Regarding Psychosis

What is Psychosis?

Psychosis is a generic term used in psychiatry to refer to a state of mind where a person is suspected to have lost touch with reality. The disruptions to brain activity which lead to expereinces of psychosis can affect a person's thoughts, emotions, and behaviours in numerous ways and to varying degrees. Psychosis itself is not a diagnosed illness but can be a part of a number of diagnosed illness but can be a part of a number of diagnosed mental health conditions such as:

  • Schizophrenia
  • Schizoaffective disorder
  • Schizotypal disorder
  • Chronic delusional disorders
  • In some cases, psychosis can be part of a personality disorder, eating disorders or mood disorders such as Bi-Polar or major depression

Experiences of psychosis are related to use of psychoactive drugs or significant sleep deprivation. Sometimes people recover from a psychotic episode with little or no further symtoms

Symptoms of Psychosis

People who experience psychosis display a wide range of symptoms and these are seen as falling into two broad categories or positive or negative symptoms

Positive symptoms-reflect an excess or distortion of normal functioning ie Experiences and behaviours are added to a person's normal way of functioning. Positive symptoms of psychosis:

  • Hallucinations
  • Delusions
  • Disorganised thinking and speech
  • Disorganised behaviour

Negative symptoms-reflect a diminution or loss or normal functions ie Something has been taken away from a person's normal way of functioning. Negative symptoms commonly seen in people experiencing psychosis include:

  • Reduced emotional expression, otherwise known as a flat affect
  • Reduced speech
  • An inability to persist in goal-directed activities, even things such as taking care of physical appearance and home (avolition)
  • Low self-confidence
  • An apparent lack of understanding about the illness, that is, lack of insight

Tips for Working with Psychotic Symptoms

  • Don't argue or reason about the content of a deulsion or hallucination
  • Show understanding and compassion eg Saying "It must be frightening to think that someone is after you"
  • Don't judge, remember that the person lacks control over what they are doing and saying
  • Ask how you can help. Agreeing to reasonable requests might help the person feel more in control and relieve distress
  • Keep speech and language simple. It is likely the person will speak slowly or have reduced concentration/information processing ability eg If discussing options provide 2 or 3 to consider rather than open-ended questions
  • Be clear about the limits of acceptable behaviour eg "I will sit with you in the room, but if you frighten me I will call the police"
  • Use non-verbal behaviour to express support. Avoid direct continuous eye-contact, be minful of touching, do not stand over a seated person but take opportunities to sit beside them eg Looking out a window together
  • Limit external stimuli eg Radio, TV, people
  • Allow the person their space. This will help them feel safe
  • Acknowledge and sicuss any threat of suicide-seek support from professionals if unsure
  • Be alert to safety, seek support from professionals if unsure and utilise 000 if you assess their is a risk to yourself or others
  • Anticipate sudden changes. Symptoms of psychosis can be very distressing and distress levels can change, even during the course of a conversation

Refer to the Carer Assist Coping Skills information sheets