How Early Intervention In Psychosis Improves Outcomes

Psychosis is a severe mental health symptom that often indicates the presence of an underlying condition. Early detection and intervention for psychosis may be a crucial first step in recovery, offering improved outcomes and the ability to manage ongoing symptoms. To understand these benefits, it can be valuable to learn more about psychosis and the benefits of availing mental health services at the onset of psychotic symptoms. 

What is psychosis?

Though not a mental health condition on its own, psychosis is a group of symptoms indicating a person has lost touch with reality and struggles to differentiate between what's real and what isn't. Psychotic episodes can cause confusing, disorienting symptoms, such as hallucinations that look and feel real to the person experiencing them. 

Other common distortions to perception include delusions, which can present as a strong conviction to bizarre or untrue ideas, and disorganized thoughts or speech, making the person appear confused and erratic. Not all people experiencing this may have hallucinations, as some may only experience delusions or a disconnect from reality.   

Potential impacts and symptoms to recognize

It may be beneficial to know how to recognize the symptoms, whether you’re experiencing these symptoms yourself or are a parent, family member, college staff member, or someone who works with young adults. While psychosis can occur in children and older adults, it is much more common in young people between the ages of 18 and 30. Symptoms may include the following: 

• Hallucinations: Hearing, seeing, smelling, touching, or tasting stimuli that no one else can perceive. Auditory hallucinations are the most common type, with people hearing indistinct sounds or clear voices. 
• Delusions: Someone experiencing this may develop an extreme conviction to unrealistic ideas, such as the belief that someone is spying on them, intends to harm them, or can hear their thoughts. 
• Disorganized or confused thoughts and speech: How someone demonstrating psychotic symptoms thinks may change as their mental health deteriorates. They may believe their thoughts are beyond their control, and their speech may jump from topic to topic without finishing ideas or sentences, making them difficult to understand. 

Approximately 100,000 young people experience psychosis each year, and as many as three in 100 people may have an episode at some point in their lives. Psychologists use the term first-episode psychosis (FEP) when an individual exhibits signs of disconnection from reality for the first time. 

When it comes to this, positive symptoms are things like hallucinations or delusions, while negative symptoms involve a lack of motivation or social withdrawal. Some people demonstrate early warning signs, called prodromal symptoms, before experiencing first-episode psychosis, which may include the following symptoms. 

Mood changes

Someone experiencing psychosis for the first time may experience changes in their typical mood, such as becoming irritable, anxious, angry, suspicious, depressed, or experiencing sudden mood swings more frequently or for longer durations. 

Thought pattern changes

If you are experiencing prodromal symptoms, you may find it more difficult to concentrate than usual, believing your thoughts are in slow motion or fast-forward. You might also have trouble remembering a situation clearly or notice “strange” ideas occurring more often. 

Perception and physical needs

When experiencing a pre-psychotic episode, your eating or sleeping habits might change. You may notice you sleep at odd hours, don’t sleep as much, don’t eat as often, aren’t as hungry, or are hungrier. You could also have decreased energy or physical symptoms like headaches or stomachaches. 

Self-concept and perception of surroundings

How you see yourself and perceive the world around you may shift. You may believe that some indefinable quality has changed in yourself or your surroundings. Some people also devote substantially less attention and effort to self-care and personal hygiene.

A drop in performance at work or school

As the prodromal symptoms of psychosis develop, functioning at school or work may become increasingly complex, leading to decreased effort. Some people may stop working altogether or end professional relationships. 

Social withdrawal

You may notice a diminished interest in associating with others socially, often in direct contrast to previous behaviors. In this stage, you may also become suspicious of your friends, family members, and loved ones. 

Identifying individuals at high- or ultra-high risk is important, as recognizing early symptoms can lead to a more accurate psychosis prediction and timely intervention.

Often, symptoms begin appearing during a person’s late teens through the mid-20s, indicating an underlying mental health condition such as a psychotic disorder like schizophrenia or a mood disorder like bipolar depression. Psychosis may occur in childhood, typically as a symptom of a non-psychotic psychiatric disorder. Older adults may experience psychosis due to neurological diseases like Alzheimer's or brain trauma. 

How does early intervention affect outcomes?

While learning that you or a loved one has a health condition causing psychosis can be scary and confusing, it can also be the crucial first step in early intervention services to get the best possible outcome. Certain key components have been identified as key to improvements in those developing psychosis. Early detection, personalized treatment plans, and continuous support have all been validated through randomized controlled trials to improve patient outcomes. 

Below are a few ways early intervention with mental health services like medication and psychotherapy improve patient outcomes. 

Treatment is often delayed until symptoms are severe

However, some people with psychosis may not understand that what they are experiencing is psychosis, so they may be hesitant to seek support, especially if they believe others are “out to get them” when trying to support them. For this reason, it can be crucial to notice warning signs before delusional thinking is more severe. 

Psychotic episodes can make it challenging to function in school, work, or social environments. By introducing early support services after the first episode of psychosis, individuals may learn to cope with their symptoms and minimize their impact before they worsen. 

Someone living with untreated psychosis may turn to unhealthy coping mechanisms, such as alcohol or substance use, dangerous or criminal behavior, self-harm, or other destructive behaviors that pose a significant risk to themselves or the people around them. Treatment can allow more people to avail of services like harm reduction or education about the harms of these substances or behaviors. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Living with a mental health condition that causes psychosis often leads to an extraordinary amount of stress, embarrassment, fear, confusion, and other aversive, uncomfortable emotions. Intervention may reduce the time someone with psychotic episodes endures overwhelming emotions without practical mental health support. 

People often form foundational values, opinions, and beliefs during the transition from teenager to young adult. Psychotic episodes can disrupt this natural development, interfering with how a person relates to the people and world around them. Treatment allows individuals to remain grounded and continue to grow and develop healthily. 

Early identification and treatment are key when someone experiences psychosis, especially for the first time. Effective treatments based on clinical practice guidelines and evidence-based paradigms may help prevent complications. Psychosocial treatments, such as family interventions or vocational rehabilitation, may help promote functional recovery and improve social functioning.

There can be a treatment delay in some cases, which is why services like Early Intervention in Psychosis (EIP) can be useful. Early psychosis services may help you or a loved one adjust after receiving a psychotic disorder diagnosis or experiencing first-episode schizophrenia or psychosis. Insights from World Psychiatry suggest that high-income countries are leading in the implementation of services for psychotic illnesses, guided by evidence-based practice. 

Such services may include a mental health caseworker who can provide resources and treatment options, such as: 

• Cognitive-behavioral therapy (CBT)
• Individual, couples, or family psychotherapy
• Antipsychotic medications
• Inpatient treatment at a psychiatric facility
• Family, work, social, and school support programs
• Randomized controlled trials

Working with trained mental health professionals early makes it far more likely that symptoms indicating a clinical high risk, such as self-harm or violence, will be noticed and treated before they can cause significant harm. Consult a doctor before starting, changing, or stopping any medication for your mental health symptoms. 

Finding early intervention for psychosis can improve long-term outcomes and make it easier for a person to understand how their altered perception affects their mood, thoughts, and behaviors. If you or a loved one are experiencing psychotic episodes, you might consider working with a licensed therapist. However, some people may find online platforms like BetterHelp more available when experiencing early signs of psychosis, as they can allow you to work with a provider from home. 

Cognitive-behavioral therapy is one of the main psychotherapy approaches for psychosis and other types of mental illness. According to research from the American Psychological Association, virtual and face-to-face CBT treatments provide similar results. Some clients also report shorter wait times, lower costs, and a comprehensive network of licensed treatment providers with teletherapy platforms. 

There are many reasons why some people may gravitate to online counseling, including the convenience and affordability of its services compared to traditional, in-person counseling. Through online therapy platforms, users can find a licensed practitioner experienced in supporting people with conditions like theirs. In addition, clients can choose between phone, video, or live chat sessions.