Recovery From Psychosis Is Expected

Rene Corbett

Web-only article from "Campuses" issue of Visions Journal, 2007, 4 (3)

Christopher* was proud of his good marks in high school. But he got a ‘C’ on his first essay in college. His teacher said she couldn’t understand his thinking. He barely passed the semester, and didn’t go back to college.

Ali* wasn’t allowed to attend college for a semester after he wore a costume to class, wrote notes to his teachers about his “special” personality and, finally, brought a replica gun to school.

At first, Jessica* enjoyed her university courses and friends—until one day she suddenly stopped going to class. She worried that students were watching her, even when she was home alone, and she became afraid for her safety. She was shocked to discover she’d failed three courses.

All of these young people turned out to have psychosis, a treatable condition caused by a brain disorder. Psychosis symptoms are different in each person, but usually include hallucinations (such as seeing, hearing or sensing something that others don’t experience) and/or delusions (fixed false ideas). People with psychosis might suddenly have odd behaviour, may be unusually suspicious of others, or may change their normal sleeping or eating patterns without explanation. Problems remembering and concentrating are common.

Doctors don’t know exactly what causes psychosis. Schizophrenia, bipolar disorder and serious depression are all illnesses that might include symptoms of psychosis. Street/recreational drugs can cause psychosis, even after people stop using them.

The good news is that, nowadays, people with mental illnesses can lead ordinary, happy lives.

Early intervention yields good results

Special mental health programs, called Early Psychosis Intervention (EPI) programs, give early, intense assessment and treatment. The programs—staffed by psychiatrists, social workers, psychologists, occupational therapists and nurses—target young people in their teens and twenties. Youth with possible psychosis can get help quickly, instead of just waiting to get better on their own, which is unlikely to happen. If youth do not have psychosis, EPI staff will suggest other mental health resources, if needed.

Research shows that EPI programs have good results.1-3 Young people who’ve received help have more full-time work, less medicine, fewer hospital stays, less problem drug and alcohol use, and better social relationships. EPI programs help people keep their friends, attend school and college, and work successfully.

Christopher, Ali and Jessica were helped by the Vancouver/Richmond Early Psychosis Intervention Program. They each met with a psychiatrist and one of the other clinicians on staff to work out what was wrong and how the EPI program could help. Christopher’s mom brought him to his EPI meetings and helped by describing more about him. Jessica didn’t get along well with her dad, so at first came to EPI by herself. Later her dad came, to learn more about her mental health. Ali brought his uncle sometimes, because his parents didn’t live in Canada. His uncle told the EPI team more about Ali’s family and upbringing. Involving family and friends is an important part of the EPI approach.

To reduce psychosis symptoms, they each took medicine and met with EPI staff, individually and sometimes in groups. They learned more about getting and staying well, by talking about what was important to them. Discussions included their illnesses, medications, ways to prevent possible relapse, healthy lifestyle choices, assertiveness, self-confidence building, and work/education/leisure issues.

As they began to feel better, they focused on the ordinary things that help to make a great life, such as seeing friends, working and going to school. Jessica attended an EPI group especially to learn to boost her self-confidence. Ali went to an EPI group to learn more about psychosis and to meet other young people with psychosis. Christopher didn’t feel ready to go to a group, so kept meeting with EPI staff individually.

EPI staff working with Ali met with a Disability Resource counsellor on the campus to explain more about Ali’s illness. The college staff were relieved to hear that his strange actions were most likely part of his illness and not his usual behaviour. With treatment, his unusual behaviour stopped. To minimize stress, Ali decided to study part-time. He met with the EPI occupational therapist to learn how to organize his time and improve his study skills. He qualified for a study grant that paid part of his tuition.4

Christopher hasn’t gone back to school yet. He says he feels confused sometimes, but is encouraged when EPI staff tell him that recovery takes time. Recently, he got in touch with friends from high school and started to play soccer.

With the support of EPI staff, Jessica enrolled in three courses to finish her degree. After a month, she doubted her decision to go back to school, worrying that she wouldn’t do well. But when she talked it over with EPI staff, Jessica realized that she was actually keeping up with her courses. She joined a campus study group to help with one course and felt better because she had someone to talk to about assignments.

So don’t wait!

People with psychosis sometimes don’t get treatment because their symptoms aren’t recognized as brain illnesses—by the person experiencing psychosis, by friends and family, or sometimes even by health care providers. Youth also don’t seek help because of the stigma that sometimes still goes with mental illness. But early treatment of psychosis helps people recover well.

At first, having psychosis was difficult for Ali, Jessica, and Christopher. It was scary to think there might be something wrong with them and that people might think they were ‘crazy.’ With the help of the Vancouver/Richmond Early Psychosis Intervention Program, they were able to get healthy. More importantly, they were each able to get back to the things that matter to them.

* Names and identifying details have been changed

 
About the author
Rene provides education about early psychosis identification to communities throughout Vancouver Coastal Health. She has worked as a mental health clinician in hospital, day program, community, and vocational rehabilitation settings. Rene trained as an occupational therapist at the University of British Columbia, where she is a clinical associate professor.
Footnotes:
  1. Agius, M., Shah, S., Ramkisson, R. et al. (2007). Three year outcomes of an early psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team. Psychiatria Danubina, 19(1-2), 10-19.

  2. Culberg, J., Levander, S., Holqvist, R. et al. (2002). One-year outcome in first episode psychosis patients in the Swedish Parachute project. Acta Psychiatrica Scandinavica, 106(4), 276-285.

  3. Garety, P.A., Craig, T.K., Dunn, G. et al. (2006). Specialised care for early psychosis: Symptoms, social functioning and patient satisfaction: Randomised controlled trial. British Journal of Psychiatry, 188, 37-45.

  4. This was a federal government Canada Study Grant for the Accommodation of Students with Permanent Disabilities. It was obtained with the assistance of a campus Disability Resource Centre counsellor and the college’s Financial Aid office. For more information about the grant, visit www.servicecanada.gc.ca/en/goc/accommodation_disabilities.shtml.

 

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