Do Not Try to Contradict the Hallucinations or DelusionThe primary symptoms of psychosis are delusions and hallucinations. For example, a person may believe that his thoughts are being broadcast to neighbors, that he is being tracked by the CIA, or that newspapers contain special coded messages. These symptoms may seem obviously unreal to you, but they are very real to the person dealing with psychosis. Thus, taking a compassionate approach is essential. Although these delusions do not conform with reality and may seem troubling, it is important not to directly contradict them. This may cause your loved one to become defensive or even paranoid that you intend to harm them.Instead, be patient and noncommittal when they expresses bizarre beliefs. There is no need to pretend to share the delusions, but it is also best not to attack them. Maintaining a middle ground, such as saying, “Yes, I know it seems that way to you,” is a neutral and non-confrontational way to address delusions.
All Psychosis Should Be Treated SeriouslyThe course and prognosis for substance induced psychosis varies by individual. In some cases, drug use may trigger the first in a series of psychotic episodes. For other people, psychotic symptoms may subside after the effects of drug intoxication diminish. No matter whether you think the psychotic symptoms will be short lived or longer lasting, it is essential to treat them seriously.
Take a Private, One-on-one ApproachAlthough staging an intervention may seem like a way to convince your loved one to seek professional help, this approach often backfires for individuals dealing with psychosis. Having a group of people collude to stage an intervention may trigger the person’s paranoia or make them feel alienated.Instead, take a one-on-one approach to encouraging your loved one to get help. Give the person space to talk about his thoughts and beliefs. Then, gently express your concern about how treatment may help with both substance abuse and mental health. Reassure your loved one that you are concerned about keeping them healthy and safe.
Assess Your Loved One’s InsightA person’s own insight into psychotic symptoms may vary. Many people believe the content of their delusions; others realize that the words they are heading are “just voices in my head.” If your loved one has good insight, being direct about your concerns is a good way to encourage her to seek help.
Medically Supervised Detoxification Is KeySubstance induced psychosis may be triggered by drug intoxication or withdrawal. In both cases, medically supervised detoxification is important to ensure your loved one’s health. This approach ensures that physicians oversee the process of detoxification and drug withdrawal. Management of psychotic symptoms and behavior problems at this point sets the stage for a healthy recovery. In particular, appropriate medication management can keep psychotic symptoms in check, allowing your loved one to stabilize and engage in additional treatment for addiction.
- Substance Abuse and Mental Health Services Administration (2005). Substance-induced disorders. Substance Abuse Treatment for People with Co-Occurring Disorders. http://www.ncbi.nlm.nih.gov/books/NBK64178/
- Mathias, S., Lubman, D.I., & Hides, L. (2008). Substance-induced psychosis: A diagnostic conundrum. The Journal of Clinical Psychiatry, 69(3): 358-367.
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