A Diagnosis Of Psychosis (NOS): Finding The Right Support
The landscape of the mind can constantly evolve. In some cases, the map a person once understood about reality can shift — whispers emerge where there was once silence, shadows flicker in unusual ways, or beliefs take root that seem at odds with the logic shared by others.
These sensory experiences might point toward psychosis. The term “psychosis” may seem scary. However, understanding what you're experiencing can help you research support options and take steps toward recovery. One diagnosis individuals may come across is psychosis (NOS). Understanding the meaning of this term may help you come to terms with what it means for you or a loved one.
What is psychosis NOS?
The term "psychosis (NOS)" stands for psychosis, not otherwise specified. It may also be referred to as a "psychotic disorder not otherwise specified" (PNOS). A non-specified psychotic episode does not meet all the criteria of a usual psychotic episode. While there are some similarities to other conditions, the specific combination of symptoms doesn't fit any label perfectly.
In some cases, providers may treat diagnosis of psychosis nos like putting together a puzzle. If symptoms are unclear, the client is diagnosed with some symptoms, but the whole picture hasn't emerged, or a complete diagnosis doesn’t fit the situation yet. In the future, they may be diagnosed differently or continue with the NOS label.
Common psychotic symptoms
- Hallucinations: Hallucinations are sensory events without any basis in the external world, such as voices no one else hears, fleeting figures on the periphery of vision, or strange sensations, tastes, or smells.
- Delusions: Delusions are fixed, unshakable beliefs that persist despite contradictory evidence.
- Disorganized behavior: Disorganized behavior can look like not responding to one’s environment, talking in disjointed ways, or acting uncharacteristically to one’s personality.
How often is PNOS diagnosed?
Some people experiencing psychosis initially receive a diagnosis of PNOS. Current research indicates as many as one in 10 individuals with a psychotic disorder receive a diagnosis of PNOS. PNOS highlights that every person's experience is different.
A diagnosis of psychosis (NOS) highlights the potential for further exploration into one’s symptoms. Psychotic symptoms can stem from a range of potential causes, including:
- Other psychotic disorders: Conditions like schizophrenia spectrum disorders, schizoaffective disorder, bipolar disorder with psychotic features, or delusional disorder also involve psychotic symptoms.
- Substance-induced psychotic disorder: Alcohol or drug use can sometimes incite psychosis.
- Medical conditions: Brain tumors, infections, neurological disorders, and other health problems can sometimes cause psychotic symptoms.
- Mood disorders: Severe episodes of depression or mania can sometimes include psychotic features.
Understanding a diagnosis of psychosis (NOS)
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a resource doctors use to understand mental health conditions. While it can be helpful, sometimes a person's experiences don't perfectly match any specific diagnosis. A PNOS diagnosis can offer more time and space to understand what an individual would most benefit from in their treatment plan.
Getting the most accurate diagnosis often depends on open communication between you and your mental health team. Your mental health professional may carefully explore different aspects of your experience to gather information, including through the following steps:
Symptom assessment: Your provider may examine the nature, intensity, and duration of any psychotic symptoms you're experiencing.
Medical history review: Tests may be ordered to rule out any physical conditions mimicking psychotic symptoms.
Personal and family history: Understanding your overall health and mental health history, as well as any family history of mental disorders, may offer valuable insights.
Is it brief psychotic disorder, bipolar disorder, or something else?
Understanding your experiences with psychosis can take time. Open communication and careful exploration may help your provider determine whether you’re living with a brief psychotic disorder, schizophreniform disorder, one of the schizophrenia spectrum disorders, or a different specific psychotic disorder. Your mental health professional can carefully assess your symptoms, health history, and personal background to create a treatment roadmap tailored to you.
The importance of support after a diagnosis of psychosis NOS
Living with a diagnosis of psychosis NOS might seem isolating. However, building or having a support system can be a way to cope with symptoms. Below are a few support options you might try:
- Trusted confidantes: Think of those who let you know you are safe and unconditionally accepted. Whether it's family, friends, or a spiritual mentor, lean on them for emotional support during positive and challenging moments.
- Therapy: Various types of therapy may offer an outlet for your emotions. Some may focus on developing coping skills and managing difficult emotions, while others, like cognitive-behavioral therapy (CBT), can help you navigate the complex thoughts that sometimes accompany psychosis.
- Support groups: Sharing experiences with others who understand psychosis may validate and combat the loneliness that often accompanies mental illness. You can find support groups, either in-person or online, specific to psychosis or broader mental health organizations.
A diagnosis doesn't define you but can underscore the value of finding support. Leaning on loved ones, seeking therapy, and joining support groups may provide comfort, guidance, and a sense of community as you manage a schizophrenia spectrum diagnosis or an unspecified schizophrenia spectrum disorder.
Learning all you can
Exploring reputable sources like the National Alliance on Mental Illness (NAMI) or SAMHSA.gov may help you better understand psychosis (NOS) and treatment options. The latest research can equip you to be an informed participant in your care.
Communicating your needs
Collaboration often depends on open dialogue. Being open with your treatment team about how your symptoms affect your daily life may reduce the guesswork.
Asking questions
Your treatment team may have your best interests at heart, but they might not know what walking in your shoes is like. Ask for clarification or express concerns about any aspect of your diagnosis and treatment plan to keep lines of communication open.
Knowing more about psychosis and your treatment options can transform you into an active collaborator in your care. Research suggests that when clients actively participate in their treatment, it can lead to improved results. Exploring trustworthy sources, communicating your experiences, and asking questions may also improve your overall well-being.
It may be easy to dismiss "self-care" as fluffy and unneeded. However, taking care of yourself isn't selfish. Self-care can be a part of managing your mental health. Acts like focusing on nutrition, finding time for hobbies, or calming yourself with deep breaths may give you a sense of control and build resilience. Below are a few other forms of self-care to try:
- Getting enough rest: Get an adequate amount of sleep to alleviate some symptoms of psychosis. Sleep deprivation can have severe mental and physical health risks. If you’re unsure how to sleep better, reach out to your doctor to discuss sleep support options.
- Physical activity: Regular exercise can lower stress, boost mood, and improve overall health.
- Stress management techniques: Stress can worsen symptoms, making coping skills even more critical. Mindfulness activities like meditation or yoga may reduce stress and promote relaxation.
Self-care isn't about grand gestures. Every step you take toward caring for yourself may strengthen your resilience. You can explore different ways to manage stress and develop a personalized self-care routine that is manageable and effective.
Treatment options for psychosis NOS
There may not be a single "right" approach to treating psychosis (NOS). Everyone's journey with mental health is unique. Your plan can involve a unique combination of different support options and may change as you learn what makes you feel your best. These options might include:
Medication to manage symptoms
Antipsychotic medications are often central to managing psychosis symptoms, regardless of the underlying cause. However, if substance use or a medical condition is inducing psychosis, addressing the root cause can become an immediate priority. Discuss potential side effects and any concerns you may have with your doctor to reduce complications.
Therapy to improve mental health
Various types of therapy can be beneficial. Cognitive-behavioral therapy (CBT) may help you with managing the complexities of psychosis. Other valuable approaches might include skill-building groups or family therapy for additional support.
Lifestyle adjustments
While not a cure-all, focusing on sleep, nutrition, exercise, and stress management may improve your overall well-being and support your recovery.
Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
How to find further support for a psychotic disorder
Managing psychosis can sometimes involve unpredictable days. In these cases, it may be difficult to access in-person therapy sessions. Online therapy through a platform like BetterHelp can offer flexibility by connecting clients with a therapist from the comfort of home. In addition, online platforms may provide unique tools, such as worksheets, journaling prompts, and support groups included in the plan.
Studies indicate that online therapy may be effective for individuals with psychotic disorders. Researchers found that online formats increase engagement. It might be easier to access support, which can lead to improved symptom outcomes. While research is ongoing, these early findings encourage future research in this area.
Psychosis (NOS) can be a confusing experience. The path to a precise diagnosis sometimes twists unexpectedly. Your initial diagnosis might change over time as your treatment team observes your response to various forms of support. This process is often a collaboration.
Life with a diagnosis of psychosis (NOS) can hold complexities and challenges. You may become overwhelmed now, but there's a path forward. With support, people with psychosis may experience a reduction in symptoms, build stability, and foster a meaningful life filled with connection and hope. Consider reaching out to a therapist online or in your area to explore your options.
What does NOS mean in psychiatric diagnosis?
NOS in a psychiatric diagnosis indicates “not otherwise specified”. The NOS designation is often given when a patient meets broad guidelines for a mental disorder, yet symptoms don’t fit into a specific category based on the diagnostic criteria. This diagnosis may be associated with a high degree of diagnostic instability, meaning an individual’s diagnosis may vary over time as more symptoms emerge or other details of the person’s mental status are uncovered. For instance, if it is determined that an individual experiencing psychotic symptoms has recently taken a drug or is withdrawing from alcohol, substance-induced psychosis must be considered.
What is the diagnosis code for psychotic disorder NOS?
The ICD-10-CM code for psychotic disorder (NOS) is F29.
There may be no single diagnostic test for primary psychotic disorders such as schizophrenia spectrum disorder or bipolar disorders. Instead, there are multiple clinical assessments that may be performed to determine a diagnosis. For bipolar disorder, psychosis symptoms usually appear during a manic episode.
No. Unspecified psychosis is a diagnosis in the International Classification of Diseases, Tenth Revision, or ICD-10. The equivalent diagnosis in the DSM-5 is “Unspecified Schizophrenia Spectrum and Other Psychotic Disorder”.
Psychosis spectrum disorders listed in the DSM-5 include:
- Schizophrenia
- Schizophreniform disorder
- Schizoaffective disorder
- Delusional disorder
- Brief psychotic disorder
- Psychotic disorder due to another medical condition
- Substance-induced psychotic disorders
- Unspecified schizophrenia spectrum and other psychotic disorder
- Other specified schizophrenia spectrum and other psychotic disorder
Attenuated psychosis syndrome is a related condition associated with some psychotic symptoms that are not severe or frequent enough to meet the diagnostic criteria for a psychotic disorder.
How is psychosis identified? What are the psychotic symptoms?
Psychosis is identified after a comprehensive clinical assessment performed by a medical professional, sometimes referred to as a disorder identification test. Some psychotic symptoms may include delusions, hallucinations, and disorganized speech.
Psychotic symptoms are typically organized into two main categories: positive symptoms and negative symptoms. Negative symptoms may include catatonic behavior, acute withdrawal from friends and family, and diminished emotional expression. Positive symptoms may include visual or auditory hallucinations, persistent delusions, and paranoia. When positive symptoms appear in schizophrenia, these are referred to as the active phase symptoms. In some cases, the clinician may use the Positive and Negative Syndrome Scale (PANSS) to evaluate clinical characteristics of psychosis.
A structured clinical interview may reveal a more complex diagnosis. For example, psychosis with prominent mood symptoms may be indicative of a mood disorder with psychotic features such as schizoaffective disorder or major depressive disorder with psychotic features (MD-Psy).
It may be important to note that severe symptoms of certain anxiety disorders may mimic psychosis symptoms. This may be something that needs to be ruled out when performing disorders identification tests.
If you suspect that you or someone you know may have psychosis, it could be necessary to contact a psychosis advisory unit like the Early Psychosis Intervention Network (EPINET).
What are the warning signs of psychosis?
There may be many different warning signs of psychosis, and these could vary by individual. Some examples include:
- Changes in mood
- Disorganized speech
- Sleep problems
- Substance misuse (formerly substance abuse)
- Social withdrawal
- Paranoia
- Persistent non-bizarre delusions
Can a mental illness with psychosis be cured?
Some people who experience a psychotic episode recover and never have another. For example, the American Psychiatric Association defines “acute psychotic episode” as psychotic symptomatology that occurs suddenly and then quickly subsides. Other people whose symptoms persist may be diagnosed with a psychotic disorder that requires ongoing treatment. According to the Substance Abuse and Mental Health Services Administration, the earlier a person receives treatment, the better the outcome will be.
What triggers psychosis?
According to clinical data gathered through mental disorders research, including participants' clinical records, there could be several different triggers of psychosis. Often, it’s a combination of factors, such as genetics, trauma, substance misuse, medications, or physical illnesses and conditions. Demographic and clinical data suggests that certain minority groups and low-income individuals may be at a higher risk of developing psychosis. Medical research ethics must be considered when developing early intervention programs for these at-risk groups.
How to calm down psychosis?
Antipsychotic medication is typically the first line of treatment for psychotic disorders.
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