How do you treat psychosis?

Like other mental illnesses, treating psychosis depends on the kinds of symptoms you have and how severe they are. The best results come from combining multiple approaches. Changing your eating habits, getting therapy, figuring out how to manage school and work, and taking medications can all be used in combination. Think about how each of these approaches might fit into your life—and how they might work together. When your brain and body are both healthy, you’ll have an easier time managing your symptoms.

Lifestyle changes

Stress

Psychosis and other mental health symptoms get more severe when you are experiencing a lot of stress. Stress can come from big changes like moving to a new place or starting college—but even smaller stressors like the pressures of doing homework can increase your stress and symptoms.

Pay attention to what stresses you out. Notice how your symptoms change or get worse when you are stressed. Make sure you are taking care of yourself and taking lots of breaks. And if you know you have something stressful coming up, try to prepare in advance.

Sleep

Brain health depends on getting enough sleep. Some people find that sleeping becomes a challenge after they experience symptoms of psychosis. You might sleep too much—or find it hard to sleep at all. Or you might want to sleep during the day and stay awake at night (this is called day/night reversal).

The most important thing is making sure you’re getting enough quality sleep. If you’re not sleeping well, talk to your doctor, who can help identify solutions.

Pay attention to your sleep hygiene—your sleep-related behaviors. Create rituals to help your body get ready for sleep. Check in on whether your timing of food, exercise, or even the kind of music you listen to impacts your sleep.

Many people take melatonin supplements for sleep. Some research has linked low melatonin to psychosis, which might be a potential cause of day/night reversal. (It’s a good idea to talk to a doctor before starting a new dietary supplement.)

Nutrition and exercise

Eating healthy foods helps your brain. Specifically, eating more green vegetables and healthy fats like omega-3 fatty acids (you can find these in salmon, flaxseed, or supplements) may help reduce symptoms of psychosis. Exercise—even brisk walking—helps keep inflammation low, which can help with psychosis and mental health in general. When we move our bodies regularly, it impacts our brain health, as well as our overall health.

Support

When you’re diagnosed with a mental illness, getting extra support is really helpful. Because stress impacts psychosis, people experiencing the earliest signs of psychosis often need support and changes at school or work. (One early sign of psychosis is hearing and seeing things, while still recognizing that those things are not really there.)

These supports are called supported education and supported employment. Typically they are embedded in other types of treatment called specialty care, assertive community treatment, coordinated specialty care, wraparound services, or enhanced services. People who don’t have access to these kinds of supports have access to other “accommodations” in school through 504 or IEP plans or college disability services.

As with any mental health condition, it’s also helpful to have support from friends or family. You might also consider joining a support group for people going through similar experiences. Talking openly about your experiences can help you feel less alone and more connected.

Therapy

Therapy can be a great way to change behaviors, gain confidence, learn new skills, and talk with someone openly and honestly. There are many different types of therapy. For individuals with psychosis, therapy can be beneficial in a couple of ways:

1. Healing from trauma
2. Learning to listen to and understand what the voices are saying and what they mean in your life

For most people, these two areas are interconnected. Voices often respond to or relate to the fears and needs we have developed because of traumatic life experiences. Taking time to listen to them can give you more insight and control over your experiences.

Medication

Medications that treat psychosis are called antipsychotics. There are older medications and newer medications. The newer antipsychotics have fewer side effects.

For psychosis, antipsychotics are more effective at treating voices and visions (called positive symptoms) than changes in our emotions, feelings, and facial expressions (called negative symptoms).

Antipsychotics work relatively quickly compared to other mental health medications like antidepressants. People often feel changes within a few days of first taking antipsychotics. The same thing happens when you stop taking antipsychotics—symptoms often return within a few days. When you talk to your doctor, here are things you can do to prepare:

1. Identify which symptoms you want to get rid of and which you want to keep. Some people find solace in their voices. It’s ok to say that and tell your doctor, “I want this voice to stop, but I don’t want that one to go away.”
2. Identify what you want to do. What are your school or work goals? Your doctor should give you medications that help you succeed in those goals. Your treatment shouldn’t make it harder for you to do those activities.
3. Keep track of the negative and positive impact of the medication—for example: your symptoms, side effects, sleep, stress, and how you feel at different times of the day.

If you’re not sure if you should take meds, check out this article.