Psychosis or psychotic episodes can be very difficult for caregivers
to know how to handle in just the right way. These episodes can be
frightening for everyone, especially the person experiencing them,
triggering extreme stress and fear which can make their symptoms
escalate. Psychosis is defined as a loss of contact with reality,
unable to distinguish between what is real and what is imaginary,
and includes delusions (false ideas about what is taking place or
who one is) and hallucinations (seeing or hearing things which
aren't there). Many times when someone is experiencing a psychosis,
they may actually be unaware that anything is wrong. It’s important
for caregivers to know how to recognize the early-warning signs
indicating that a psychosis is developing, and to know where or from
whom to seek assistance.
Some of the early warning signs to look for include: anxiety,
depression or irritability; suspicion, hostility or fearfulness;
difficulty sleeping, or unusual waking hours; appetite changes; loss
of energy, motivation and interest, or hyperactivity, or alternating
between the two; concentration or memory problems; preoccupation
with certain ideas (such as religion); social withdrawal - not
wanting to spend time with friends and family members; thinking
problems such as racing thoughts or slowed down thoughts; difficulty
meeting responsibilities such as work or study; deterioration in
self-care and personal hygiene; appearing perplexed; and personality
becoming different in some way. None of these signs by themselves
necessarily mean that a psychotic episode is about to happen,
because some may be caused by a physical illness, or by the stress
and strain of work or school, or problems with important
relationships. However, if a loved one shows several of these signs
without them going away fairly soon, or if they become more
pronounced over time, then it would be a good idea for them to seek
assistance from their mental healthcare specialist.
Knowing what to do for the symptoms of psychosis can be very
difficult because you may not know what to say or do. This can be a
very stressful and confusing time for everyone, so just know that
there isn’t really a “right” thing to say or a “correct” way to
behave or react. There are some things that you can keep in mind
that may be helpful. Try and understand what the person may be
experiencing, like hallucinations or delusions, which will seem very
real to them. Try not to take anything that they may say personally,
keeping in mind that they aren’t behaving and talking as they
normally would. Avoid long debates in which you try to convince them
that their delusions or hallucinations aren't real, because this
will make them feel like they can't talk to you about what they’re
going through. Try to find things to talk about that are neutral,
instead of concentrating on their mistaken beliefs; this will most
likely not upset them or get you frustrated. As tempting as it may
be, don’t go along with their delusions or hallucinations, just
listen and sympathize with what the person is experiencing. You
might want to say something like, although you’re finding it
difficult to understand what they are going through, you do realize
that they must be very scared, frustrated, or angry. If it’s at all
possible, try and minimize the stress and stimulation around the
home during these times. Also, when someone is experiencing or
recovering from a psychosis, they can almost seem child-like, and
may need your help in making decisions. Show your concern and care
for the person by avoiding confrontations, and not criticizing or
blaming them.
