Psychosis is a debilitating condition that involves disturbances in thought, perception, and emotions, which make it difficult for the individual to recognize what is real and what is not. It can present itself in various mental illnesses like schizophrenia, bipolar disorder, and major depressive disorder.
One of the main questions for those suffering from psychosis or their caregivers is whether psychosis will resolve on its own without medical treatment. In this blog post, we will explore this question in detail and provide insights into the experience and course of psychosis with and without medication.
Course of Psychosis Without Treatment
Let’s look at how psychosis typically progresses when left untreated:
Acute episode
An initial psychotic episode often lasts from a few weeks to a few months. Symptoms are generally more severe during this period and include delusions, hallucinations, disorganized thinking and behavior.
Relapse
Without proper treatment, around 70-80% of people who experience a first episode of psychosis will experience a relapse within five years. Relapses are characterized by a reemergence of psychotic symptoms.
Chronic psychosis
For around 30% of people, psychosis does not fully remit even after a single episode and continues in a chronic course. Symptoms may reduce in severity but continue to be recurring.
Cognitive impairment
Studies show that prolonged episodes of untreated psychosis can lead to a negative impact on cognitive abilities like attention, memory, problem-solving, and processing speed over time.
Functional decline
Lack of treatment impacts social and occupational functioning. Untreated psychosis significantly decreases the chances of living independently and maintaining relationships or employment.
Co-occurring issues
Issues like substance abuse, depression, anxiety, suicidal behavior, and homelessness are more common among those with untreated psychotic disorders.
Role Of Medication in Psychosis
Medications play a crucial role in successfully treating psychosis and altering its typical course. Some key points about medications:
- Antipsychotic medications are very effective in reducing positive symptoms like hallucinations and delusions during an acute episode.
- Maintaining treatment with antipsychotics beyond the initial episode significantly decreases the risk of relapse by around 70-80%.
- Compliance with medication helps prevent the reemergence of full-blown psychotic episodes and supports overall stability.
- Newer second-generation antipsychotics have fewer side effects than older ones and have better acceptance rates.
- Along with antipsychotics, other medications may be used for co-occurring depression, anxiety, or sleep issues related to psychotic disorders.
- Medication allows for better management of symptoms and improved psychosocial functioning in relationships, independent living, education, and employment over the long run.
Managing Psychosis Without Medication
While medication is strongly recommended, some choose not to take it or stop prematurely. In such cases, alternative strategies may help minimize relapse risk:
- Strong social support system and therapy to provide emotional support and help recognize early warning signs of relapse.
- Healthy lifestyle practices include adequate sleep, a balanced diet, exercise, and stress management techniques.
- Continuous therapy/counseling to identify and cope with triggers. CBT, family therapy, and peer support groups show promise.
- Avoiding recreational drugs and limiting substance use, which can worsen symptoms.
- Alternative/natural treatments should only be accepted under medical guidance as some may interact or not have proven efficacy.
- Working with the doctor on relapse prevention plans and contingency plans in case symptoms start recurring without medication.
- Accepting re-evaluation and resuming medication promptly if any concerning symptoms emerge rather than waiting for a full-blown relapse.
FAQs
Can talk therapy alone treat psychosis?
A: While talk therapies like CBT have some benefits, medication supported by therapy offers the strongest evidence for preventing relapse and maintaining wellness for psychotic disorders.
How long do you have to take medication for psychosis?
A: It varies based on the specific disorder and individual, but lifelong maintenance treatment with antipsychotics is usually required for mental illnesses like schizophrenia to prevent relapse.
What percentage of people stop taking their psychosis medication?
A: Nearly 50% of people with psychotic disorders discontinue medication within 1-2 years, usually due to issues like side effects or subjective feeling of being better.
Is it common to need medication changes for psychosis?
A: Yes, it is quite common to require one or more medication changes in the course of treating psychosis. This is done to better manage side effects, find the most effective therapy, and overcome non/partial response.
Can stress, trauma, or drugs trigger a new psychotic episode?
A: While underlying predispositions like genetics play a major role in psychosis, current life stressors, past trauma, and drug or substance use can act as risk factors, worsening symptoms or potentially precipitating an initial psychotic episode, even in those without a prior history of mental illness.
Conclusion
Medication significantly helps alter this typical course, shorten and prevent further episodes, manage co-occurring issues, and optimize functioning outcomes when combined with appropriate therapy and lifestyle management strategies.
An individualized treatment approach tailored by a mental healthcare provider usually offers the best results for successfully treating psychosis and living well in the long run.
