How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 15
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with indifference or resignation, or they simply “fall into” the psychosis and lose interest in external reality.
Shame and humiliation of being different often complicate the experience and make getting help more difficult.
Is Psychosis a Diagnosis?
No. Psychosis is like fever—a very important symptom. When a person has a fever, it could be from a virus in
the respiratory system or a bacterial infection of the urinary tract. These are two very different causes of fever
and each cause requires different treatments. The reduction of fever is one way to know the condition has been
addressed properly.
While we understand less about the three-pound “universe” that is the human brain than we do about infectious
disease, the same broad principles apply. The goal of a comprehensive evaluation is to determine if there is an
underlying, reversible medical cause of the condition and—if there is none—to determine the psychiatric
diagnosis. After the symptoms, the associated history and relevant workup have been put into a diagnostic
framework, the next step is to develop a collaborative and comprehensive plan with the person to address the
symptoms in the context of this diagnosis. A comprehensive plan attends to the person interests and strengths
and looks to school, work and relationships as the person’s goals dictate.
What Is a First Episode of Psychosis?
A first episode of psychosis is the first time a person experiences a psychotic episode. The first such episode
often is very frightening, confusing and distressing, particularly because it is an unfamiliar experience.
Unfortunately, there are also many negative stereotypes and misconceptions associated with psychosis that can
further add to this distress. You are not alone if you are having this experience (estimates place the risk of
psychosis at about three in 100. Help is out there both for the individual and the family, and this help comes in
many forms. By exploring this web resource, you are already looking at the issue and seeing how your resilience
and coping strategies can be employed to best deal with psychosis.
Psychosis is treatable. Many people recover from a first episode of psychosis and never experience another
psychotic episode. Finding support and resources is essential to managing the experience, whether it is shortlived or lasts a good deal longer.
Early Onset of Psychosis
When young children report hallucinations in the context of poor school performance social withdrawal or
exhibit other odd behaviours then a diagnostic evaluation is required.
The caregiver will assess the child, perform laboratory tests and may request developmental or psychological
testing to help make a diagnosis. This could include neurologic problems, bipolar disorder, or childhood
schizophrenia, which is a rare, but real, presentation.
Schizophrenia typically occurs in a window of the mid- to late-teens to the early 30s (this age range is a few
year later for females, often the presentation is early- to mid-20s as opposed to the teen years). Symptoms of
schizophrenia in school-age children are rare, and this is unexpected and traumatic for the family while they are
seeking help and assessment. As this is an uncommon condition, local caregivers may struggle to put together a
comprehensive plan. A teaching hospital with a department of child and adolescent psychiatry would be a good
place to begin.
The National Institute of Mental Health (NIMH) has a research and clinical service centre in Bethesda, Md.,
to better understand childhood schizophrenia, while providing state-of-the-art care to children in care. This
program offers diagnostic and treatment options to children who have had the onset of psychosis prior to the age
of 13. Children aged 6-18 are eligible to enrol.
Young Adults and New Onset Psychosis
Young adults are the most common age group to be at risk for their first episode of psychosis. The experience of
psychosis impacts young adults at a developmentally vulnerable time. This is a stage of life that usually
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