Psychotic Disorders

Holistic Psychiatry, Ketamine Treatments and TMS in Golden and Greenwood Village, CO

“The signs of catastrophe seem mild—a feeling of being out of place, the impression of hearing voices, the sense that something has entered the body… Some process seems to be altering the self…People are no longer safe. But the rest of humanity seems oblivious.” ― Christopher Bollas
Owl & Eagle Health and Wellness provides treatment for Psychotic Disorders in Colorado

Psychosis refers to a group of symptoms that can have many causes, including substance abuse, medication side effects, and numerous medical and psychiatric disorders. A person with psychosis experiences changes in sensory perception, thinking, emotion, and beliefs, and they may become disconnected from what is actually happening around them. They may see, hear, or feel things that are not there. Their thoughts and speech may become disjointed and incoherent. They may develop beliefs that don’t make sense. This can be very scary and upsetting to them and to other people in their lives.

A person experiencing psychosis for the first time should receive care as soon as possible, so the correct underlying cause can be discovered and addressed. No matter what the cause for psychosis, accurate diagnosis and early treatment provides the best possible prognosis. Unfortunately, studies show that people often struggle with psychotic symptoms for over a year before they get care.

About 3% of people with experience an episode of psychosis at some point during their lifetime. Psychosis can occur at any age, but most commonly presents in the teens to 20s. New-onset psychosis can be substance induced, may be secondary to medical conditions, such as autoimmune, endocrine, or neurological diseases, or may be due to a psychiatric disorder.

Psychiatric disorders that cause psychosis are collectively known as psychotic disorders. The majority of psychotic disorders are chronic, disabling conditions, so people with psychotic disorders usually require comprehensive care on an ongoing basis. Studies show that holistic treatment that addresses psychiatric symptoms, psychosocial influences, and overall health is most effective.

At Owl & Eagle Health and Wellness in Golden and Greenwood Village, Colorado, our team of board-certified psychiatric nurse practitioners and psychotherapists offer highly effective, holistic, and compassionate outpatient care for people with psychotic disorders. We perform a thorough diagnostic evaluation to identify psychotic disorders and any co-occurring psychiatric disorders, and rule out non-psychiatric causes. We will work with you to design a comprehensive, holistic treatment plan combining up to date psychiatric treatments, psychotherapy, and evidence based integrative care tailored to your unique needs and preferences. This holistic approach can effectively treat your psychiatric symptoms, while improving your overall health, function, and well-being.

Please note: If a person with psychosis is behaving aggressively, having thoughts of suicide, or hearing voices telling them to harm themselves or anyone else, they require inpatient care. They should be taken to the nearest emergency room, or 988 should be called. If they are calm and not in danger of harming anyone, outpatient care can be appropriate.

If you would like to learn more about treatment for psychotic disorders at Owl & Eagle Health and Wellness in Golden or Greenwood Village, Colorado, Contact Us with questions or Book Now to schedule an in person or telehealth intake appointment today.

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Psychosis Q &A

What causes psychotic disorders?

There are multiple factors that increase risk for psychotic disorders: 

1) Genetics. About 70-80% of the risk for psychotic disorders is attributable to genetics.

2) Trauma and psychological stressors. Adverse experiences such as poverty, violence, abuse, and discrimination increase risk for psychotic disorders.

3) Substance use. Some drugs, such as stimulants, cannabis, hallucinogens, and newer “designer” drugs, can induce acute psychotic symptoms during intoxication, and in some cases these symptoms do not resolve after cessation of use, leading to chronic psychotic symptoms. It is not yet clear if this is due to primary effects of the substance, or if the substance use causes emergence of a prodromal psychotic disorder.

4) Brain changes. There are differences in structure, activity, and connectivity in multiple areas of the brain in people with psychotic disorders, which progressively worsen and become more widespread over time. Altered level of neurotransmitters including dopamine, GABA, glutamate, and acetylcholine, are also involved.

 

What are the symptoms of psychosis?

Psychosis causes five groups of primary symptoms:

Hallucinations: Spontaneous, involuntary sensory perceptions that are not induced by external input. Hallucinations can affect any of the senses.

Delusions: Persistent erroneous beliefs that do not change when challenged by evidence.

Disorganized Thinking: Thoughts that get stuck on one idea, are slowed or inhibited, jump from topic to topic, or are completely incoherent.

Abnormal Movement: Movements can be slowed down, sped up, uncoordinated, repetitive, or inappropriate to the situation.

Negative Systems: Negative symptoms refer to reduction or absence of normal features, such as lack of motivation, diminished emotional expression, impaired cognition, or reduced self-care behaviors.  These symptoms are associated with more severe disability.

Other symptoms that may occur with psychotic disorders include mood changes, sleep problems, erratic behavior, self-harm behaviors, and suicidal ideation and behavior. People with psychotic disorders can sometimes display threatening or violent behavior, but this is not typical, and occurs in only about 3% of people with psychotic disorders. Command hallucinations, which are auditory hallucinations of voices telling the person to harm others, and co-occurring mood, personality, or substance use disorders significantly increase the risk for violent behavior.

 

What are the types of psychotic disorders and their primary features?

Excluding substance and medication induced psychosis and psychosis secondary to medical disorders, there are ten types of psychotic disorders:

  • Depression with psychotic features: Primary symptoms of depression with secondary psychotic symptoms that only occur during depressed episodes
  • Bipolar disorder with psychotic features: Primary symptoms of depression and mania with secondary psychotic symptoms that only occur during mood episodes
  • Brief psychotic disorder: Psychotic symptoms lasting less than a month
  • Post-partum psychosis: Psychotic symptoms arising after giving birth
  • Delusional disorder: Delusions without other psychotic symptoms
  • Paranoid personality disorder: Persistent paranoia present since early childhood
  • Schizotypal personality disorder: Persistent odd behavior or speech, magical thinking, and discomfort in close relationships present since early childhood
  • Schizophreniform disorder: Psychotic symptoms lasting 1-6 months
  • Schizophrenia: Psychotic symptoms lasting at least 6 months with functional decline
  • Schizoaffective disorder: Primary psychotic symptoms combined with depression or bipolar episodes, but psychotic symptoms are present in the absence of mood episodes

 

How is psychosis treated?

Treatment for psychotic disorders can be complex for multiple reasons. First, people with psychotic disorders believe that their hallucinations are real and their delusions are true, so they may not realize they need treatment. They may also be distrustful of medical professionals due to paranoia. Due to lack of motivation and impaired cognition, they may be uninterested in care, or may not be able to remember appointments or manage transportation.

Medications for psychotic disorders can take time to work and often have side effects, so patients may stop taking them prematurely. Friends and family members can be essential in encouraging people with psychotic disorders to get treatment and follow their treatment regimen. If people with psychotic disorders are able to obtain treatment and remain adherent to their treatment regimen, treatment can be very effective.

At Owl & Eagle Health and Wellness, our board certified psychiatric nurse practitioners and psychotherapists offer skillful, comprehensive, and caring outpatient treatment for people with psychotic disorders. We will perform a thorough diagnostic evaluation to rule out any non-psychiatric causes for the symptoms, and to identify the psychotic disorder and any co-occurring psychiatric disorders. This will include a detailed history, complete mental status exam, and laboratory testing, and can include brain imaging, EEG, psychological testing, and neurocognitive testing when necessary.

Once the diagnosis is established, we will work with you to create a holistic treatment plan incorporating up-to-date psychiatric medications, psychotherapy, and evidence based integrative care such as nutritional guidance, vitamins, supplements, stress management, sleep hygiene, exercise, yoga, and meditation. Medications frequently used to treat psychotic disorders and common co-occurring conditions include antipsychotics, antidepressants, anxiolytics, mood stabilizers, and sleep medications. Genetic testing can help identify which medications are most likely to be effective and well-tolerated.

We can also help with paperwork for school and work accommodations, FMLA, or short term disability applications. For patients who need long-term disability assistance, we can help with referrals for functional status evaluations and legal assistance. We can also help you access special services when needed, such as occupational and speech therapy, job training, help with finding employment, housing assistance, and help with housework, shopping, or transportation. With prompt,  comprehensive, holistic treatment, the symptoms of psychotic disorders can be effectively controlled, improving function, overall health, and quality of life.

If you would like more information about treatment for psychotic disorders at Owl & Eagle Health and Wellness in Golden or Greenwood Village, Colorado, Contact Us or Book Now  to schedule an in-person or telehealth appointment today.

 

Sources:

https://www.nami.org

https://www.nimh.nih.gov/

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https://mhanational.org/mentalhealthfacts

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https://www.apa.org/monitor/2021/04/ce-mental-illness

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686644/

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8732862/

https://www.nimh.nih.gov/health/publications/understanding-psychosis#part_6511

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https://www.nimh.nih.gov/health/publications/understanding-psychosis

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https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Psychosis