How to help your loved one through a psychotic crisis

Helping your loved one through a psychotic episode

5 Step Plan

1. Gather information
2. Recognise the signs
3. Trust your instincts
4. Who to contact
5. Look after yourself

Seeing a friend or loved going through a psychotic episode is a heartbreaking process. Not knowing what to do or how to help can compound feelings of helplessness, fear and anxiety, both for you and your loved one.

Having a plan of what to do when the situation arises can minimise the stress, and help you retain some inner control.

Here are some guidelines you can follow in order to prevent or minimise panic when a crisis occurs. Before you make your plan;

1. Gather information: Find out as much as you can about what psychosis is. You could start by learning some facts from www.rethink.org

2. Recognise the signs: Learn to recognise the early signs of psychosis;
Pay attention to behavioural warning signs

Behavioural signals can provide awareness regarding someone’s intentions. Pay attention to cues that might indicate discontent or distress. Some behavioural signals might include:

• Significant changes in “normal” behaviour or routines
• Sudden changes in expression, physical activity, or posture
• Dramatic increase or change in voice, volume, or tone
• Expressions that communicate extreme anger or distress
• Communications of despair and hopelessness
• Body posture that is intimidating or threatening
• Verbal or physical threats

Other warning signs could be;

• Disturbed patterns of sleeping or eating
• Confused or muddled thinking
• Noticing that things and people seem strange or unreal
• Being preoccupied with particular ideas or thoughts
• Unusual experiences such as seeing or hearing things
• Struggling to cope at school, college or work
• Being withdrawn e.g. refusing to join the family for meals
• Self neglect e.g. not having a bath for days, poor personal hygiene
• Bizarre behaviours e.g. stop sleeping on a bed and starting to sleep on the floor
• Poor concentration e.g. difficulty with study
• Lack of interest e.g. refusing to attend classes, refusing to go to work
• Unexpected outbursts of anger or upset

3. Trust Your Instincts: Be aware of, and trust, your own internal warning system. Your body may send signals when it senses danger. If you become concerned and sense impending danger, talk to someone about it, follow your plan and respond accordingly. Some of your own instinctual signs/signals might include:

An increase in your breathing rate

A sensation of pressure on your chest

An increase in perspiration

A ‘sinking feeling’ in your stomach

An increase in sensory acuity

(Sensory acuity is defined as the ability to observe, examine, and interpret the external cues received from other people. For example being aware of non verbal communication such as body language, postures, eye movements, changes in energy. Are you aware of what’s going on ‘around’ you?)

Be aware that psychosis is a medical condition and requires medical intervention. Just as you can’t heal a broken arm without medical help, so you’ll require assistance in dealing with psychosis.

4. Who to contact: Contact a mental health professional. If your friend or relative is displaying several of these early signs of psychosis, you could contact their GP or local Community Mental Health Team. The local GP surgery or any other health care professional should be able to provide you with relevant contact details of your local Community Mental Health Team. Find your local crisis/early intervention team and explain to them your concerns.

5. Look after your self: Do not allow yourself to become rundown and fragile. Ask for help from friends and community sources. Your loved one depends on you to be their guide through dark times and you need to be in peak condition to do this. Delegate everything that you possibly can. Don’t fall into the belief that you are indispensable. Remember what they tell you when you are on an aeroplane 'Fasten your own seatbelt first'!