Returning to routine after a psychotic episode
Most people begin to recover within a few weeks or months of starting treatment after a first psychotic episode. Most symptoms are then less intense, or some even disappear. This makes them feel more capable of coping with their daily lives . Returning to daily routines, such as going back to work or resuming leisure activities, can present certain challenges. But what can I expect from returning to my routine? Will everything be the same as before? How do I manage my expectations?
It's likely that immediately after a psychotic episode, a person won't be able to immediately resume everything they were doing before, but they will almost certainly be able to gradually return to the things that made them feel good. Every recovery process is different and takes time, but to manage expectations effectively, it's best to set easy short-term goals to boost self-esteem and then expand them into medium- and long-term objectives. The goal is to have a fulfilling and meaningful life plan.
What's the hardest part about getting back into a routine?
After a psychotic episode, there are some aspects that make returning to routine difficult:
- Much of the antipsychotic medication has side effects (slows thinking, flattens emotions, lowers libido, etc.), which do not facilitate a return to normal routine.
- In addition, you may feel bad about actions, words, or even thoughts developed during the outbreak that make it difficult to reconnect with the people you were close to during the crisis.
- Once a person is diagnosed, it is time to face the social stigma and work on self-stigma , that is, not to create in ourselves the stereotypes that fall on mental health (dangerousness, incompetence, inconstancy, impulsiveness, etc.) feeling shame, guilt, pitying ourselves or limiting ourselves.
The recovery model from the perspective of its protagonists
What can help us in the recovery?
First, it can be helpful to establish a daily routine that we enjoy, while still allowing for some flexibility, as this tends to create stability and helps us organize our day. A healthy routine should include time for work and leisure activities, with realistic goals, and good eating and sleeping habits.
In this routine, social relationships are very beneficial , both for providing support and for fostering a sense of belonging and connection, thus preventing isolation. It can also be beneficial to engage in physical exercise or activities that we enjoy, and to maintain a regular and balanced diet. All of these habits will help prevent further psychotic episodes.
A healthy routine should include time for work and leisure activities, with realistic goals, and good eating and sleeping habits.
The role of family and friends in returning to routine
It's not easy to support a loved one in times of suffering, but there are some guidelines that can help:
- Maintain close, consistent, and reciprocal emotional family relationships.
- Pay attention to criticism, overprotection, and hostility.
- Maintain a clear family organization (rules, roles).
- Maintain close, consistent, and reciprocal emotional relationships.
- Having clear communication about the disorder and its management.
- Assume that recovery processes take time and are not linear.
- To transmit hope.
- Hear.
- To accompany without deciding for the other person.
The environment is also key in the process of regaining self-confidence after a psychotic episode. It's important to feel you have trustworthy people you can lean on and talk to about your worries. Furthermore, identity is built in relation to others, so it's crucial that your close circle reflects a positive image of yourself back to you. This will help boost self-esteem, if positive, or lower it, if negative. It's worth remembering that regaining control of your life's path increases self-esteem and fosters well-being.
How can they detect a possible relapse?
Relapses depend on multiple factors; life is full of difficult or stressful moments. From our perspective, the person best prepared to avoid or minimize relapses is the one with the disorder who is aware of their situation and manages it to live with it as best as possible. Overprotection or external control does not help people with mental health problems take responsibility for their own lives.
Regarding how to know if a person is in crisis, there are several warning signs:
• Difficulty concentrating.
• Decreased academic performance (in childhood and adolescence).
• Impulsiveness.
• Alterations in thought and perception.
• Confused thoughts.
• Distrust towards people in the environment.
• Sudden mood swings.
• Social isolation.
• Drowsiness and trouble sleeping.
• Lack of personal care or hygiene.
• Unusual and excessively intense ideas.
• Strange feelings or absence of feelings.
• Problems expressing oneself verbally.
• Difficulty distinguishing reality from fantasy.
• Disorganization of behavior.
• Extreme and involuntary lack of energy, motivation, interest, etc.
Relapses in psychotic disorders
Returning to work after a psychotic episode
When returning to work, the first thing to know is that there is no legal requirement to disclose a psychotic episode . The decision to reveal it or not is entirely yours. However, it's important to weigh the pros and cons of sharing your experience, as it's still a socially stigmatized experience, and disclosing it could expose you to further discrimination.
Pros:
- Relating to others with honesty (not having to hide or lie).
- Discovering that, like you, there are many more people who have suffered psychological distress.
- The possibility of finding support within the group.
- Achieve reasonable adjustments in the workplace.
Cons:
The possibility of experiencing various forms of discrimination: distancing, mobbing , relegation to minor tasks, demotion, or dismissal for reasons other than the mental health problem.
But what we must understand is that most people with psychotic disorders are stable for most of their lives, meaning their personal and professional performance doesn't necessarily have to be affected. People diagnosed with psychosis who receive appropriate treatment can perform their jobs just like anyone else without a mental health diagnosis. In some cases, the person may adapt better to certain types of work that don't involve high levels of stress.
Most people with psychotic disorders are stable for most of their lifespan, meaning that their personal and work performance does not necessarily have to be affected in any way.
However, if the person is unable to continue working after the outbreak, it is important to identify the activities that motivate them most . There are many options, for example:
- Nurture social relationships by meeting up with friends or family.
- Practice hobbies
- Engage in physical activity or sports
- Volunteering
- Take courses
People with experience in mental health disorders
Where can I get help getting back into my daily routine?
If after the psychotic episode I don't feel entirely confident resuming all my usual activities, there are different options that can help you gradually get back to your routines:
- Contact mental health support groups, also known as first-person mental health organizations . These organizations, which you can join, offer leisure, cultural, and awareness-raising activities, Mutual Support Groups (MSGs), advocacy for the rights of this community, and more. It's a space where you can regain your daily routine without feeling judged.
- Contact or join a Social Club . You can apply directly or ask your designated professional to submit an application to the social club.
Both associations and social clubs can offer you support to carry out activities of interest to you and gradually recover your previous activity.
The origin and evolution of social clubs in Catalonia
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