PSYCHOSIS CAN BE TREATED!
Psychosis can be treated!
The main means used to treat psychosis and avoid relapses are the combination of medication, an essential basis for the treatment of psychosis, and psychosocial interventions including psychotherapy.
In addition, as explained on this site, a healthy lifestyle and stopping drug use and moderate alcohol consumption are also key elements in avoiding relapses.
CAN PSYCHOSIS BE TREATED?
After psychosis, anything is possible
WHY EARLY INTERVENTION IS IMPORTANT
In the 1990s, Australian and British teams identified that young patients with early psychosis have specific needs that require different care than older people or whose illness has several years of progress. In this context, increasing efforts at the international level have therefore been devoted to the establishment of specific programmes for first psychotic episodes, some practice guidelines having even been developed for this purpose.
In the 1990s, Australian and British research teams identified that young patients with first-episode psychosis have specific needs that require a different approach to care than that provided to older patients or those whose illness has been ongoing for several years. In light of this, increasing international efforts have been directed toward establishing specific programs for first-episode psychosis, with some practice guidelines even being developed for this purpose.
One of the main goals of early detection is to reduce the duration of untreated psychosis (PND), which is the time between the onset of psychotic symptoms and the initiation of appropriate treatment. Study data have shown that longer NTD is associated with a poorer prognosis. This delay, which averages one year when no early detection program is available, is therefore associated with a poor symptomatic and functional prognosis. Psychosis then causes a great deal of suffering and its impact has repercussions to varying degrees on the social, family, school and professional functioning of the subject.
The "psychosocial toxicity" of the disease can have serious consequences (homelessness, job loss, deterioration of the social network, criminalization, poverty, increase in substance abuse, suicide, etc.) that can disrupt a life. However, early detection and intensive intervention can lead to a complete remission of symptoms and thus avoid prolonged suffering and disability.
Early intervention in these programmes is therefore aimed as much as possible at preventing the psychosocial deterioration that is too often observed in the early stages of the disease. An intensive treatment approach from the first difficulties in social, family and professional functioning makes it possible to avoid this deterioration, if not to lessen its effects and to optimize the accomplishment of a meaningful life project for the person. It stimulates hope in the young person and his or her family, in the face of an illness that can represent a "trauma" in itself. Early intervention is advocated worldwide by almost all clinics for first episodes of psychosis and combines the administration of medication at minimum effective doses, family interventions, group therapeutic activities, and individual or supportive psychotherapy. This approach has been shown to be effective in numerous studies.
LEARN MORE
Getting help early (EPPIC)
CMHA – Early Intervention for Psychosis
THE EVALUATION
The first evaluation is done as soon as possible after receipt of the reference. Initial contact is made, usually within 48 (working hours) to determine if the person has probable signs of the onset of psychosis. Subsequently, a more in-depth evaluation is completed by a multidisciplinary team of experts to determine if the person is suffering from psychosis and what their difficulties, needs and life plans are.
After the assessment, a comprehensive and intensive medical and psychosocial treatment is offered to the young adult by the multidisciplinary team of psychiatrists, social workers, occupational therapists, peer helpers and nurses, in a friendly and welcoming atmosphere, prioritizing intervention in the young person's living environment as much as possible. When necessary, the shortest possible hospital stay is facilitated. In moments of crisis, follow-up can be intensified if necessary. It is often even possible for a young person to come to the clinic daily in order to avoid or shorten the hospitalization. Every effort is made to ensure that the young person returns to an optimal level of functioning.
MEDICATION: AN ESSENTIAL BASIS
The main classes of drugs used in the treatment of psychotic illnesses are antipsychotics. When necessary, antidepressants and/or mood stabilizers are sometimes used to optimize the effect of antipsychotics
Taking medication is essential when treating the acute phase, i.e. when the symptoms are clear and present: delusions, hallucinations, confused thinking. The objective of medication is to help stabilize the patient's condition, to help him or her "get back in touch with reality" in order to be able to begin a follow-up with the people involved in the treatment team: psychiatrist, occupational therapist, social worker, nurse and/or peer supporter. Regular medication therefore makes it possible to effectively and often quickly control the symptoms of psychosis and then to initiate multidisciplinary treatment.
During the stabilization and maintenance phases, medication helps prevent possible relapses and maintain control of symptoms, allowing you to pursue your life goals. Adherence to medication and abstinence from drugs are key factors in preventing relapse. It is essential to take the medication as prescribed (dose, frequency, etc.) by your doctor. If you are reluctant to take them (health beliefs, side effects, unacceptable solution for your crop, etc.), talk to your treatment team.
MANAGEMENT OF SIDE EFFECTS
All side effects are more pronounced in the first few days, but usually in less than a week the body adapts and many side effects disappear. Side effects should be reported to the treating physician as soon as possible so that he or she can make the necessary changes. However, it is imperative not to stop taking the medication in order to control the risk of relapse, which remains high, especially during the first year.
WEIGHT GAIN
One of the most common side effects of taking antipsychotics is weight gain. It is important to know that the weight gained can often be lost through exercise and proper nutrition. For example, if a person gains 15 or 20 pounds because of the medication, it is quite possible to lose it gradually. It's better to reach your healthy weight more slowly and maintain it healthily. You should also be wary of "fat-burning" drugs or supplements, which often contain a lot of caffeine or even psychostimulants (risk of relapse). It is also best to be careful from the start to avoid excessive weight gain. If you have an increase in appetite, it is important to control the quantity and quality of the food you eat.
NUTRITION
In terms of diet, it is best to avoid "miracle" diets or diets of extreme deprivation, which usually give disappointing and temporary results. On the other hand, you should favor a healthy diet, i.e. avoid soft drinks and fast food and favor homemade dishes. In addition, even though fruit juices and milk are healthy foods, they contain a lot of sugar and it is best to moderate the quantities. To achieve and maintain a healthy weight, it is important to choose whole foods, fruits and vegetables, and lean protein sources (poultry, beef, fish, egg). The tips and recipes available on the Canadian Guide to Healthy Eating website can be a helpful aid in guiding meals.
PHYSICAL EXERCISE
While opting for a healthy diet and reasonable portions, it is imperative to exercise regularly. It is best to choose one or more activities that you enjoy so that it is a hobby and not a chore. WHO makes the following recommendations for the 18 years and older age group :
- Adults aged 18 to 64 years should engage in at least 150 minutes of moderate-intensity endurance activity or at least 75 minutes of vigorous-intensity endurance activity, or an equivalent combination, during the week.
- Endurance activity should be done in periods of at least 10 minutes.
- To reap additional health benefits, adults should increase the duration of their moderate-intensity endurance activity to 300 minutes per week or engage in 150 minutes per week of vigorous-intensity endurance activity, or an equivalent combination of moderate- and vigorous-intensity activity.
- Muscle-strengthening exercises involving major muscle groups should be done at least two days a week.
DROWSINESS
Drowsiness may be more pronounced in the first few days of taking medication, but should fade in less than a week. In addition, your body may need more rest and "recover" from the sleep you missed and the extra energy you "expended" during the restless or insomnia.
However, if waking up in the morning is still difficult, you can try taking your evening medication a little earlier in the evening, or even around dinner time (consult your doctor or pharmacist to see if this is possible with your medication). However, you may want to go to sleep earlier in the evening. Gradually adjust the time of taking the medication to find a balance so that waking up is easier and your evenings enjoyable.
Using a caffeinated beverage in moderation (e.g., coffee in the morning) can help combat medication-related drowsiness or sedation. Exercise can also help increase energy.
Talk to your doctor. He may be able to adjust the dose or even change the medication to one that is less sedative, because some medications are more sedative than others.
COGNITIVE DIFFICULTIES
Cognitive difficulties can be caused by both the disease and medication. Difficulty concentrating, memory problems and difficulties in expressing oneself often due to the disease; Nearly 85% of people with psychosis have cognitive impairment. These can sometimes be aggravated by certain medications.
Thus, if the difficulties with concentration and memory and the lack of energy seem to be due to the psychosis itself, it will be more advantageous to adjust the medication upwards at first. However, if the symptoms are more the result of the medication itself, it is advisable to try adjusting the dose or timing of administration (in the evening rather than in the morning, for example) or perhaps try a different medication.
In any case, it is important to discuss this with your doctor or a member of your treating team, as it is very risky to make changes to the dosage yourself. In addition, the treatment team is there to work with you and for you and will try at all times to minimize discomfort due to medication and psychosis.
SEXUAL DISORDERS
Some medications can cause a temporary decrease in libido or orgasm (in men or women) or erectile dysfunction. All these side effects are reversible when the medication is stopped. Although most people will not have sexual problems, certain medications are more likely to cause sexual problems (eg, risperidone, paliperidone). It is possible to adjust the dose, change the medication or use Viagra or Cialis to counteract this side effect. If this side effect occurs, don't be embarrassed and talk to your doctor or nurse. Sexuality is a very important facet of life.
MOVEMENT DISORDERS
Tremors, rigidity of the arms or legs, or other problems such as "fidgeting" (akathisia) may also be present, especially with first-generation antipsychotics. Adjusting the dose, taking an "antidote" medication, such as procyclidine (Kemadrin) or benztropine (Cogentin), and changing antipsychotics, can control these side effects.
STRESS MANAGEMENT
How can I effectively cope with stress?
Some important life events can be stressful. For example, starting a new job, getting married or becoming a parent. Frequent worries about finances or the future of your children can also be stressful. Everyday problems like a car breakdown or being late for work are other stressors. Not all stressful events are necessarily negative. We may perceive them as difficulties that enrich our lives, or as stressors that prevent us from enjoying life. The way we perceive these events greatly influences our physical, mental, and social well-being. You can improve your quality of life by better managing your stress. The following techniques can help you better manage your stress:
- Find the right balance between work and play. Schedule moments of rest without feeling guilty and try to be efficient at work.
- Take the time to laugh.
- Delegate tasks. You don't have to do everything yourself.
- Explore relaxation techniques like yoga or meditation; Explore your spirituality.
- Move! And why not combine exercise with household chores like gardening or cleaning?
- Prioritize to better manage your time. Make priority lists.
- Eat healthy. The alcohol, caffeine, and fats you consume hinder your ability to cope with stress. On the other hand, fruits, vegetables, and whole grains help you overcome it.
- Dedicate enough time to rest, sleep, and your body's needs.
- Discuss your problems openly with friends, family or counsellors.
- Take a getaway from time to time. Take a complete rest. Have fun!
- Know that you don't need to "win" every discussion. Leave your competitive spirit behind.
- Don't try to be perfect, and don't expect others to be perfect either.
LEARN MORE
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