Early Assessment and Support Alliance

Path To Recovery

EASA

1. Recognizing A Problem

The following checklist can help you decide whether you may be experiencing a condition needing attention. In some situations, others who are close to you may notice changes you don’t notice.

Changes In Your Perceptions

  • Things look, sound or feel different than they did before
  • Other changes that are hard to describe
  • Seeing or hearing things that other people don’t

Changes In Your Thoughts

  • Obsessing about certain ideas
  • Racing thoughts
  • Developing unusual beliefs

Harder To Do Things

  • Having trouble with memory or concentration
  • Not doing as well in school or work
  • Having conflicts in relationships with family or friends
  • Withdrawing socially from other people
  • Not as interested in basic self care: eating, staying clean, etc.

Changes In Your Moods

  • Angry or depressed disproportionate to your circumstances
  • Extreme highs and lows
  • Fear of others hurting you

Changes In Your Sleep

  • Not sleeping, sleeping all the time, or sleep reversed from normal

Physical Changes

  • “Special sensitivity”
  • “Unable to filter information”
  • “Special abilities”
  • Difficulty concentrating or sleeping

EASA

2. Getting Support

Support

  • Family and friends are one of the most important things in helping us to regain wellness
  • Ask someone you trust to help you through this process.
  • Your family and friends will need support and education, just like you will.
  • Encourage them to get educated at the same time that you’re educating yourself.
  • Give permission to doctors and counselors you work with to talk to the people you have chosen as supporters.
  • Stay involved with other people- social interaction is important for recovery!

EASA

3. Staying Safe

Staying Safe

  • Use words, not actions to express strong feelings.
  • Carry their phone numbers with you and put it in several places around the house.
  • Have a back-up plan
  • Anticipate what could happen and have a plan.
  • Include other people in your plan: family, friends, trusted professionals.
  • Consider completing an advanced directive.
  • For more information on crisis planning

EASA

4. Keeping An Open Mind

Keeping An Open Mind

  • When you have found a doctor or counselor you trust, share what are you experiencing and how you are interpreting it.
  • Pay attention if other people are expressing concern about changes in your behavior or thinking. Often, other people are better able to observe changes in us than we are
  • Listen to the interpretations of others you trust, and work together to come to a shared understanding
  • Stay focused on the things that have always mattered to you- school, work, hobbies, relationships, etc.

EASA

5. Keeping Hope

Keeping Hope

  • Look for opportunities to meet other people who have been through the same thing and who are doing well
  • Remember: you are not an illness! don’t accept negative assumptions about labels such as “psychosis”, “schizophrenia” or “bipolar disorder”.
  • Be around people who are positive toward you, and avoid being around people who act negatively toward you.
  • Give yourself time to recover and give yourself credit for what you are able to do.

EASA

6. Take Responsibility

Take Responsibility

  • You are responsible for your own life! Others can offer support, but no one else can do this for you
  • Use the resources and supports available to you.
  • Listen, listen, listen.
  • Ask questions and share your concerns.
  • Write things down: keep track of what works, what doesn’t work and why.
  • Look for your own answers and share them with others.
  • Set long-term and short-term goals.
  • Take it one small step at a time. It’s OK to rely on others.
  • Most people need significant support from others during recovery
  • Let others know what you need and want.

EASA

7. Know Your Rights

Know Your Rights

  • To make informed decisions about your own treatment;
  • To reasonable accommodations at work and school
  • To receive financial and health care assistance
  • To choose your own treatment
  • If your illness endangers your safety or that of others
  • Family members may also have the right to take time off from work through the Family Medical Leave Act.

EASA

8. Choose The Right Treatment

Once an assessment is complete, the doctor and counselor will be able to provide preliminary information about your diagnosis and what type of treatment is likely to be helpful. One of EASA’s goals is to support you in making your own informed treatment decisions.

Treatment for psychosis normally includes the following:

  • Ongoing fine-tuning of the assessment and diagnosis
  • Medications prescribed by a psychiatrist or psychiatric nurse
  • Education about your condition, recovery process
  • Participation in groups with other people
  • Assistance with financial, housing, relationships, school, work, and other areas
    Support for your family and friends
  • Counseling by a mental health professional to:
    • help you adapt to the situation
    • learn to manage the symptoms
    • clarify and support progress toward your goals
    • keep your self esteem

EASA

9. Medications

Most people who experience ongoing psychosis need to take medicine in order to manage the symptoms. Antipsychotic medications help restore the brain’s chemical balance. There are two general types of antipsychotics: Novel or atypical, and typical antipsychotics. “Typical” antipsychotcs are the older medicines. 

Be Sure To Talk To The Doctor About:

  • How you will you know this medicine is working
  • When during the day you should take the medicine
  • What to do if you miss a dose
  • How long it will take before you can expect to see improvement
  • What side effects should you watch for, and what should you do if you experience them?

EASA

10. Adapting

Psychosis is a no-fault illness. Successful adaptation goes through a series of stages, which may be repeated and which may overlap.

Psychosis brings many losses, and most people who experience it go through a grief process to heal from those losses. Predictable stages of grief include:

Remember: don’t accept negative assumptions or stigma. You are a unique, talented person with a lot to contribute.

Anger- at yourself, others, the system. Talk about your feelings with someone you trust.

Bargaining- Thinking if I just do this, things will be back to the way they were. If I just take my medicine, if I just pray, if I just work hard enough.

Depression- It’s OK and natural to experience depression as part of the healing process from psychosis. It’s just part of the process.

Acceptance: Acceptance involves the acknowledgement that you are the person who has the “key to your own life.”

EASA

11. Educating Yourself

Part of the process of moving forward is educating yourself about the things that affect you. 

  • That includes your specific medical condition/diagnosis and other things which relate to your specific goals.
  • Your doctor and counselor will be a great source of information.
  • You may also want to seek out a college counselor, vocational rehabilitation counselor, or others who have specific knowledge you need.

EASA

12. Setting Goals And Pacing Yourself

  • Know where you want to go, but take it one step at a time.
  • Set small, specific short-term goals for yourself, then stay focused on them.
  • Make changes gradually.
    Pat Risser, a long-time mental health advocate, uses the analogy of a ladder.

EASA

13. Preventing Relapse

An important part of long-term recovery from psychosis is relapse planning. The more experience you have, the more sophisticated your self awareness becomes, and the more proactive you become in managing your own health.

Psychosis Is Cyclical:

  • The “well” stage either before the onset, or when symptoms are in remission or under control
  • A “prodromal” stage when you are seeing early warning signs which are progressively becoming more severe (more intense, more frequent and lasting longer)
  • An “acute” stage when you experience the most obvious symptoms of psychosis- hallucinations, delusions and/or thought disorder
  • Early recovery when acute symptoms have gotten better and you are beginning to stabilize
  • Late recovery when you are getting back to a “well” state- you may still have some persistent symptoms, especially issues with memory and concentration, but they are manageable and not getting worse.
  • This same pattern applies to many chronic illnesses.

Things that can make psychosis better:

  • Regulating sleep so you keep balance
  • Avoiding substances which haven’t been prescribed
  • Taking the proper dose of prescribed medicines
  • Staying involved with a supportive social network
  • Identifying your most important needs
  • Setting and following through on manageable goals
  • Having regular contact with supportive professionals
  • Staying active physically and mentally
  • Keeping good nutrition and water intake
  • Regularly doing things you enjoy

Some things that can make psychosis worse ("triggers"):

  • Not sleeping
  • Living in a very stressful environment
  • Interacting with people who are very critical or negative toward you
  • Making too many demanding changes at once (moving out on your own while starting a full-time job, etc.)
  • Extreme social isolation
  • Using street drugs or alcohol
  • Using large quantities of caffeine
  • Not eating or drinking well
  • Not moving your body enough
  • Anniversaries of traumatic events
  • Not taking medicine as prescribed

An effective relapse plan includes the following information:

  • Daily practices which will help you stay well
  • Triggers which may make you more vulnerable to relapse, and what you will do to reduce their impact
  • Early warning signs indicating that you may be heading toward a psychosis, and what you will do if they occur
  • Late warning signs that indicate you are in an acute stage
  • You also have the right to turn your relapse plan into an advance directive.

EASA

14. Coping with persistent symptoms

Symptoms are just that: they are symptoms. They do not prevent you from acting on your goals. How you react to symptoms is more important. For example, if you hear voices that tell you to do things, and you do what they say, it will probably get you in trouble in life. If you learn to ignore the voices and use your judgement, you will do much better.

EASA

15. Giving Back To Others

Many people find that when they have begun to achieve a solid recovery, an important part of their recovery process is to give to others. There are many ways to do this- to share your experiences in person or writing, to co-facilitate a support group, to volunteer your time in the community, or just to be a little kinder to people you know. .