Transcript Psychotic Symptom De-Escalation

Rhonda Nelson, M.S. Ed, LCPC
Aimee Anderson, MS
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A serious mental disorder characterized by
thinking and emotions that are so impaired
that they indicate that a person experiencing
them has lost contact with reality
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Difficulties concentration
Depressed mood
Sleep changes – sleeping too much or not
enough
Anxiety
Suspiciousness
Withdrawal from family and friends
Ongoing unusual thoughts and beliefs
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Delusions
Hallucinations
Disorganized speech – switching topics
erratically
Depression
Anxiety
Suicidal thoughts or actions
Difficulty functioning
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A firmly held false belief or impression even
when contrived by reality and what is
commonly known as true.
Delusions of Paranoia
 Grandiose delusions
 Somatic delusions
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A sensory perception in the absence of outside
stimulus.
Seeing
 Hearing
 Smelling
 Feeling
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Delusions and Hallucinations are the positive
symptoms of psychotic disorders. They seem
real to the person experiencing them
Negative symptoms include:
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Loss of motivation
Social withdrawal
Blunted emotions
Thinking difficulties
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Schizophrenia
Delusional Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Schizoaffective Disorder
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Bi-polar disorder
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During periods of mania
Major Depressive Disorder
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During periods of severe depression
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Brain diseases: Parkinson’s, Huntington’s, and some
chromosomal
Brain tumors or cysts
Dementia (including Alzheimer's disease)
HIV, syphilis, and other infections that attack the
brain
Some types of epilepsy
Stroke
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Alcohol
Illegal drugs:
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Simulants
 Methamphetamine
 Cocaine
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Hallucinogenic Drugs (LSD)
Bath salts; synthetic drugs (K2)
Long periods without sleep
Prescription drugs: steroids and stimulants
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Possibly genetic
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50% chance of developing a psychotic disorder if
identical twin has been diagnosed
Higher risk if immediate family (parent/sibling)
member has been diagnosed
Brief reactive psychosis
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Response to an extreme situation, death of family
member, short-lived response (days)
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Rapid tranquilization
Medications
Therapy
Psycho-education
Case Management
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Approach the person in a caring and nonjudgmental way to discuss your concerns
Allow the person to talk about their experiences
and beliefs if they want to, but do not force them
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Choose a private time and place, free from
distractions
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Let the person know you are concerned and
want to help- state the specific behaviors that
concern you
Let the person know you are available to talk in
the future
Be sensitive to the way the person is behaving
 Respect the person’s privacy and
confidentiality
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Let the person set the pace and style of
interaction
Do not touch the person without permission
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Assist the person by remaining calm
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Talk in a clear, concise way
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Use short, simple sentences
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Speak quietly in a non-threatening tone at a
moderate pace
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Answer questions calmly
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Comply with reasonable requests
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Maintain your safety and access to an exit
Do not do anything to further agitate the
person
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Understand the symptoms for what they are
Empathize with how the person is feeling
about his/her beliefs and experiences
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Be patient and allow plenty of time for
responses
Be aware that just because the person may be
showing a limited range of emotions this does
not mean they are not feeling anything
Do not assume the person cannot understand
you, even if the response is limited
Give the person hope for recovery
Provide practical help
Do not make any promises that you cannot keep
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Doctors – Primary Care Physicians
Psychiatrists
Social workers, counsellors & other mental health
professionals
Certified Peer Specialists
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Peer support groups
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Family, friends, faith and other social
networks
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Family support groups
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Discontinuation of alcohol and other drugs
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Encourage the person to talk with someone
he/she trusts
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Never threaten the person with hospitalization
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Remain patient
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Remain friendly and open
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The person may want your help in the future