Frequently asked questions (FAQ)

“Psychosis” is not a specific illness but a term to describe a broad range of mental health symptoms. These symptoms may include changes in our thoughts and perceptions that can make us feel confused or distressed when interacting with the world. 

Symptoms can come and go and vary in intensity over time, but sometimes they persist or worsen, disrupting day-to-day activities like studying, working, or socializing. In the United States, about 100,000 young people experience psychosis for the first time each year.

Watch this video to learn more about psychosis.

The past decade has led to advancements in understanding of psychosis and schizophrenia, including the recognition that the onset of psychosis symptoms is typically preceded by less intense, identifiable symptoms in pediatric and adolescent years, also known as the clinical high risk (CHR) syndrome. Research has shown that while some individuals with the CHR syndrome ultimately develop psychosis, most do not. 

Distinguishing between CHR syndrome and early psychosis is important for treatment planning. Studies have shown that the earlier psychosis is identified and treated, including with dopamine-blocking medication, the better the clinical outcomes (i.e., better treatment response, reduced symptom severity and improved long-term quality of life).

However, research to date does not support the benefit of initiating dopamine-blocking medications during the CHR syndrome. For individuals with the CHR syndrome, psychoeducation, clinical monitoring and psychotherapy are the main evidence-based treatment approaches today.

Every person’s experience with early psychosis is unique and can change over time. However, the below symptoms are common among those experiencing early psychosis. If you or someone in your life is experiencing any of the below symptoms, contact the Path Program for support.

• Unfamiliar thoughts or feelings
  • Believing that ordinary things in the environment have special meaning
  • Having difficulty organizing thoughts or finding the right words
  • Having ideas that seem strange, grandiose or illogical
  • Believing that others can read their mind or know what they are thinking
  • Thinking that other people are watching them or talking about them
  • Thinking they are not control of their own thoughts, ideas or actions
• Sensory or perceptual changes
  • Seeming confused about which events are real and which are imaginary
  • Hearing or seeing things that others do not, such as voices, shadows or images
     

Additionally, symptoms of withdrawal, loss of motivation, or changes in typical routine can often accompany psychosis symptoms. Alone, these accompanying symptoms (described below) may not be a sign of psychosis but could be a signal of another mental health concern, such as depression. 

• Withdrawal or loss of motivation
  • Feeling disconnected or withdrawing from your friends and family 
  • Losing interest in everyday activities or caring for yourself 
  • Feeling less pleasure from things that used to be enjoyable
• Changes in your typical routine
  • Having difficulty concentrating, organizing thoughts or expressing ideas clearly to others 
  • Having trouble understanding what you are reading or what people are saying to you 
  • Having extra energy which may keep you awake for days, or low energy that makes you feel unmotivated

If you notice these symptoms alongside the common symptoms of psychosis described above, contact the Path Program for support.

If you are not sure, you can use our mental health screener to help you assess whether or not to reach out to the Path Program.

Hearing voices or other sounds such as music, background noise, or animal sounds that others cannot cannot hear can be a strange experience. In fact, sometimes it can be difficult to tell that you are hearing sounds that others cannot because they can seem quite real.

For some, this experience can be negative and feel scary, while for others it can feel positive and even exhilarating. Regardless of how you experience this, it’s important to seek support as soon as possible to ensure it doesn’t have a negative impact on your life. 

If you believe you or someone in your life is hearing voices or other sounds, contact the Path Program as soon as possible. If we aren’t able to immediately enroll you, we will help you find appropriate resources. 

You can also visit our resources page to find local peer support groups and other resources to help you navigate these experiences. 

Medications approved for treating psychosis, also known as “antipsychotic medications” or “dopamine-blocking medications”, are designed to block dopamine receptors in the brain, which are associated with the sensitivity of the sensory system and are known to have effects on cognition and perception. For some, the effects of dopamine-blocking medications are very helpful for reducing the impact of psychosis symptoms, and for others, they may be less helpful, if helpful at all. In some cases, the side effects of being on the medication can outweigh any benefit.

Research focused on the impact of dopamine-blocking medications has found that:

• On average, the impact of psychosis symptoms are reduced by a “small to moderate amount” among those that take dopamine-blocking medications
• About 20-25% of those taking dopamine-blocking medications do not experience an impactful benefit from doing so
• About 30-40% of those taking dopamine-blocking medications do experience a large benefit (significant reduction in symptoms)
• 35-50% of those taking dopamine-blocking medications experience a modest benefit, which must be weighed against the negative impacts and side effects

In determining whether medication is the right fit for a participant, the Path Program will consider a participant’s personal preferences, the symptoms they are experiencing, and the side effects they experience after taking the medication, which vary from person to person.

It’s also important to note that the effectiveness of dopamine-blocking medications (as with all medications) does not increase with a higher dose of the medication, once the range of FDA approval is reached. In other words, a “double dose” doesn't lead to a “double effect”. So, there is typically little reason to increase an initial dose of medication past the average range.

To learn more about dopamine-blocking medications, watch this presentation by Dr. Demian Rose of the Path Program.

Research shows that patients recovering from early psychosis experience better outcomes when their family members (including chosen family and other caregivers) are informed and involved. While family involvement is encouraged, it is not required. 

The Path Program team partners with families to address concerns and help develop a recovery plan tailored to the needs of your loved one. We also offer family support groups, so you can hear and learn from others going through similar challenges.

Here are a few tips for family members about how to support loved ones through recovery:

• Learn about psychosis. Becoming informed about what psychosis is, how it can feel, and how you can offer support can go a long way. Learn more about psychosis on our website and check out some of our recommended resources. 
• Encourage your family member to be direct and honest.  Help motivate your loved one to be honest and direct about how they’re feeling and what they need. This might include talking about medication side effects, sharing concerns about progress, and asking for help with specific tasks, such as getting accommodations for school or work, applying for a job or housing, or navigating insurance coverage. 
• Pay attention to changing needs. If you’re noticing changes in mood, behavior, or daily routines, such as sleep or eating patterns, or if you’re worried about the safety of your loved one, let us know. The recovery journey is not a straight line and can sometimes include setbacks. It’s important to keep our team in the loop, so we can address any problems or adjust treatment plans accordingly. *If you believe your loved one is in crisis, call or text 988 for immediate support.
• Be patient and hopeful. Recovery is very possible, but it does take time. Staying calm, positive, and hopeful can help your loved one maintain determination. View some of our favorite stories of recovery and other resources for families if you need some inspiration.
• Don’t forget to take care of yourself. Taking care of yourself is just as important as taking care of your family. Try to carve out a little time for yourself each day to do something that relaxes you. 

Schools can play a critical role in supporting young people navigating recovery from psychosis. In fact, students with severe mental illness who stay in school while receiving treatment experience greater recovery. Below are a few ways schools can support students with mental health concerns, whether they are managing symptoms or side effects of medication. Review our guide for more information about how schools and educators can help and support students with early psychosis.

School accomodations that can be helpful for students:

• Connect students with school-based counselors for school and social support
• Provide preferential seating away from distracting/noisy peers, windows or areas
• Allow extra time and flexible deadlines to complete exams, homework or projects
• Offer note-taking assistance, such as class recordings or shared notes
• Give alternatives to public speaking, such as submitting a recording to the teacher
• Provide organization assistance, including support with time management
• Offer support with application process for college / post-grad or jobs, for example
• Provide 1:1 aide that can shadow students and help them achieve their academic goals
• Allow accomodations for medication, such as leaving class to take medication or address side effects. 

Research has found an association between cannabis use and the development of schizophrenia for those that use cannabis daily over long periods of time or that use high-potency cannabis particularly during adolescence. 

THC (tetrahydrocannabinolis) is responsible for the “high” associated with cannabis and most of the intoxication effects of cannabis. CBD (cannabidiol) has very little psychoactive effects and there is no evidence of intoxication as a result of any dose of CBD.

Since the 1970s, there has been a trend toward sales of stronger cannabis with higher THC levels in the U.S. To be considered high potency, cannabis must have a 10% or greater level of THC. Most dispensaries in the U.S. today advertise cannabis products as having 15% or greater levels of THC. Because of the potential risks of cannabis use in contributing to psychosis onset or worsening the course of psychosis, we recommend that our clients minimize use, particularly of high-potency forms of cannabis, to optimize their recovery.

To learn more about the relationship between cannabis and psychosis, watch this talk by Dr. Demian Rose of the Path Program.