What is Psychosis?
─ Psychosis usually occurs as an episode, not as a constant state
─ The person may experience a loss of some contact with reality
─ The person may experience severe disturbances in thinking, emotion, and behavior
Common Symptoms
Changes in emotion and motivation:
─ Depression
─ Anxiety
─ Irritability
─ Suspiciousness
─ Deadened, flat, or inappropriate emotion
─ Change in appetite
─ Reduced energy and motivation
Changes in thinking and perception:
─ Difficulties concentrating or paying attention; expresses odd ideas
─ Feeling that self or others are behaving differently
─ Unusual experiences of smell, sound, color, etc.
Changes in behavior:
─ Sleep disturbances
─ Social isolation or withdrawal
─ Reduced ability to carry out work and social roles
Types of Disorders in which Psychosis May Occur
─ Schizophrenia
─ Bipolar disorder
─ Psychotic depression
─ Schizoaffective disorder
─ Drug-induced psychosis
How To Help a Person Who May be Experiencing Psychosis
─ Approach the person in a calm, caring, and non-judgmental way
─ Do not touch the person without permission
─ Let the person know you are concerned and that you want to help
─ Remain calm; speak quietly in a nonthreatening tone, calmly, slowly, and caringly
─ Note signs of disruptive or aggressive behavior
─ Try to find a place to talk that is safe and free from distractions
─ Listen and watch for suicidal thoughts and behaviors
─ Be sensitive to the way the person is responding and behaving
─ Let the person set the pace of the discussion and tell you about their experiences and beliefs
─ Answer questions calmly; comply with reasonable requests
─ Maintain your safety and access to an exit
─ Do not do anything to further agitate the person
─ Respect the person’s privacy and confidentiality
Try to De-escalate the Situation
─ Don’t argue or challenge the person
─ Don’t make threats
─ Don’t raise your voice or talk too fast
─ Use positive words instead of negative words
─ Stay calm and avoid nervous behavior
─ Don’t restrict the person’s movement
─ Try to be aware of what may increase the person’s fear and aggression
─ Pause; don’t fill every moment with talking
Respond to disorganized speech by talking in an uncomplicated manner
─ Speak slowly and use short sentences
─ Repeat things if needed; be patient and allow time for responses
─ Be aware that the person is still experiencing feelings, even though the person may be showing a limited range of emotions
─ Do not assume the person cannot understand you, even if the response is limited
─ Treat the person with respect and dignity
─ Offer consistent emotional support and understanding
─ Provide practical help
─ Do not make any promises that you cannot keep
─ Encourage appropriate professional help
Remember to:
─ Understand the person’s symptoms for what they are
─ Empathize with how the person says she or he is feeling
Remember not to:
─ Confront the person
─ Criticize or blame
─ Take comments personally
─ Use sarcasm or patronizing statements
─ Correct the person’s beliefs and experiences
What if the person doesn’t want Help?
─ If you think the situation warrants emergency responders, call 911 or ask someone else to make the call
─ Encourage the person to talk with someone he or she trusts; ask if there is someone you can call
─ Never threaten the person (i.e. with hospitalization)
─ Remain patient, friendly, and calm
─ Later, remind yourself that the person may remember you as someone who treated them kindly, and appreciate yourself for that.