Experiencing a Psychotic Break Doesn’t Mean You’re Broken

By Laura Greenstein | Mar. 12, 2018

 

Each year, about 100,000 youth and young adults experience psychosis for the first time. They might see or hear things that aren’t there. They may believe things that aren’t true. It’s like “having a nightmare while you’re awake,” describes Elyn Saks, a legal scholar and mental health-policy advocate.

Unfortunately, when someone starts having these frightening experiences, doctors and medical professionals often tell them that their life won’t ever be the same. That they may never get better. That the best-case scenario is a sub-par existence where every goal they have is limited by their mental state.

Saks, for example, was diagnosed with schizophrenia as a young woman after multiple visits to a psychiatric hospital. “My doctors gave me a prognosis of ‘grave.’ That is, at best, I was expected to live in a boarding house and work at menial jobs.”

This narrative is not only exaggerated, but it’s also inaccurate. It’s akin to telling someone who recently went into diabetic shock that their life is pretty much over. Having diabetes does require proper treatment and lifestyle adjustments. It isn’t an easy health condition—nor is any illness—but you can still live a productive life. The same goes for psychosis and the mental health conditions it accompanies.

Understanding Recovery

There are two categories of recovery for mental health conditions that involve psychosis: clinical recovery, which refers to decreasing/eliminating symptoms and the time spent in the hospital, and personal recovery, which is “a unique process rather an end point with key recovery themes including hope, rebuilding self and rebuilding life.” This form of recovery involves personal goals and values that make life fulfilling.

Personal recovery has received more attention in recent research to help combat the myth that you can’t lead a good, fulfilling life with psychosis. Even if a person hasn’t achieved a complete clinical recovery (yet), they can still work towards personal recovery. According to a 2017 study, “We should make efforts to scientifically characterize the conceptual framework of personal recovery, so that users, family members, caregivers, and professionals can understand and contribute to the users’ personal recovery and subjective well-being.”

Clinical recovery takes time. And during that time, life shouldn’t be on hold. While a person is in treatment, they can still work towards theirs goals and do things that make them feel fulfilled. That way, once they leave a treatment program or a hospital visit, they have a foundation to continue building the life they want.

Setting Goals Leads to Better Outcomes

Clinical recovery and personal recovery work together and complement each other. According to NIMH’s research project, Recovery After Initial Schizophrenia Episode, it is essential for people experiencing psychosis to have personal goals that drive their treatment. For example, getting a degree for the career they want or getting involved with a specific cause. Working towards clinical recovery is incredibly hard, and having aspirations for the future helps individuals stay motivated and engaged in their recovery process.

This is why giving someone a “grave prognosis” can be harmful and counter-intuitive: Because people experiencing psychosis have better outcomes when they are focused on achieving future aspirations. That’s hard to do when you’re feeling hopeless about your future.

“Fortunately, I did not actually enact that grave prognosis” states Saks, who refused to accept that the psychosis associated with schizophrenia would define her life. “Instead, I’m a chair professor of law, psychology and psychiatry at the USC Gold School of Law; I have many close friends; and I have a beloved husband.” Saks isn’t an exception to the rule. In fact, many medical experts today believe there is potential for all individuals to recover from psychosis, to some extent.

Experiencing psychosis may feel like a nightmare, but being told your life is over after having your first episode is just as scary. Both personal recovery and clinical recovery are possible—that’s the message we should be spreading to the thousands of young people experiencing episodes of psychosis.

 

Laura Greenstein is communications manager at NAMI.

Comments
Laura Lincoln
I'm wondering if anybody can help me in trying to help my 29 year old nephew. He lives in Texas with my sister. He has taken over her life and quite easily as my sister doesn't want confrontation because his reaction becomes worse. In the meantime he is destroying her home, breaks anything he wants (including doors) and has told her he will kill her.
I'm moving out this week to live in my sister's home because I'm extremely worried about her.
He does hear voices and hallucinates all the time. He works but is unable to keep a job for any length of time.
He has been hospitalized in the past but not for any length of time. He's been known to hoard his medications so at this point I'm not sure if he's taking them or not. I believe he isn't as his violent episodes are just one after another.
I don't know how or what to do.
It sounds like he needs a long term mental health facility to me. Am I correct in that assumption?
Any and all feedback is more then welcomed.
Thank you
4/17/2018 1:50:01 AM

Renee
My son just turned 31. He is Schizoeffective. He is currently in county jail (during a psychotic episode) causing him to run not realizing or having any touch with reality; One of his long term med was effecting his kidneys therefore leading his Dr. changed his meds. he is awaiting what seems to be a wonderful opportunity to be part of a program behavioral health. Temp live in a independent living arrangement enable him to learn how to be independent manage disorder. attend classes. He is doing well,the best I have seen him in a long time. He is on a nice *****tail to manage his disorder. He underestimates what he could do. I don't.
4/7/2018 12:37:29 PM

Elyn Bell
i appreciate the articles hopefulness for us.
4/2/2018 12:26:31 AM

Glenna Nolan
Good information.
4/1/2018 9:08:48 AM

Johnny Kent
I have lived many years of my adult life under the stigma of this abuse by the professionals "opinions".
To in many ways cover for their poor ethics...its kept my life destabilized for the most part...i haven't been able to overcome the effects.
I'm not psychotic and never have been...
I do suffer from depression and it is aggravated by the opinion which has become to some extent public knowledge and gets used against me creating an attitudinal barrier.
My life has never returned to the way it was before the opinions negatively affected my ability to work and function.
It has negatively affected every area of my life.
3/29/2018 10:14:20 PM

Patrick Llewellyn
Related to Becky Snows' query about steroids:
I had severe allergic migraines one year, and the doctor put me in Medrol for a 10-day cycle. While I do have Major Depressive Syndrome, I'm almost never an angry person. On Medrol, in the beginning I was experiencing blissful highs, but into the late part of the cycle, I flew into rages and paranoia at the slightest provocation. Then, I was back to my normal self afew days after the Medrol cycle was complete. So, at least for my biology, yes, there is a correlation or causation.

All the best!
3/29/2018 2:19:57 PM

Charlotte Hagedorn Peterman
Thanking all those who posted comments, sharing their journeys of personal recovery after psychosis. I am 69, and am off all antipsychotic meds for the first time since 1975. It is not easy. At times I miss the blunting effect of strong emotions by the antipsychotics, but I feel alive again, having feelings that make me who I am, and moving forward with plans and dreams, despite Tardive Dyskinesia acquired as a side effect of older antipsychotic meds.
3/29/2018 11:11:11 AM

Chrid George
Along with 'some' drug therapy I advise personal 'self-help' counseling.- To get over 'some' psychosis- one can turn to daily socializing, reading, actively pursuing personal interests as small or big as they are-religion and philosophy, volunteering, PT working , hygiene and changing one's attitude -too stay positive during these difficult times where the mind and body need an influx of positive change.
3/29/2018 8:41:06 AM

Todd Webster Miller
I also believe in working through psychosis, as a natural course of action, to live for, that is also, to function for or vice versa. I find also that course of action, with the help of seeking out psychiatry and psychological, "provisional care", in tandem, is or had been very helpful, for me, par example, et, or so - My Best, Todd Miller of Burlington, VT
3/28/2018 6:45:56 PM

Silvana
Great insight!
3/28/2018 5:30:33 PM

Mary Lynn
Thanks. Very informative! It has given me motivation to do more.
3/28/2018 5:29:55 PM

Alan
I welcome the article, and I also have written a blog about what a dad ought to do when it is clear that his son's bipolar will not be cured. My son manages very, very well. Is employed, lives on his own, has good friends, is witty and charming. However, after 20 hospitalizations on psyche wards, it is clear that his disorder will not be cured, but it will be and can be managed. That is good. For the blog, www.inmi.us.
3/28/2018 5:19:22 PM

Karen
This article has given me hope. I was diagnosed as bipolar but maybe it was just a psychotic breakdown I had when I was 19 and 40 thank you so much for the insight and Light
3/28/2018 3:48:02 PM

Robyn Cohen
I’m wondering if anyone has any suggestions for a good psychiatrist in the San Diego area for my 30 year old son that experienced a psychotic episode 4 years ago.
3/28/2018 3:39:27 PM

Becky Snow
I’m curious about phycosis and asthma. I’ve been diagnosed bipolar for 12 years but only recently noticed horrible reactions after I’ve had a steroid shot for my asthma symptoms. My behavior becomes manic like and the agitation in my brain is overwhelming. What’s the link to this and how many others have encountered this? I visited an urgent care last month and they gave me a steroid shot for my asthma and I nearly ruined my entire life in one afternoon.
3/27/2018 11:14:13 AM

steve
I have manic depression 1 and have had episodes of psychosis, I am on disability
3/26/2018 6:37:42 PM

Lynne
What's the (clinical &/or practical) difference between psychosis & hallucination, at least as far as "hearing & seeing things that aren't there"?
Duration? Frequency? Amount of disruption to the person's life?
3/18/2018 6:59:01 PM

April
I read Saks book A Center could not hold. I found it to be very inspiring. I have schizophrenia and still have good dreams for my future
3/18/2018 4:35:39 PM

Betty
Can anyone reccommend a Duo Diagnonsis residential program in Georgia that accepts medicare and medicaid?
3/16/2018 1:25:22 PM

Karen Rasch
Until mental disease is brought out of the closet, there will always be a grave prognosis. I had been diagnoised as bipolar for many years with no help from many medications. I fought the diagnosis for years until I was properly diagnosed with Cealics Disease, which has a higher rate of suicide than bipolar. There is not a magic pill for Celiacs, only strict adherence to diet. An individual has to fight for for their mental health daily. I’m proud to say that I am off all medications as Celiacs was causing my organs to fail and left me with deep seated feelings of hopelessness and the desire to end my life. I have been in the fight for my life, my health and my mental health, but I am making great strides for a better future and not a grave future as the doctors led me to believe I would have. Many of the medications for bipolar caused my psychosis but no matter how hard it was, I believed that I could live a normal life and had to keep fighting and not give into the grave prognosis that irresponsible medical professionals gave me.
3/15/2018 5:09:13 PM

Anne Powell
Are there affordable, long-term facilities where someone who needs oversight could also work part-time or full-time?
3/14/2018 3:17:02 PM

Pauline Zaimah
I agree totally, my son is 25yrs and Ventura County is trying to make him permanent public guardian, I’m interjecting this, because institutionalizing, does not improve a person Behavior, without training them and set goals for the future! It’s demoralizing, and inhumanity, they don’t treat animals like that!
3/14/2018 8:57:25 AM

Betty
Very informative
3/14/2018 7:53:12 AM

Sandra Kilko
Daughter has Bipolar 1 Psychosis
3/13/2018 6:53:47 PM

Roxanne
This is an excellent article!
3/13/2018 1:30:18 PM

Ted Van Horn
Thanks!
Very well written and hopeful article!
We need more of these types of messages out there about schizophrenia to help end the stigma and educate people on this much misunderstood disorder.
3/13/2018 12:24:44 PM

Traci Fox
There are also multiple causes for a psychotic break. It isn't always due to Schizophrenia or another major illness. Sleep deprivation, high doses of corticosteroids and some people's reactions to certain other medications, for example can induce a psychotic state.

I was misdiagnosed as bipolar and put on antipsychotic and mood stablizing drugs that I didn't need for several years, after suffering one manic episode with psychotic features. Nobody, none of the doctor's anyway, mentioned that my recent near-death experience from pneumonia + asthma and subsequent 2 weeks on a ventilator and month in a critical care unit on very high doses of steroids may have been the root cause of it. I was bipolar, they said, and this illness just triggered it. I would never be off of the likes of lithium, Stellazine and antidepressants.

After many drug changes over the next 7-8 years thst caused everything from hoplessness, to fainting, to seizures, I worked with a psychiatrist and endocrinologist to change my original diagnosis.
For the past 20 years I have been healthy and happy on an antidepressant and 5 mg prednisone for adrenal failure.

Under the bipolar diagnosis, I was on disability. I could not finish college or hold a job. Now I have 2 masters degrees and a successful14 year carrer as a teacher.

All I can say is, if you have experienced psychosis, don't be intimidated by physicians. Don't give up on your instintics and do listen to the opinions of people who are closest to you. Read as much as you can about your diagnosis, and alternate ways of looking at it, because one of those might be a better description of your particular situation.
3/13/2018 7:45:15 AM

Lizanne Corbit
Thank you for putting this out there! This is such an important thing to be aware of -- it is NOT a final sentence. Unfortunately, far too many doctors are way too quick to give the "this is how it will be forever" response. This can be wildly upsetting and disheartening. Every individual is different and recovery can look different but there is indeed solid potential for individuals to recover.
3/12/2018 6:47:11 PM

Kathleen M Maxwell
The medication that psychiatry puts you in inhibits personal growth. They leave you in a fog, your brain not functioning appropriately. It is,a life sentence if you listen to the world of psychiatry.
3/12/2018 5:59:56 PM

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