrienders Worldwide or Suicide Stop if you’re not in the United States and need to find your country’s crisis hotline
If you decide to call an emergency number like 911, ask the operator to send someone trained in mental health, like Crisis Intervention Training (CIT) officers.