My wife went psychotic last summer and I’ve successfully treated her over the last year, despite being unable to get her medication. Some pointers:
Sleep is 80% of the process. She cannot recover without it. But she’s like a fire truck with sirens blaring, she can’t sleep surrounded by threats. He has to find a way to turn the sirens off.
So step one is calm and trust. Everyone she’s exposed to (fewer the better) must take responsibility for everything that’s happened to her since the first psychosis. And everything that happens today. Apologize for the big things, apologize for the little things. Make it clear she is not to blame.
Turn her home into a sanctuary. Remove and block anything that might cause stress. Declutter where possible. Offload his external responsibilities. Help him make bills auto pay with nothing mailed to the home.
Make her life pro sleep. Designate someone who can earn her trust enough to take walks and other activities with. Wear her out so she can’t help being sleepy. Remove and change lighting so it’s as warm and dark as possible after sunset. Especially screens, get flux and nightshift on everything.
Learn how to communicate in a non threatening manner. Never indicate she’s sick and make every change and request about you: https://www.amazon.com/dp/0967718937/. Learn what agency is, realize she doesn’t feel any and practice helping her get it back.
Stop focusing on information, her brain can’t process it. When she talks, ignore the information, it will only make you stressed. Focus on what the information is telling you about her mood. When speaking with her, how you say it matters much more than what you say. Stop saying things that hurt calm and start saying things that help trust and calm.
Make self care a religion. Help him get sleep and build a simple daily routine to have shelter among the chaos. Join a family support group and go every week: https://www.nami.org/Find-Support and do the 12 week training, both of you!
Caregiver here, couple of points
There are two kinds of psychosis, with and without insight. Drug induced seems to leave insight and people with insight tend to populate this sub. Sleep deprivation psychosis tends not to leave insight and they don’t know so they don’t tend to populate this sub (until they’ve been medicated).
I see psychosis like an emotional rewiring. And humans use emotions to verify things. ‘That feels right ‘. So it becomes easy for your loved one to believe false things are real because their emotions tell them it’s real. And they need their new feelings to make sense so they are creating a new reality to do that.
Trust is the most important thing you are loosing right now and trust is the most important thing you have to earn back. They are scared and telling them their feelings are wrong will only hurt them and break trust.
Stop focusing on details and start focusing on mood. What does what they share tell you about their mood and how does what you share affect their mood. Stop making their mood worse and start making their mood better.
Psychosis is uncontrolled energy. The more they have the worse they will be. Find ways to safely release that energy. Listen when they will talk and get them as active as possible. You want them as tired as possible when the sun sets at the end of each day.
Their sleeping is your biggest goal. If anyone lives with them, make sure they know everything above and have them make the home as dark and quiet as possible. Have them track sleep hours day and night and gradually try things to improve sleep.
Laws vary between states. Bigger states tend to have psych hold options that allow your friend to be evaluated. Check with nami to see which you are dealing with...
Read this book (https://www.amazon.com/dp/0967718937/) and get to a family group here (https://www.nami.org/Find-Support)
Successful caregiver here
I’ve not found any other reddit sub, outside of more specific topics like bipolar spouses. But those are pre-psychosis and don’t really apply.
Get yourself and as many family members as will go to training and a local support group: https://www.nami.org/Find-Support
If you’re loved one lacks awareness, learn how to communicate: https://www.amazon.com/dp/0967718937/
But above all, make sure your loved one is getting enough sleep. Having to little may be the cause but even if not, having enough is crucial to healing.
Thankfully you live in a country with both functioning healthcare and commitment laws. In most us states she couldn’t get care unless she volunteered (which she can’t do because she lacks insight) or became violent (which often results in injury).
This book will help you learn how to communicate: https://www.amazon.com/dp/0967718937/
And you’ll want to spend this time preparing for her to get out. In the states, they get released the moment they are allowed to consent, even in the middle of the night. I assume that also won’t be an issue there.
Sleep loss and sleep recovery are both cumulative. Focus on providing it consistently.
Configure a place for the following:
No threats / surprises
Easy sleep, both day and night
Daily exercise, even if it’s just walking
Low effort outdoors, relaxing
Non judgmental people, no exceptions
Games and puzzles to rebuild thought and confidence
I had just emailed NAMI on a sort of similar issue the replied me with the following:
>Thank you for contacting NAMI, the National Alliance on Mental Illness. We’re grateful you’ve reached out to us and hope that the information provided below will guide you to helpful resources and next steps.
>We’ll highlight a few options for you now, but please consider calling the HelpLine to speak with one of our volunteer Information & Resource Referral Specialists to talk through additional options if we have not been able to fully address your question. Our volunteers have “lived experience” – either living with or caring for a loved one with a mental health condition, so we’re passionate about helping to find the best options for you.
>Firstly, you may wish to view our Want To Know How To Help A Friend Infographic to begin the conversation.
>Secondly, often an individual living with a mental health diagnosis – particularly one that involves a serious mental health condition (or one complicated by substance use disorder) – may not actively participate in their own recovery. This is known as Anosognosia [Ah-no-zog-nosha], a co-occurring disorder that can accompany a serious mental health condition and render the individual unable to recognize that they have a mental health condition and/or that they need to seek help.
>To learn techniques for communicating with your loved one, and to help them agree to partner in their recovery, we would recommend reading I’m Not Sick, I Don’t Need Help!, a book by Dr. Xavier Amador - a psychologist whose experiences with his own family demonstrated how challenging this phenomenon could be. In his book, Dr. Amador discusses the condition of Anosognosia and outlines strategies for communicating with a loved one to help them work toward recovery. The first half of the book is accessible to the public on our website here; the book is available in English and Spanish for purchase at online booksellers.
>A broader discussion of the strategies of Dr. Amador’s LEAP method, including videos on how to apply the LEAP method, are available for free here.
>Additionally, an alternative option to consider: Mobile Crisis (MCU) or Mobile Crisis Rapid Response Team is an emergency mental health service offered by many counties to provide on-scene evaluation, treatment and crisis interventions in the community. The teams specialize in providing these services to individuals who are experiencing a mental health emergency and who need, but are unwilling or unable to seek, mental health treatment.
>While the goal of the MCU is to enlist the individual’s cooperation and develop the least restrictive treatment options, the MCU is authorized to recommend and facilitate involuntary hospitalization and treatment when necessary.
>The criteria for requesting an MCU varies depending upon the county or city mental health agency. However, a person experiencing a crisis that presents a danger of harm to self or others and is unwilling or unable to accept emergency services would qualify for mobile crisis services. If about you are unsure about the availability of mobile crisis services in your area or when it’s appropriate to call, contact the emergency mental health services in your county for more information by dialing 211.
>A final note - we would urge you to reach out to the NAMI Affiliate serving your area. Our Affiliates can provide additional information and referrals to local resources in your community. They also offer free support groups, classes and other programs where you can learn more about mental health, how to support recovery, and most importantly - where you can be among peers in your community who face similar challenges living with or caring for a loved one with a mental health condition.
>Membership is not required to participate. Your local NAMI Affiliate or NAMI State Organization can help you register for NAMI courses and programs. To find your nearest NAMI Affiliate, click on your state through the Find Your Local NAMI menu.
>We hope this has been helpful. To speak with one of our volunteer Information & Resource Referral Specialists, please call the NAMI Information HelpLine at 800-950-NAMI (6264), available Monday through Friday, between 10:00 am and 6:00 pm EST. Visit our website for more information at www.NAMI.org.
This is very resourceful and if you live in US then you could even contact the numbers they mention. If you have any more questions then you can just email them.
Psychosis is a brain injury and a psychotic brain without insight (doesn’t know he’s injured) is incapable of making decisions. He’s hurting and all he knows how to do is react.
If the law won’t get him care because he’s not violent and won’t volunteer, your legal hands are tied. But there are still options.
1) this book teaches you how to communicate with someone without insight. Every family member should read it: https://www.amazon.com/dp/0967718937/
2) this organization has classes and support groups and everyone interacting with him should attend: https://www.nami.org/Find-Support
3) ultimately if you can’t get him meds, the only option is sleep. And he can’t sleep reliably until the threats are gone.
4) without insight he has to explain everything that happened to him as someone else’s fault. Accept that and apologize for everything. This will regain trust.
5) without insight the world no longer makes sense so he is constantly surprised, ruining his calm. Reducing all stress, threats and surprises possible so he can relax. once he can trust and calm he can sleep and heal.
6) remove anyone from his life who can’t do the above, they will slow healing.