If you are reading this article about having another episode, then it’s likely that you already know that you have psychosis. And because you’ve had an episode before, you know that you might be experiencing another episode or flare-up.
Relapses with psychosis can be normal and common, and often part of living with this chronic illness. The important thing to do when you think you are having another episode is to plan for it. This means thinking about what happened during past episodes and telling someone. That way the people in your life can be there to support you when you need it.
We are people, not a diagnosis. We have a right to change and sustain our own recovery.
What does it mean to have another episode?
Having another episode can mean losing touch with reality. One of the signs of a psychotic break is finding it hard to tell what’s real and what’s not real.
Ask yourself:
- Are there visions, voices, or beliefs that feel more and more real or like they’re really happening to you?
There are moments when you can tell that your brain is playing tricks on you. But when it becomes more and more difficult to realize that these tricks aren’t real, that’s when you start to lose control. And you may start seeing, hearing, believing or experiencing things that aren’t real. The more you lose control over reality, the more you are at risk for having another episode.
Another episode can be a major disruption to your life. School, work, relationships, and other areas of your life may be affected if you do nothing. So, if you are noticing any changes in your symptoms or experiences of psychosis, it’s important to act. Planning ahead, reflecting on past experiences, and getting support from others can help keep you safe and give you stability.
If you don’t know where to start planning ahead for an episode, here are some resources that can help:
- Think Ahead: Mental Health Crisis Plan
- Crisis Plan for Your Support System
- Be prepared: Crisis planning with a psychiatric advance directive (PAD)
- Do I need to go to the hospital?
- Who makes mental health decisions for me if I can’t?
What were your past episodes like?
Taking time to think about what your first episode or previous ones were like can help you understand what’s going on right now. Now that you have been through it, you know what signs to look for and how to tell if something is off.
What symptoms did you have during your last episode/break with reality?
For example,
- Did you going days without sleeping well?
- Did you feel like you were isolating from others?
- Did you have beliefs or thoughts that were out of your norm?
- Did you have strange or weird experiences that were hard to describe?
- Do you feel like you are experiencing any of things on this list again?
Everyone’s experiences are different, but some common signs of having another episode include: [1][2]
- Increased stress or anxiety
- Insomnia
- Withdrawing from family, friends, and loved ones
If you had a really bad episode the first time, then getting support sooner rather than later can help in the long run. Taking a psychosis test can also help you check in with yourself. And this tool can help you reflect on your psychosis experiences, triggers, and supports. You’ve been here before, and now you are in a better position to figure out how to move forward.
Why finding support now is important
Going through this alone and not planning ahead means that you could potentially fall apart. And there’s nothing wrong with that, but it’s much easier to get back up after falling when you have support. This is why it’s important to find support right now. You’ll have people who can help you get up, recover, and rebuild.
Who are the people who can support you?
- Your parents, friends, or other loved ones: These are trusted people in your life. They aren’t dismissive when you say, “Hey, something is wrong.” They may even be aware of what you’re going through and have supported you in the past. If you think that you are having another episode, then you are going to want them there for you. If you can’t stop the episode from occurring, knowing that there are people who will be there for you through it and support you afterward means the world. You can also make them an emergency contact if needed. Talking to loved ones can be hard, so this tool can help you prepare for the conversation.
- Your trusted providers like your psychiatrist, therapist, or doctor: This is your care team. And now is a good time to let them know that you’re experiencing increased symptoms and having trouble managing them. Let them know that your medication didn’t work, isn’t working, or stopped working, and you might need to change or up your meds. They can help you figure out your medication needs. And they may also be able to provide strategies to help you reality-test and stay grounded in reality.
Taking action now can lead to a better outcome. If you’re noticing that something is going on, then it’s time to loop others in while you still can.
- Eisner, E., Drake. R, & Barrowclough, C. (2013). Assessing early signs of relapse in psychosis: Review and future directions. Clinical Psychology Review, Vol. (33), 637-653. https://doi.org/10.1016/j.cpr.2013.04.001
- Almuqrin, A., Georgiades, A., Mouhitzadeh, K. et al.(2023) The association between psychosocial stress, interpersonal sensitivity, social withdrawal and psychosis relapse: a systematic review. Schizophrenia (9), 22. https://doi.org/10.1038/s41537-023-00349-w
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