On the Lakeside-Milam blog, we’ve previously discussed psychosis: a combination of hallucinations and delusions that can be brought on by heavy drug use. Sometimes, individuals can begin to enter a psychotic state due to severe mental illness, not substance abuse. How can you tell if a person is losing their grip on reality? We recommend learning the early warning signs of psychosis.

Psychosis is Individual

Before we get started, we have an important disclaimer. As is the case with every mental health condition, no two people experience psychosis the exact same way. While some of these symptoms may line up with what your loved one is experiencing, they probably will not match up perfectly. Even if you identify just a few of these signs, we encourage you to seek professional treatment as soon as possible – especially if they seem to be getting worse. The earlier that mental health practitioners can intervene, the better a patient’s outcome will be.

We also want to provide a reminder that psychosis is a symptom, not a full-fledged disorder. It can emerge due to severe sleep deprivation, depression, Alzheimer’s, schizophrenia, or bipolar disorder. It can also be triggered by certain medications or substance abuse. For this reason, many healthcare providers will run urinalyses, liver tests, and even MRIs to check for physical causes of psychosis.

Changes in Social Activity

The first early warning signs of psychosis will probably emerge in one-on-one interactions. You may notice your loved one withdrawing from friends and family members. If they completely drop out of once-loved activities, this can be a sign of worsening mental health. However, if this withdrawal happens because they are losing friends left and right, it may be a symptom of something more serious.

The main social hallmark of psychosis is the degradation of important relationships. This usually occurs because of intense shifts in a person’s behavior. Someone who was once kind and trusting may lash out or become extremely suspicious of others. They may miss clear social cues and struggle to understand interactions. If someone begins acting strangely and alienating others, they may be struggling with mental illness.

Other social symptoms include:

• Unease and paranoia about other people
• Declining job or school performance
• Disordered speech
• Difficulty communicating
• Incoherent speech
• Behaving inappropriately

Inappropriate, Strong Emotions

Psychosis calls up strange feelings in those who deal with it. In addition to harmful thoughts, they may experience a chaotic range of emotions. These usually include:

• Depression and anxiety or euphoria and mania
• Excessive crying or inability to cry at all
• Inability to express happiness or joy
• Abnormal, overly intense feelings
• Inappropriate laughter
• Rapid shifts in personality

Strange and Erratic Behavior

Perhaps the best word to describe behavioral changes due to psychosis is “bizarre.” While some people view this condition as frightening, it is important to remember that your loved one can get well. There are physical signs that can be noticed at a glance, like a rapid deterioration in personal hygiene or staring without blinking. Your loved one may also begin to act out of character. For some, this involves impulsive and reckless behavior. Others quickly vacillate between hyperactivity and inactivity. Other behavioral cues include strange gestures, agitation, excessive writing (that does not make sense), and threats of self-harm.

Changes in Thinking and Perception

Finally, these internal signs may not be outwardly obvious to you or others. However, if your friend or family member mentions any of these concerns, be sure that you remember that they point to early warning signs of psychosis.

People experiencing the early stages of psychosis may report that things around them feel strange – like they’ve been changed, but they’re not sure how. Their statements will be irrational and may reflect deeply held beliefs and ideas that seem outrageous to you. Sometimes this takes the form of religious zeal or an intense interest in the occult.

You might also notice:

• Strange sentence structures
• Unusual sensitivity to light, texture, or sounds
• Lapses in memory
• Distractibility and inability to concentrate
• Rapid speech or reduced speech
• Seeing and hearing things that are not there
• Growing suspicion or paranoia
• Difficulty distinguishing fantasy from reality
• Persistent beliefs that cannot be rationalized
• Gradual, non-specific shifts in perceptions or thoughts
• Trouble thinking clearly

When to Seek Help for Early Warning Signs of Psychosis

Encouraging your loved one to seek treatment for psychosis is important. Usually, the entire thing will begin with gradual changes that are troubling or even frightening. While most people may think that these thoughts or feelings will pass with time, psychosis tends to worsen if left untreated. For that reason, we recommend that you seek accredited mental health care from the emergence of a loved one’s first symptoms. If they are unwilling to accept help (usually because of fear, delusions, or stigma), don’t give up hope. Keep encouraging them while remaining nonjudgmental.

Psychosis Treatment

As we mentioned above, early intervention achieves the best results for patients with psychosis. Coordinated care should address all aspects of the patient’s life, including:

• Medication management
• Psychotherapy (individual and group)
• Case management
• Family education, support, and involvement
• Life skills training for success in education and employment

If someone you love is dealing with hallucinations and delusions, there is hope. By identifying the early warning signs of psychosis, you can help them to connect with treatment resources and begin the process of recovery.

To learn more about mental health care and substance abuse treatment in Washington, contact Lakeside-Milam.