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Psychosis: Information for Youth Coping with Psychosis

Summary: Do you hear voices that others can't hear? Do you see things that others can't see? Do you worry about others following you? Do you have troubles with your thoughts and feelings? If you so, you are not alone. Many other people have similar experiences, and the good news, is that there are ways to help...
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My Story, Part 1

It all started in college. I began having a hard time with school work, and my part-time job. I just couldn’t focus on anything, and it was like my thoughts were all jumbled. And then I began hearing this really negative voice -- it was quiet at first, then it got louder. I began to feel that everyone was watching me. 
 
Things got so bad, that I had to quit my job and I began skipping classes. I hid this from my parents, but my friends started to worry. I just wanted to hide all day. When I watched TV, I thought the people on the shows were speaking directly to me. 
 
Luckily, I had a good friend who told my parents, and they took me to see the doctor… At first I was upset that my friend told my parents, but looking back, I’m very happy she told them, because in the end, thanks to my friend and my parents, I began getting the help that I needed… 

What is Psychosis?

Psychosis is a treatable medical condition that can affect your thoughts, feelings and behaviours. Having psychosis can feel very scary. Sometimes you don’t even know what’s real or what’s not.
 
For example:
  • You might hear things that others cannot, such as voices.
  • You may see things that others cannot, such as people following you, or shadows.
  • You may have some thoughts that can be very scary, such as worrying that others are out to harm you, or that the government is spying on you.
All of these things can be extremely scary and frightening.  The good news, is that many things can be done to help you in order to help you feel safer.

Who Gets Psychosis? 

You are not alone. Psychosis usually starts in teens and young adults (i.e. between age 16-30).

What Does Psychosis Look Like?

People with psychosis may:
  • Hear, see, feel, smell or taste things that others don’t;
  • Have an unusual belief about something that other people don’t understand;
  • Feel suspicious or paranoid that others are watching or following;
  • Have troubles focusing, thinking or speaking;
  • Withdraw or isolate themselves from others;
  • Lack energy or motivation;
  • Feel numb and not have much emotion;
  • Have trouble sleeping;
  • Have trouble doing everyday things like going to school, working, shopping or chores;
  • Have trouble with self-care, e.g. troubles bathing or showering regularly.
Many times when you have psychosis, you don’t notice anything wrong, and its more the people around you that become concerned.

Why Do I Have Psychosis?

Its complicated. There are many things that can increase a person's risk of getting psychosis such as:  
  • Stress from home, school and relationships
  • Trauma, which is having gone through extremely stressful situations at home   
  • Street drugs especially marijuana (i.e. weed / pot), stimulants (i.e. caffeine, cocaine) and hallucinogens (such as shrooms, acid and LSD) 
  • Family history: If there are other family members who have had psychosis, then you may be at higher risk as well. 

How is Psychosis Treated?

With psychosis, the sooner that you get treatment, the better. Early treatment increases the chance that psychotic episodes will resolve. On the other hand, the longer that people wait, the harder it is to get treated and feel better. 
 
Typical treatments include:
  • Medications: Especially If you are feeling unsafe, hearing scary voices, or seeing scary things, medications can be very helpful.

    Key points about medications:
    • They are not addictive.
    • They do not take control away from you, in fact they give you more control over your life, because they give you freedom from the distressing symptoms of psychosis.
    • Imagine what it would be like to be free again fromhearing scary voices, seeing scary things, or having scary thoughts!
Once your symptoms are under control, then the medications can be stopped at a later date working with your doctor.
  • Talk Therapy (counselling). A therapist will work with you to figure out how s/he can be helpful. Usual goals include helping one cope with psychosis and managing stresses such as school, work, family and relationships. A therapist can also educate your family about how to support you through this experience.

Self-Help for Psychosis: Lifestyle Changes

The good news is that these are many ways you can help your brain to deal with psychosis: 
  • Get enough sleep, at least 8-11 hrs/night. Studies show that only 25% of teens get the sleep they need. The biggest reason? Staying up late from using electronic devices… Put your device away by 9 PM, so that you can be in bed by 9-10 PM, and hopefully get a good 8 to 11 hours of sleep…
     
  • Stay away from drugs and alcohol. Many substances that can make hallucinations and paranoia worse such as:
    • Marijuana, i.e. pot/weed. 
    • Hallucinogens such as LSD, shrooms 
    • Stimulants such as cocaine 
    • Legal stimulants such as energy drinks / coffee.
       
  • Get outside every day. Nature is good for the brain, and helps for many brain conditions including psychosis. Ideally aim for 30-60 minutes outside every day. You might try:
    • Walking, biking, running outside.

    • Simply sitting outside when you read, or even use your technology. 
       

  • Avoid sensory overload. You may find that you are very sensitive to noise, lights and other sensory stimulation.
Are you bothered by too much noise? If so, you could try:
   * Letting others know that noise bothers you;
   * Finding a quiet place to go to, like your bedroom;
   * Wearing ear plugs.
   * Wearing headphones and listening to soothing nature sounds or relaxing music
 
Are you triggered by too much light or fluorescent lights? You could try:
   * Closing your drapes so its dimmer at home;
   * Wearing a baseball cap, hoodie or sunglasses if overhead light bothers you.
  • Get things done. It gets very stressful if you are falling behind in school, work or other obligations. Get organized and stay and top of things. You can
    • Try to keep a regular schedule, e.g. have the same routine every day as much as possible.
    • Plan ahead, e.g. at the end of each day, think about what you have to do for the next day.
    • Use an agenda or calendar: When you have deadlines and things coming up, add new tasks into your agenda (paper-based, cell phone or online). 
    • Make To Do Lists: For stuff that doesn’t fit into a calendar, write it down on a To Do List -- there are many apps that can help with this. 
       
  • Deal with school stress. Are you stressed out from school? If so, tell your school (i.e. your teachers or guidance counselor) that you are feeling stressed out, so that they can work with you to figure out how to reduce those stresses.
     
  • Deal with home stress. Are you feeling stressed from home? Talk to your parents about your home stresses to see if there is a solution. Unable to tell your parents? If so, then tell another adult that you trust, e.g. relatives, friends of the family, teacher, doctor, or others. They might have some ideas on how to help. 
     
  • Have healthy activities in your routine. Too many people fill their day with activities (e.g. sitting several hours a day in front of a screen) which really isn’t healthy. Try to make sure you have healthy things in your daily routine, such as quiet time to chill out (without using electronics), yoga, sports or art…
     
  • Be mindful. Mindfulness is about paying attention, on purpose to what is happening right now, without making any judgements about what is happening. You can practice mindfulness anytime, anywhere. For example, as you’re walking outside, notice the sights, sounds, smells, and sensations. Do you feel the wind on your face? Can you smell fresh cut grass? Are squirrels chirping at each other?

    Some people like to practice mindful meditation, where they sit quietly for a few minutes, and focus attention on something. They often start by focussing on their breath. There are many apps and videos for mindfulness meditation. 
     
  • Practice ‘Belly Breathing’. Everyone can benefit from taking a few minutes every day to focus on breathing deeply and calmly.

    One way to do this:
    • Sit or stand and relax your shoulders. Place one hand on your chest, and the other on your belly.
    • Close your eyes if you’re in a place where you can do this
    • Breathe in deeply through the nose.
    • Expand your belly out as you breathe in. Notice how the hand on your belly moves out as you inhale. Notice how the hand on your chest stays in the same spot.
    • Hold your breath for a brief moment and release slowly through your nose (if your nose is clear).
    • Focus on the feeling in your belly or your nostrils as you breathe.
    • Repeat a few times.
       
  • Spend quality time with others. Spend time face to face with people who can listen and support you. If you just want them to listen, tell them that you just want them to listen. Consider calling someone or a phone support line. 

Self-Help for Psychosis: What to do if you are feeling overwhelmed by seeing or hearing things

If you find that you are seeing or hearing things that are overwhelming, there are things you can do in the moment to help: 
  • Grounding strategies. Grounding strategies use sensory input to bring your brain back to reality. Here are some examples of things you can try:
    • Smell: Smell a bottle with perfume.
    • Oral: Suck on strong mints; Chew a piece of gum; Suck on a popsicle, chew ice chips.
    • Get physical: Stamp your feet or clap your hands hard; Do something vigorous like going for a run, or lifting weights. 
    • Touch: Take a cool shower; Snap a rubber band on your wrist. 
    • Fidget: Play with something in your hands by squeezing a ball.
       
  • “5-4-3-2-1” Exercise. This uses both sensory input and concentration together:
    • Think about 5 things you see
    • Think about 4 things you can touch or feel
    • Think about 3 things you hear (e.g. music, singing out aloud)
    • Think about 2 things you can smell (e.g. put lotion in your hand)
    • List one thing that is positive about you
       
  • Self-compassion: Be mindful and kind to yourself by accepting how you feel. When you are hearing voices, or seeing things (e.g. a critical voice that says "You're no good!" "You're a bad person!"), we tend to be hard on ourselves which often makes things worse, by saying, "Why does this have to happen to me? Why is it so unfair!"

    Do you have a negative inner voice that is negative, or criticizes you, or makes you feel bad? What would you tell a loved one or friend who is struggling? You’d probably tell them things like “It’s okay, you’ll get through this.” Try to tell yourself the same positive things that you’d say to a friend or loved one…

    Try using self-acceptance when you hear a negative, critical or scary voice. You might try the following:  
    • Accept that you are hearing a voice: “I’m having a voice that says, e.g. I’m no good. 
    • Accept how it makes you feel: "It makes me feel sad.” 
    • Accept that you are not alone: "That’s okay, because everyone feels sad from time to time.”  
    • Show gratitude: “I’m grateful that there is a voice letting me know that I’m feeling sad.” 
    • Accept that this makes you human: “I’m not alone -- I know that many people cope with sad feelings too. In fact, its part of being human for me to feel sad.” 
    • Accept and move on: “I accept that I’m feeling sad and here are some things that I might do about it right now…” 
       
  • ​Muscle relaxation. Feeling stressed out and tense is not very pleasant. How can you relax? Its actually not that complicated – if you tense every muscle in your body, they automatically relax afterwards! Try this basic muscle relaxation exercise:
    • Lie down or sit comfortably.
    • Tighten all the muscles in your feet, crunching your toes up. Hold this for a few seconds, then relax while breathing out slowly. Imagine the tension flowing out of your muscles.
    • Move to your calves, tightening and releasing the muscles as you did for your feet. Breathe out as you relax the muscle.
    • Continue to tighten and relax other major muscle groups, working toward the top of your head:
      • Thighs
      • Buttocks
      • Back & stomach muscles
      • Hands and arms
      • Chest, shoulders and neck
      • Face and jaw.
         
  • Distract yourself to get your get your mind off the hallucinations. The brain can only really focus on one thing at a time. So if the hallucinations are stressful, do other things that requires your attention.

    Examples of activities that require attention include:
    • Crosswords / word search puzzles;
    • Jigsaw puzzles;
    • Sudoku
    • Playing solitaire;
    • Drawing, doodling;
    • Reading;
    • Juggling;
    • Yoga;
    • Guided meditation or imagery (there are many websites, apps and Youtube videos that can help with this)
    • Being social with others, e.g. calling up someone to talk on the phone.

My Story, Part 2 

My family doctor referred me to a clinic that sees people with psychosis. I learned that it’s quite common for people with psychosis to have other mental illnesses. And with my family history, it was no real surprise. They gave me medication at first to control the paranoia and delusions I was having. I wasn’t thrilled about this at first, but it was actually quite helpful.
 
The year following my first episode was really hard. The challenging part was changing the way I was living my life. My counsellor helped me to gain more control over my life by reducing the stresses. No more staying up until the wee hours of the morning. No more drinking and partying. Eating a regular, healthy diet and exercising everyday gave me a good routine and helped me structure my life.
 
Although I had to take some time off from school, I was able to return with a reduced course load. This was a big shift for me at first. But I’m really happy with my new lifestyle. This whole experience made me realize that I need to take care of myself. I fill my time with plenty of calm and low key hobbies, like scrapbooking and photography. I make sure I don’t become too stimulated. I’ve also made some new friends along the way. And with the help of my family and friends, I’m a lot more thankful for the simple things in life.

Want to Learn More? 

The Early Psychosis Intervention (EPI) website has a very helpful “Dealing with Psychosis Toolkit (DWP)”, with detailed information on practical strategies for psychosis.
 
Help4Psychosis also has very helpful information for those with psychosis

Authors

Written by the health professionals at the Children’s Hospital of Eastern Ontario (CHEO). Reviewed by the Mental Health Information Committee at the Children’s Hospital of Eastern Ontario (CHEO). Special thanks to Michel Poirier and the YouthNet Youth Advisory Committee (YAC-CHEO). 

License

Under a Creative Commons License. You are free to share, copy and distribute this work as in its entirety, with no alterations. This work may not be used for commercial purposes. Contact the Mental Health Information Committee at the Children's Hospital of Eastern Ontario (CHEO) if you would like to adapt these for your community!

Disclaimer

Information in this fact sheet may or may not apply to you. Your health care provider is the best source of information about your health.
Date Posted: Apr 15, 2018
Date of Last Revision: Dec 7, 2018

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