Living With 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 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

Psychosis manifests in various ways. Below are common symptoms of a psychotic episode:

• 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.

Psychotic symptoms in schizophrenia, bipolar disorder, and other conditions

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 journey toward a diagnosis

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.

Self-advocacy: Your voice matters

Your journey toward healing is uniquely yours. Your input can help your team create a treatment plan that fits your needs. Self-advocacy may empower you to play an active role in your healing. Below are a few ways to respect and center yourself in your treatment journey: 

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.

The role of self-care in mental health

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.