Her daughter faced significant challenges, yet she found the courage to speak to her mother about wanting to understand the voices and seek help. As they delved into treatment options, they discovered that grasping the concept of “What are hallucinations?” was just the starting point.
To effectively intervene early, it’s essential to recognize, document, and report any signs and symptoms. This responsibility heavily involves family and friends.
When I started assisting clients with psychosis spectrum disorders, I felt overwhelming gratitude.
While I had been coping with my own emotional and mental health issues for many years, it paled in comparison to the struggles faced by individuals with conditions like schizophrenia.
It always weighed heavily on my conscience.
Introduction
We are concluding our three-part series on hallucinations. In the first part, we provided general information, and in the second, we explored causes, risk factors, and triggers. Now, it’s time to discuss treatment.
Before we start, let’s quickly revisit a few points from the previous sections.
Here’s our working definition of a hallucination…
A hallucination occurs when a person perceives sensory information as real, even though there’s no external stimulus present.
As you may be aware, hallucinations come in various forms, with auditory hallucinations (mostly voices) being the most prevalent.
Important: Our review of treatment will focus on schizophrenia. Why?
In a psychiatric or psychological context, hallucinations associated with emotional and mental conditions (like schizophrenia) are the only ones that have been thoroughly studied and treated. Those caused by illness, medication, or substance use differ significantly.
I believe most readers are interested in the psychiatric and psychological perspective.
What are the treatment options for schizophrenia?
Early intervention, assessment, diagnosis, psychotherapy, psychosocial therapy, medication, follow-up
The information available on Chipur is only as reliable as its sources. That’s why the upcoming content is derived from the Schizophrenia & Psychosis Action Alliance: Breaking down barriers to treatment, survival, and recovery.
Importance of Early Intervention
Early intervention is crucial for individuals with schizophrenia. Studies indicate that many people experiencing their first psychotic episode show symptoms for over a year before seeking treatment. This delay is too lengthy.
For early intervention to be effective, it is vital that signs and symptoms are recognized, documented, and communicated. Families and friends play a key role in this process.
Moreover, research highlights that individuals with schizophrenia who receive early and intensive care tend to achieve the best long-term outcomes, especially if they have a robust support network.
Here are some signs and symptoms to watch for…
Intense emotional expressions, unpredictable mood changes, engaging in high-risk behaviors (like shoplifting, risky sexual behavior, gambling, reckless driving), severe social withdrawal, misuse of prescription or illegal drugs, incoherent speech or misunderstanding of others, distractions from what seems like internal stimuli, noticeable weight fluctuation, poor personal hygiene, untreated injuries, worn-out clothing, unpleasant body odor, and obvious disconnection from reality.
This is a troubling list. It’s understandable to feel hesitant about getting involved. However, delaying action only makes things harder on the individual and anyone they interact with.
Save lives: If someone is expressing thoughts or actions that may harm themselves or others, do not hesitate—call 988 (or 911 if necessary) in the U.S. Psychology Today offers a comprehensive list of suicide hotlines and prevention resources worldwide.
Role of Psychotherapy
If you are unfamiliar with psychosis spectrum disorders, you may ask why psychotherapy is included as a treatment option. Isn’t it primarily about medications?
Actually, therapy can significantly help manage thoughts and behaviors, deepen understanding of the illness, and differentiate between reality and hallucinations—just like it does for any emotional or mental health concern.
Every few minutes, the voices hurl insults at me, which can be quite discouraging. But I must summon the strength to respond, ‘Hey, stop following me! Leave me alone!’ I have to maintain this mental battle all day long.
—Brian Wilson, composer, producer, vocalist, and musician
Common therapies used for psychosis spectrum disorders include cognitive behavioral therapy (CBT) and cognitive enhancement therapy (CET), also known as cognitive remediation.
It’s also worth noting that family members often seek therapy or counseling for themselves to better cope with the challenges.
Psychosocial Therapy
With sufficient effort and the right therapist, psychotherapy can foster improvement for those with schizophrenia. However, there’s additional work required, such as learning how to reintegrate into the community—which is where psychosocial therapy plays a pivotal role.
Here are some key components…
- Social skills training: Focused on enhancing communication and social interactions.
- Rehabilitation: Since schizophrenia often arises during significant career-building phases, rehabilitation might include job counseling, problem-solving support, and financial management education.
- Family education: Understanding psychosis spectrum disorders allows family members to support their loved ones more effectively.
- Self-help groups: Community initiatives to advance social skills.
- Coordinated specialty care (CSC): Aimed at individuals experiencing their first psychotic episode. This team-based approach merges medication with psychological therapies, along with social and employment services. The goal is to influence the course and outcome of the condition by addressing it early. Again, research indicates that those with schizophrenia who receive prompt and comprehensive care achieve the best long-term results.
- Assertive community treatment (ACT): Provides tailored services to assist individuals with schizophrenia in managing daily life challenges, such as adhering to medication plans. ACT professionals also work preventively to avoid crises.
- Social recovery therapy: Aims to help patients set and achieve personal goals, fostering a sense of optimism and positive belief systems regarding themselves and others.
Now,
That’s quite a lot to consider, but overlooking one aspect could lead to serious consequences.
Inpatient Treatment Programs
It’s likely that an inpatient treatment program may become essential at some point. Typically, family members are part of the decision-making process.
This is undoubtedly a heavy burden. While I haven’t included them in this text, the Schizophrenia & Psychosis Action Alliance offers an excellent list of important questions for families to consider when looking into available options.
Medications
Antipsychotic Medications: First and Second Generation
While I am speaking generally, I have yet to encounter a case of psychosis spectrum disorders that doesn’t require medication. This is one reason why working with individuals affected by schizophrenia has deeply impacted me; it can be an extremely difficult journey.
The main medications used to treat psychosis are first and second-generation antipsychotics.
Second-Generation Antipsychotics
Also referred to as atypical antipsychotics, these medications began emerging in the late 1970s, with most introduced during the 1990s. They primarily function by blocking receptors within dopamine pathways.
Though they are generally associated with fewer severe side effects than first-generation drugs, they can still lead to weight gain and increased blood sugar and cholesterol levels.
This category includes:
- aripiprazole (Abilify)
- asenapine (Saphris)
- brexpiprazole (Rexulti)
- cariprazine (Vraylar)
- clozapine (Clozaril)
- iloperidone (Fanapt)
- lumateperone (Caplyta)
- lurasidone (Latuda)
- olanzapine (Zyprexa)
- paliperidone (Invega)
- quetiapine (Seroquel)
- risperidone (Risperdal)
- ziprasidone (Geodon)
It’s important to note that atypical antipsychotics are frequently prescribed as supplementary treatment for other conditions and used off-label in various first-line medication combinations.
First-Generation Antipsychotics
First-generation antipsychotics, often called typical antipsychotics, were introduced in the 1950s, with chlorpromazine (Thorazine) being the first.
These medications are thought to have a stronger effect on dopamine receptors, potentially leading to significant movement disorders, including severe muscle stiffness or tardive dyskinesia.
Examples of these medications include:
- chlorpromazine (Thorazine)
- fluphenazine (Prolixin)
- haloperidol (Haldol)
- loxapine (Loxitane)
- perphenazine (Trilafon)
- pimozide (Orap)
- thioridazine (Mellaril)
- thiothixene (Navane)
- trifluoperazine (Stelazine)
Managing medication for psychosis spectrum disorders can be a challenge, and those who rely on them truly need and deserve proper support.
Conclusion
This concludes our series on hallucinations. If you or someone you care about is experiencing them, I hope this information has been beneficial.
As we close, there’s plenty of reason to remain optimistic about the future treatment of psychotic spectrum disorders. For more insights, visit the Schizophrenia & Psychosis Action Alliance website (link below) and check out the Research (and Support) section.
Don’t forget to refer back to part one for general information on hallucinations and part two for important causes, risk factors, and triggers.
A big thank you to the Schizophrenia & Psychosis Action Alliance for providing valuable information, along with their compassion and dedication. Make sure to explore what they have to offer.
If you’re interested in more uplifting content and information on emotional and mental health, browse through the articles on our page or by category below.
After battling panic, anxiety, mood fluctuations, and alcohol dependence for many years, Bill discovered his true passion: helping others in similar situations. At 49, he enrolled in graduate school and earned counseling credentials, continuing his commitment to serve through Chipur and various projects.