Treatments for Psychosis
Medication plays a vital role in the treatment of individuals with psychosis. Thus, individuals with psychosis will often be offered and advised to take medication. The type of medication, dosage and format of medication ( e.g tablets, injections, liquid ) prescribed to an individual will vary from one person to another and will depend on several factors, including the pattern ( cluster ) of symptoms and physical ( DNA ) makeup of the individual.
Medication may help to stop and/or reduce the voices the person experiences, reduce levels of anxiety and restlessness, and help the individual to think more clearly. It can also protect against stresses coming from their own experiences and everyday life. Medication given in the form of injections have the same affect as the tablets, but can be given less often because one injection lasts for a long time as it is injected into the muscle area ( e.g the buttocks ) and as the muscle expands and contracts the medication is slowly introduced into the bloodstream. Those individuals that are not compliant with tablets it is more convenient to take the injection that way the the tablet dependency is taken away from the individual and the Medical professionals are assured that the individual is being treated with the right dosage of medication at the right times.
Initially when I was put on medication, I was given Haloperidol & Procyclidine ( to counter the side effects of Haloperidol ) following my first psychotic episode, I was ‘non-compliant’ i.e rebelling against taking medication, and so after a meeting with My family and Psychiatrist at the time I was put on Depixol injections once a fortnight, that way I did not have to worry about 'popping the pill' and My family and Doctor were satisfied that I was taking the medication.
The psychological trap that an individual can fall into when taking medication is that once a sense of normality ( whatever that is for you ) has been restored, the sufferer thinks because they are fine now they have no need for the medication and so stop taking the prescribed drugs and after sometime they then suffer a relapse with another psychotic episode and possible hospitalisation, and once stabilised again you have to go back and pick up the pieces of your life again and so the cycle continues…..Until self realisation and insight is reached about the illness ( if ever ).
After a while on Depixol injections, I was put on Lithium tablets. Lithium medication dates back to Roman times. The Romans used to take salt out of the sea to make tablets to treat individuals with depression. When on Lithium medication, for the right amount to be therapeutic, regular blood tests must be taken, as too much is poisonous and too little is ineffective. One of the major side effects of Lithium I suffered was because of it’s salt based content I used to feel thirsty a lot and therefore with the intake of fluid, urination increased proportionally. I complained to my Psychiatrist about feeling unwell and he suggested a drug which was new on the market called Abilify. After a period of time on Abilify I relapsed and was hospitalised and was a inpatient at three different hospitals, that was in 2005 arguably one of the worst relapses I have ever had. What I found out later was that if Abilify was given initially at first diagnosis it proved to be a very good antipsychotic drug, however if you changed over to Abilify from other medications then you would risk relapse ( as not enough research has been done about it ).
It has taken years of trial and error to arrive at the present combination of medication which I take, which is Depakote ( Mood Stabiliser ), Prozac ( Antidepressant ) & Olanzapine ( Antipsychotic ). This combination seems to work for me, one factor that is very important is FEEDBACK Communication to the Medical professionals that are dealing with you, so that they can ascertain types and dosages of medication to give you. The other point worth noting is that with age, circumstances in life, everything changes including DNA makeup therefore it is imperative to have Medical Reviews with Healthcare Professionals to make sure the medications you are taking are still effective and helping you to live a full and normal life as possible, and also to get regular blood tests done via your General Practitioner, so that physical health is not neglected and kept in check. The Six important biological metrics that should be monitored in a blood test are Sugar Level, Salt Level, Thyroid Function, Kidney Function, Arthritis & Cholesterol Level.
Unfortunately, like medications used for other conditions, the medications used in the treatment of psychosis can have some unwanted side effects. Most commonly, people can feel tired and less energetic. Other effects may include problems with appetite, weight gain, and sexual functioning. Any problems with medication, however small, awkward or seemingly embarrassing, should always be discussed with the person’s GP, Psychiatrist or Community Psychiatric Nurse.
People with psychosis are generally advised to take medication for an extended period of time even when they are feeling better. However, a lot of people find it very difficult to continue with their medication when feel well because it seems unnecessary. Unfortunately psychosis does not usually go away. This is similar to individuals with other long term difficulties e.g diabetes, blood pressure etc, people with psychosis often have to continue taking medication even when they feel well, to prevent further episodes and to remain well.
In the same way that there is no sudden improvement when an individual starts medication, there is no sudden change if they stop it. When a person has not taken their tablets or missed an injection, symptoms may not reappear immediately. For most people, it can take some weeks or months until symptoms reappear. This is commonly referred to as a ‘Relapse’.
Talking to someone about distressing experiences and things that make you worry can also be an important part of the treatment for psychosis for both the person with psychosis and those who care for them. This may occur at different stages during an individuals psychosis and recovery. Talking treatments may be offered during a hospital admission and/or when someone is living in the community. What is spoken about in the individual or family sessions will always vary from one person to another depending on the need of the individual and those who provide support and care.
Talking treatments include CBT ( Cognitive Behavioural Therapy ) and Family Interventions, they both involve talking things through with a therapist ( two therapists in family intervention ). Arts Therapies are also helpful e.g Art therapy, Dance therapy & Music therapy for individuals with psychosis.
Carers may also find it helpful to have their own talking therapy, where they can meet with a therapist on their own to talk about their thoughts and feelings and how their caregiving role is affecting them.
Social and Vocational Support
Individuals with psychosis may be offered help in improving their everyday living skills that have been adversely affected because of their difficulties. These are skills such as shopping and learning how to manage their time and money.
Individuals with psychosis may also receive help in areas of training and employment, e.g they may undertake a period of training which could equip them with skills that may lead to improved employment opportunities, Alternatively, people with psychosis like many other people may choose to work in a voluntary capacity or in a job that provides them with a high level of support.
Other Support Factors for Psychosis Sufferers
Medication and talking treatments are not the only things that can help a person with psychosis. The atmosphere in their home and the way that daily problems are tackled are also important. This is because people with psychosis are known to be particularly sensitive to events happening around them. They can be much more easily upset than other people by the ups and downs of daily life.
Changes in routine can make an individual with psychosis feel unsettled and life events such as moving into a new flat or starting a new course may trigger another episode. While such events cannot be avoided, it is generally a good idea to discuss any changes with the individual beforehand, so they prepare and look after themselves.
It can often be helpful for the individual with psychosis and their relative to develop a plan about what they would both do if the individual with psychosis had a crisis or relapse in their mental health problems or if a relative felt concerned, e.g there might be a plan about what the relative says to the individual with psychosis, how they offer help & support, or the people they should contact. The plans , which are sometimes called ‘crisis’ or ‘relapse prevention’ plans can always be revised and updated. They are often helpful because the individual with psychosis and their relative have had an opportunity to discuss beforehand what they would do and/or what they would like to happen should a crisis occur. It is important to note however, that having a family crisis plan does not mean that a crisis will happen, but it can help everyone to feel prepared.