Psychosis is an exceptionally broad term that can describe patients who have, in some way, lost touch with realistic thinking or reality, and who usually manifest some symptoms like hallucinations, delusions or fully incomprehensible communications. Psychosis can manifest with mental illnesses such as schizophrenia or in acute manic or depressed phases of bipolar disorder, but it can also have other causes such as the presence of brain tumors or certain other illnesses. Therefore, types of therapy for psychosis vary based on cause and a variety of other factors.
In classic cases of psychosis, where the reason is clearly mental illness, the gold standard therapy for psychosis is to first minimize psychotic symptoms with medications. This usually means giving antipsychotics to get the psychotic symptoms under control. People may also begin receiving mental health or talk therapy. At first, such therapy may be supportive only and help provide extra oversight and advocacy for the client.
For a long time, it was thought that no “talking” therapeutic applications were of much use for psychosis. Recent research questions this belief, and there are now several therapies that have been used in people who were manifesting some degree of psychosis or in those who experience psychotic episodes that show beneficial effect. Cognitive behavioral therapy for psychosis is one such method that can be used adjunct to medical therapy.
Another behavioral therapy that has shown promise in this area is Acceptance and Commitment Therapy. In limited, but encouraging, studies it has proven useful in work with schizophrenics. More classic therapies have also been employed, though many therapists do feel that patients in the grips of extreme psychosis can usually only receive supportive help and aren’t able to do much in the way of depth work due to their mental status.
While therapy for psychosis in those with proven mental illness is a combination of antipsychotic drugs and talk or behavioral therapy, these treatments may be wholly inappropriate in other circumstances if psychosis has other origins. Antipsychotic drugs don’t address an underlying brain tumor, though they might treat some psychotic symptoms. Therapy doesn’t cure progressive dementia, though it may promote some comfort.
In cases of other clear, underlying causes, the therapy for psychosis must be aimed at its cause. Not all conditions resulting in psychosis have effective treatments, but some conditions do. An electrolyte imbalance from dehydration can cause a psychotic episode and this might be cured with administration of proper fluids. Certain autoimmune diseases like lupus or AIDS may occasionally induce psychosis and medication adjustments might treat these. Brain tumors can often be removed or shrunk with radiation therapy.
It’s evident that therapy for psychosis must address its cause in order to have a chance at being curative. This means accurate diagnosis of the origin of psychotic symptoms is vital. Choice of effective therapies, when available, depends on diagnosis.