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Family members and friends, often unfamiliar with the nature of psychosis, may struggle to understand the condition and how best to support their loved ones.
June 3, 2024
Those experiencing psychosis may have hallucinations—seeing or hearing things that others do not—or delusions, which are strong beliefs in things that are not based in reality. The age range most commonly affected by first-episode psychosis, 16 to 30 years, coincides precisely with the critical period of young adults establishing their independence and laying the groundwork for their future lives.
When young adults encounter first-episode psychosis during this developmental stage, the impact can be serious. The symptoms of psychosis can severely impair their ability to engage in everyday activities, achieve academic and professional goals, and maintain social relationships. The presence of a co-occurring substance use disorder further exacerbates these challenges, creating a complex interplay of mental health issues that can hinder progress and recovery. Addressing first-episode psychosis involves recognizing the unique stressors and developmental milestones faced by the individual. Effective intervention requires a comprehensive approach integrating mental health care with support systems that address educational and vocational aspirations, social skills development, and overall well-being. Early intervention programs tailored to young adults are necessary, as they offer specialized treatment and support during the formative years of adulthood.
By understanding the interconnected nature of these issues and providing targeted support, we can empower young adults to navigate this complex phase of life successfully, ultimately leading to improved outcomes and a more promising future. Psychosis is a condition that profoundly disrupts an individual's thoughts and perceptions, making it challenging to distinguish between what is real and what is not. This disruption manifests through various symptoms, including delusions—false beliefs that are firmly held despite contradictory evidence—and hallucinations, where individuals see or hear things that others do not. Additional symptoms include incoherent speech, memory issues, difficulty thinking clearly, disturbed thoughts or perceptions, poor executive functioning, and behaviors inappropriate for the situation. These symptoms collectively impair an individual's ability to navigate daily life effectively.
Psychosis is a feature of several disorders, such as schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, and delusional disorder. It can also occur as a severe secondary symptom in major depression or bipolar disorder. The onset of psychosis, particularly during adolescence or early adulthood, can be a period marked by fear, stress, and significant uncertainty for both the affected individuals and their families. The stigma surrounding mental illness often exacerbates this isolation, leaving many unsure of where to turn for help or support. Young adults experiencing their first episode of psychosis frequently face additional mental health challenges, including depression, anxiety, sleep disturbances, and social isolation. These symptoms can disrupt their ability to perform in school or work environments with inadequate support systems to accommodate their needs. This lack of support can hinder their educational and professional development, further compounding the stress and isolation they experience.
Family members and friends, often unfamiliar with the nature of psychosis, may struggle to understand the condition and how best to support their loved ones. This knowledge gap can prolong the journey to a correct diagnosis and effective treatment, leading to a longer duration of untreated psychosis. This period, marked by the persistence of untreated symptoms, poses additional risks, including hospitalization or legal issues.
In the United States, young adults typically experience symptoms of psychosis for over a year before receiving appropriate treatment. Reducing this duration of untreated psychosis is key, as research indicates that early intervention leads to better outcomes. When young people receive effective treatment promptly, they are more likely to feel better and resume their important activities and goals. The shorter the duration of untreated psychosis, the higher the likelihood of achieving positive outcomes, pointing to the importance of early detection and intervention.
The key to mitigating these impacts lies in reducing the duration of untreated psychosis through early and effective intervention, thereby facilitating a path toward recovery and improved quality of life. Substance misuse and substance use disorders represent a spectrum of behaviors and consequences associated with the use of various substances. Among young adults, experimentation with substances and recreational use is fairly common, with many engaging in infrequent or moderate drinking without significant issues. However, substance misuse involves patterns of use that increase the risk of negative outcomes. For instance, binge drinking, defined as consuming four drinks for women or five drinks for men within about two hours, raises blood alcohol concentration to 0.08 g/dL and is linked to immediate and long-term health, interpersonal, and cognitive problems. Similarly, regular use of marijuana can lead to health complications and cognitive impairments.
For some individuals, patterns of misuse escalate into substance use disorders (SUDs), which encompass the problematic use of a wide range of substances, including alcohol, cannabis, cocaine, heroin, hallucinogens, inhalants, opioids, and various prescription medications. Substance use disorders are characterized by continued use despite significant negative consequences. These include consuming larger amounts over time, failed attempts to reduce or stop use, spending excessive time on substance use or recovery, and sacrificing important social, occupational, or recreational activities due to substance use. Over time, these behaviors result in a noticeable decline in an individual's ability to function.
Research has highlighted the specific impacts of substances like alcohol, cannabis, and tobacco on individuals experiencing first-episode psychosis. Alcohol use among this group is associated with poorer medication adherence, reduced quality of life, and diminished social functioning. Cannabis use has been linked to the onset of psychosis in some young adults, with regular use often preceding the onset of psychotic symptoms. Those who continue to use cannabis after experiencing first-episode psychosis typically face significantly poorer outcomes compared to those who have never used or those who quit following treatment. Consequently, cannabis use is a primary target in the treatment of first-episode psychosis.
Early and effective intervention in substance misuse can mitigate the progression to substance use disorders, enhance treatment outcomes, and support the overall well-being of affected individuals. Reducing the use of substances such as alcohol, cannabis, and tobacco is much needed in managing first-episode psychosis and improving the quality of life for young adults navigating these challenges.
