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How to Treat Psychosis or Schizophrenia in Teens

If your teen has a mental health issue involving psychosis, it’s undoubtedly a nerve-wracking time.  Schizophrenia, schizoaffective disorder, PTSD, and even depression or anxiety can involve frightening psychotic episodes. Teens can start hallucinating. They can start entertaining delusions, such as thinking they have certain powers, or someone is watching or following them. They can become extremely paranoid. In their out-of-control experience, they can threaten to hurt themselves or others. Their words can become jumbled and incomprehensible. Note that teens can experience symptoms of psychosis without being diagnosed with a psychiatric disorder.

As a parent, you might be extremely nervous. You might hope this is a passing phase, and not actually psychosis. The stigma against mental health conditions still exists, especially for such issues like schizophrenia or psychosis. For this reason, you might delay seeking treatment for your adolescent.

However, this is a mistake. The longer you ignore such illnesses, the worse they become. Early intervention is crucial for psychosis. Treating such mental health conditions early on can prevent years of suffering later on. In fact, studies show that if a teen receives quality treatment after their psychotic episode, their chances of relapsing later on decreases by more than 50%. (Note that there is no actual cure for psychosis, just symptom management.)

The first step, of course, is getting an accurate diagnosis. After that, treatment can begin.

Let’s take a look at the various ways professionals treat psychosis and prodromal symptoms:

CBTp

Cognitive Behavior Therapy for psychosis, or CBTp, is an evidence-based treatment for psychosis. To understand how CBTp helps, it’s important to first understand what it doesn’t do. It does not attempt to stop a teen from hallucinating. Or to question the legitimacy of the voices in one’s head. Likewise, a CBT therapist does not try to “burst the bubble” of one’s delusions—no matter how unreal they may seem.

Instead, CBTp attempts to help the teen change the way he responds to these bizarre experiences. Rather than becoming agitated from or frightened of these psychotic experiences, and listening to the voices when they tell your teen to do bad things, a teen learns how to control and manage these thoughts and feelings in the healthiest way possible.

Medication

The question of medication for teens undergoing psychosis is controversial. Anti-psychotic medication exists, but it comes with intense side effects. Some of these uncomfortable side effects include trembling/stiffness, restlessness, lethargy, weight gain, dry mouth, and blurry vision. As such, many don’t recommend it for adolescents unless their symptoms are quite severe (meaning, they’re not just prodromal). However, other parents may be fully on board with medication, as long as it’s working. For many, anti-psychotic medication reduces the effects of the hallucinations or delusions, but does not remove them entirely. (For example, if a teen is hearing harsh, commanding voices, medication may temper these voices to become more neutral, but it doesn’t stop the voices altogether). As always, follow your specific doctor’s recommendation and advice.

Maintaining Good Health

In addition to therapy and medication, there are other things a teen should be doing if they’ve had a psychotic episode or are currently experiencing prodromal symptoms of psychosis. This includes eating healthfully and staying away from junk food. Abstaining from drugs is also vital, as it can make psychosis worse. Sleeping enough every night is important, too. Sleep deprivation can exacerbate psychotic symptoms. (Some experts say it can even cause psychosis in the first place!) Family members can help with these tasks if the teen is not managing to take care of themselves.

Stress

To put it simply, stress is not good for a teen struggling with psychosis. According to the Child Mind Institute, stressful situations can trigger relapses. Family and friends can help by reducing stressful situations around the teen (such as trying not to provoke conflict or get involved in arguments). They can also encourage a teen not to get involved in commitments that might become stressful later on.

Residential Treatment for Psychosis

If a teen’s symptoms are acute enough, they may need a residential treatment center (RTC). An RTC combines all of the above treatment elements under one roof: therapy for psychosis, medication management, health maintenance, and a limited-stress environment. Teens learn how to deal with and overcome past trauma, receive training on coping skills to deal with unpleasant emotions, and participate in daily groups and activities that help them process their mental health issues in healthy ways. Additionally, the firm structure of an adolescent treatment center – early nighttime curfews, standard wake-up times, daily physical exercise, three healthy meals a day, the absence of any toxic friends or relationships —can do wonders for a teen struggling with the up-and-down roller coaster of psychosis.

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