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.

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

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

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

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

Ted Van Horn
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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