Psychosis and ACT

What is psychosis?

Psychosis is a complex mental health condition characterised by a wide variety of symptoms and experiences. Psychosis can be associated with various underlying conditions, such as schizophrenia, bipolar disorder, severe depression, or drug-induced psychosis. It is important to note that experiencing a single psychotic episode does not necessarily mean someone has a chronic or ongoing psychotic disorder. However, individuals who experience psychosis are at an increased risk of future episodes.

Treatment for psychosis typically involves a combination of medication, such as antipsychotic drugs, structured psychological intervention and support. Early intervention is essential in managing symptoms and improving long-term outcomes for individuals with psychosis.

If you or someone you know is experiencing symptoms of psychosis, it is important to seek professional help from a mental health provider.


Common symptoms of psychosis

Someone with psychosis may exhibit a range of symptoms, including hallucinations, delusions, disorganised thinking, and changes in behaviour and emotions.

  • Hallucinations are sensory experiences that only the individual can perceive. They can involve seeing, hearing, smelling, tasting, or feeling things that are not actually present. For example, a person with psychosis may hear voices that others cannot hear or see things that others cannot see.
  • Delusions are strongly held beliefs that persist despite evidence to the contrary. These beliefs are often very difficult to change, cause a lot of distress and are very preoccupying. Common delusions include paranoid delusions (believing that others are plotting against you) or grandiose delusions (believing that you has special powers or abilities).
  • Disorganised thinking can manifest as difficulty organising thoughts, speaking coherently, or connecting ideas logically. People experiencing psychosis may have trouble expressing themselves clearly or may speak in a way that is difficult to follow.
  • Changes in behaviour and emotions can also occur in psychosis. Individuals may exhibit unpredictable or unusual behaviour, have difficulty concentrating, experience emotional instability, or withdraw from social interactions.

It’s important to understand that experiencing one or more of these symptoms does not necessarily indicate psychosis. However, if these symptoms are persistent, severe, or interfere with daily functioning, it is crucial to seek professional help from a mental health provider for a comprehensive evaluation and appropriate intervention.

What are some early warning signs or symptoms of psychosis?

Recognising early warning signs or symptoms of psychosis can be crucial for early intervention and effective treatment. Here are some common early signs that may indicate the onset of psychosis:

  • Social withdrawal: The person may start to isolate themselves from friends, family, and social activities they previously enjoyed. They may become increasingly distant or disengaged from their usual social networks.
  • Changes in behaviour and personality: There may be noticeable changes in the person’s behaviour, mood, or personality. They may become unusually irritable, anxious, or suspicious. Their behaviour may become unpredictable, and they may exhibit agitation or restlessness.
  • Decline in functioning: A decline in overall functioning is often observed. This may include a drop in academic or work performance, neglecting personal hygiene, difficulty concentrating or making decisions, or struggling with everyday tasks.
  • Disturbed sleep patterns: Significant changes in sleep patterns can occur. The person may experience insomnia or have disrupted sleep, which can contribute to increased irritability and emotional instability.
  • Changes in thinking and perception: The person may exhibit disorganised thinking, difficulty expressing thoughts coherently, or having trouble following conversations. They may also experience perceptual changes, such as hearing voices, seeing things that others don’t, or having unusual beliefs.
  • Heightened sensitivity or suspiciousness: The person may become overly sensitive to stimuli, feeling easily overwhelmed or distressed by normal sensory input. They may also develop paranoid thoughts or suspicions, believing that others are plotting against them.
  • Unusual or intense beliefs: The development of unusual beliefs is common in early psychosis. These beliefs can be resistant to change, are often very distressing and are preoccupying.

Early intervention is key in managing psychosis and improving long-term outcomes, so if you or someone you know is experiencing concerning symptoms, it’s important to reach out to a healthcare professional promptly.

Common causes of psychosis

Psychosis can have various causes, and it is often associated with an underlying mental health condition. Here are some common causes and contributing factors:

  • Environmental factors: Stressful life events, trauma, substance abuse, and social factors can also play a role in triggering psychosis. These external factors can interact with underlying vulnerabilities and contribute to the onset of symptoms.
  • Traumatic experiences: Trauma, such as physical or sexual abuse, can increase the risk of developing psychosis. Traumatic events can have a profound impact on an individual’s mental health and may trigger the onset of psychotic symptoms.
  • Stress and anxiety: High levels of chronic stress and anxiety can potentially contribute to the development of psychosis. Prolonged periods of stress can affect the functioning of the brain and increase vulnerability to psychotic experiences.
  • Substance abuse: Psychosis can be induced by substance abuse, particularly the use of certain drugs. Stimulants like amphetamines or cocaine, hallucinogens like LSD or psilocybin mushrooms, and excessive alcohol consumption can trigger psychosis or worsen existing psychotic symptoms.
  • Medical conditions: Certain medical conditions or neurological disorders can cause psychosis. Examples include brain tumours, epilepsy, Parkinson’s disease, and autoimmune disorders that affect the central nervous system.
  • Sleep deprivation: Prolonged periods of inadequate sleep or chronic sleep disorders can trigger psychosis or exacerbate existing symptoms. Sleep disturbances can disrupt normal brain functioning and contribute to the onset of psychotic episodes.
  • Schizophrenia: Schizophrenia is a longstanding mental disorder characterised by psychosis. The exact cause of schizophrenia is not known, but it is believed to involve a combination of environmental, psychological and genetic factors.
  • Bipolar disorder: Bipolar disorder, (previously known as manic-depressive illness), is a mood disorder that can involve episodes of mania and depression. During manic episodes, individuals may experience symptoms of psychosis, such as hallucinations or delusions.
  • Major depression: Severe depression can sometimes lead to psychotic symptoms, a condition known as psychotic depression. People with psychotic depression may experience hallucinations and delusions.
  • Postpartum psychosis: Some women may experience psychosis after giving birth. Postpartum psychosis is a rare but serious condition that requires immediate medical attention. Hormonal changes, sleep deprivation, and pre-existing mental health conditions can contribute to its development.

It’s worth noting that the causes of psychosis can vary from person to person, and sometimes the exact cause may not be identifiable. A comprehensive evaluation by a qualified mental health professional is important in order to determine the underlying cause and develop an appropriate treatment plan.

Can ACT therapy help to treat psychosis?

Acceptance and commitment therapy (ACT) is a form of psychotherapy that can be used as a complementary approach in the treatment of psychosis. ACT focuses on developing psychological flexibility and promoting acceptance of difficult experiences, rather than trying to eliminate or suppress them. While ACT may not directly target the specific symptoms of psychosis, it can help individuals with psychosis learn to cope with distressing thoughts, emotions, and experiences in a more adaptive way.

  • Mindfulness and acceptance: Mindfulness can help individuals learn to observe their experiences without judgement and develop acceptance for their internal experiences, including distressing thoughts or hallucinations. Instead of attempting to eliminate or control symptoms, ACT helps individuals develop a different relationship with their symptoms to  minimises distress and interference with daily life.
  • Cognitive defusion: For someone experiencing psychosis, cognitive defusion techniques can help them relate to strongly held beliefs with more flexibility so that they do not completely dominate or overwhelm the person.
  • Values and action: In the treatment of psychosis, individuals are encouraged to explore their values and engage in activities that are meaningful to them, even in the presence of challenging symptoms. This can help individuals maintain a sense of purpose and fulfilment in their lives and committing to take action towards these goals and values, despite any challenges or distressing experiences they may be facing. This can involve setting small, achievable goals and gradually increasing engagement in activities that support overall well-being.

ACT is often used as a part of a comprehensive treatment approach for psychosis, which may also include medication, psychoeducation, and other therapeutic interventions. The suitability and effectiveness of ACT may vary depending on the individual and their specific needs and goals. A mental health professional experienced in ACT and psychosis can provide a tailored approach and guidance in its implementation.

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