Management of Psychosis and Bipolar Disorders


Mental health has become an underrated topic that affects people in one way or another. People need to assess their well-being and check on their abilities. Besides, knowing your mental status enables a person to preserve his/her ability to enjoy life. Stable mental health allows a person to work productively. Therefore, people need to find balance in their daily activities with their psychological resilience. Psychological resilience enables people to react effectively to a crisis while protecting themselves from potential adverse effects such as stress. There are many psychological disorders associated with mental health, such as psychosis and bipolar. Psychosis is a condition that affects the way the brain integrates information. Psychosis affects the way a person thinks and the touch of reality. Psychosis is not a disease but a symptom caused by a mental illness such as schizophrenia. Psychosis interferes with the capacity of a person to meet ordinary demands in life. Psychosis usually occurs in episodes and can become a clinical condition if not treated in the early stages. This essay discusses an in-depth analysis of psychosis and the treatment of psychosis.

Pathophysiology of the Psychosis Condition

Psychosis can be caused by other prevailing conditions such as mental illness, several disease conditions, and drug abuse. Many people have mental health concerns that make them miserable in life. Examples of mental illness include; anxiety disorders, depression, schizophrenia, and eating disorders. However, symptoms of mental illness can be managed by therapy and medication. Individuals that suffer from psychosis have several pathological mechanisms within their brain systems. The symptoms of psychosis include; extreme mood changes, withdrawal from friends, intense fears or worries, delusions and hallucinations, changes in eating habits, confused thinking, suicidal thinking, violence, and excessive anger (Lieberman 2018, pp. 270-280). The most common symptom of psychosis is hallucinations that affect hearing, sense of taste, and sense of smell.

Hallucinations are subdivided into different forms such as auditory hallucinations, visual hallucinations, and tactile hallucinations. Auditory hallucinations involve hearing non-existent sounds even when no one is around you. Auditory hallucinations are termed as thought echoes, where one will hear contrasting voices (Lieberman 2018, pp. 270-280). For example, a person with psychosis may listen to his/her name being mentioned or being called, yet in reality, no one is calling them. Visual hallucinations involve seeing things and people that are not there. Visual hallucinations can occur when one is falling asleep (hypnagogic) or waking up (hypnopompic).

Tactile hallucinations involve a strange feeling and emotions that you can’t explain, such as feeling sad for no reason. Hallucinations can be distinguished from illusions. Hallucinations without insight can also be contrasted with hallucinations that individual persons consider as unreal. Besides, the occurrence of hallucinations is not necessarily pathological, especially if they happen without preserved insight. Also, hallucinations may not be directly involved with a person’s emotions, feelings, and other cognition disturbances.

Delusion is another common symptom of psychosis. In this case, people develop beliefs that don’t make sense to others despite evidence of the contrary. People develop beliefs that don’t go in line with their culture. Common delusions come as a result of misinterpreting day-to-day activities. People with non-bizarre delusions develop imaginations of situations that can exist in real-life such as; being followed, conspired against, poisoned, deceived, and conspired against (Lieberman 2018, p. 270). Besides, people with bizarre delusions are physically impossible beliefs such as believing one’s organs were replaced with organs of a different person. Also, one may think that unknown people are harming him/her, and such tendency may result in self-harm. These delusions involve exaggeration of real-life experiences and perception of one’s experiences before. People who suffer from delusions can continue to function normally and socialize with other people. However, people who experience delusions can get pre-occupied with their non-existent bizarre experiences till their lives are disrupted. This condition is a common symptom of schizophrenia, and it mostly occurs in middle-late life. Delusional disorders can be genetic and can be passed from parents to children. Also, an imbalance of neurotransmitters in the brain can lead to delusion disorders.

Psychosis can be subdivided into three groups; idiopathic psychosis, toxic psychosis, and psychosis due to medical conditions. Exotic psychosis is caused by drug and substance abuse and prescribed medication that leads to toxic substances in the body. Situations in which the pathological features of psychosis are known can be treated by targeting the causal agent (Lieberman 2018, p. 270). Psychosis can have a historical background on a person depending on their underlying disorder. The most common psychotic conditions, such as bipolar disorder, schizophrenia, and depression, typically affect people in late teens or early adulthood. Exotic psychosis can occur at any age as it is induced by drug abuse or prescribed drugs. However, young people are likely to get it as they are exposed to different kinds of situations in life that may overwhelm them. Parents may observe the early episodes of psychosis in their children by a sudden change in personality traits. Psychosis makes people lose interest in almost everything and spend time alone than usual.

The brain is the central focus of psychotic disorders. A procedure called pneumoencephalography is undertaken to assess the stability of the brain. The procedure involves taking fluids from the brain, which are then replaced with air to study the x-ray pictures of the brain. The brain is the central processing unit of the body and holds emotions, feelings, sensations, and the control center for judgment and perception (Lieberman 2018). Overthinking affects the brain’s capacity to be able to distinguish between reality and imagination. All information is transferred into the brain via the sensory organs to form coherent thoughts. In people with psychotic disorders, the sensory organs produce spontaneous reactions that result in hallucinations. The main problem with psychosis is the inability to distinguish between hallucinations, delusion, and reality. In people with auditory hallucinations, parts of the brain that processes speeches and hearing are affected adversely. Also, neurotransmitters in the brain play a more prominent role in depression, psychosis, and other forms of mental illness.

Mechanism Actions and Drug Profiles for Olanzapine and Aripiprazole

Psychotic disorders can be treated with antipsychotic drugs such as Olanzapine and Aripiprazole. However, most antipsychotic drugs are generic, and hence they have adverse effects on the general body. Besides, there is no such assurance for the long-term effectiveness of antipsychotic medications as the condition is likely to repeat itself. It is crucial to treat psychotic disorders regardless of drugs’ efficiency as they reduce life expectancy by nearly 20 years. Treatment should be person-centered as it goes a long way to enable them to accept their conditions without suffering from denial.

In this case, inpatient psychosis treatment is advantageous and aids in improving patient satisfaction, increasing patient empowerment, and reducing the frequency of involuntary treatments. Patients should always be involved in the treatment process and through their consent. To understand the prevailing conditions of patients and the history of their condition, questionnaires are prepared for quantitative data collection (Gómez-Revuelta 2020, pp. 217-229). Besides, it helps a patient develop a perceived positive notion of the treatment process and submit it to the treatment.

Antipsychotic drugs are classified into first-generation drugs, second-generation drugs, and third-generation drugs. Aripiprazole is a third-generation antipsychotic drug that has a unique pharmacological profile compared to other medications. It is moderate and has various properties on neurotransmitter systems. Aripiprazole balances the serotonin and dopamine levels found in the brain and is responsible for thinking and the sense of feeling and touch. It is more effective in the long-term effectiveness of treating psychotic disorders. Clinical trials of Aripiprazole showed that it is effective within the first 26 to 52 weeks for treating different psychotic conditions such as schizophrenia (Gómez-Revuelta, 2020: pp.217-229). Clinical trials also showed that Aripiprazole was effective in treating bipolar disorders when combined with mood stimulators such as valproate.

Unlike third-generation antipsychotic drugs, second-generation drugs are also useful in treating bipolar disorders but have intense side-effects. The efficacy of Aripiprazole has continuously been reviewed and evolved by health experts to reduce the underlying side effects. Clinical efficacy of antipsychotic drugs such as Aripiprazole should not only be viewed as a result of a short-time treatment but also as a result of long-term treatment. Aripiprazole has side effects that range from long-term to short-term side effects. The commonly reported side effects of Aripiprazole include; vomiting, nausea, headache, dizziness, insomnia, limb pains, anxiety, restlessness, and drowsiness (Gómez-Revuelta 2020, pp. 217-229). Aripiprazole can be taken in the form of a tablet or powder form after disintegrating the tablet. There are some side effects of Aripiprazole that may require immediate medical attention, such as difficulty with speaking, muscle trembling, uncontrolled body movements, stiffness of limbs, and drooling. Besides, it is essential for a person under medication with Aripiprazole drugs to seek the doctor’s recommendations on the timelines to take medicine. Other side effects may not require immediate medical attention, and they include; blurred vision, anxiety, fear, fever, heartburn, indigestion, inability to sit still, nervousness, and running nose.

Besides, suicidal thoughts may occur in some patients’ especially young adults and teens, such as the case of the 27-year old female. Besides, older adults who suffer from dementia-related psychosis may be adversely affected by the drug and may acquire stroke and transient ischemia attacks. Also, an overdose of Aripiprazole can be harmful to the body as it will only weaken the body. An overdose of the drug increases the sensitivity of the eyes to the light and leads to irregular heartbeats. Patients need to adhere to the doctor’s prescription or seek medical advice to avoid such complications. Also, patients should keep in touch with their health providers to ensure information regarding safety precautions of the drug is updated.

Olanzapine is a second-generation antipsychotic drug that works through restoring the balance of certain natural substances of the brain. Olanzapine is used in the management of schizophrenia and other psychotic disorders such as bipolar. Olanzapine is taken by mouth with or without food, and its dosage depends on the medical condition of a patient. To get the maximum benefit from the drug, a patient should take the medication regularly. However, a patient should talk to a doctor about the risks and benefits of the drug before making a decision to be treated. Besides, a patient should read the precautions outlined by the manufacturers and apply them where necessary to avoid the complexity of the condition. There are acute side effects of Olanzapine that intersect with metabolic responses associated with obesity (Gómez-Revuelta 2020, pp. 217-229). To reduce the risk of getting side effects, doctors advise patients to start medication with a low dose before gradually increasing the dose.

The common side effects of Olanzapine include dizziness, drowsiness, increased appetite, stomach upset, lightheadedness, and constipation. Dizziness and lightheadedness can cause a person to fall. Doctors always prescribe the drug after assessing the risks of the side effects to the patient. Besides, many people who use this treatment have no severe side effects. The most adverse impact of Olanzapine is weight gain. People who have schizophrenia are obese with unknown pre-existing obesity-associated metabolic dysfunction arguments (Gómez-Revuelta 2020, pp. 217-229). Olanzapine induces high blood sugar levels in the body by increasing the blood glucose concentration levels. Other side effects of Olanzapine include; swelling of joints, swollen glands in the neck, muscle aching, voice changes, increased salivation, increased appetite, and stuffy nose.

Why Aripiprazole might be an alternative for the patient

The 27-year old patient was treated with Olanzapine in the early stages of diagnosis and still suffered from psychotic disorder symptoms such as suicidal thinking. Treatment of patients with Aripiprazole has fewer side effects than the treatment of patients with Olanzapine and first-generation antipsychotic drugs. When a patient uses the Aripiprazole treatment, it reduces weight gain under Olanzapine treatment. Besides, Aripiprazole is considered more effective on the negative symptoms of schizophrenia than on positive signs (Gómez-Revuelta 2020. pp. 217-229).

Also, Aripiprazole reduces anxiety among patients and enables them to have a stable, calm condition in the event of reacting to their psychotic conditions. Besides, Aripiprazole can be used in combination with other drugs to treat depression and anxiety disorders. Depression and anxiety orders are the main catalysts to suicidal thoughts. Aripiprazole has long-term effectiveness in treating schizophrenia and bipolar disorders compared to Olanzapine treatment. Hence, I strongly recommend Aripiprazole treatment as it has no relativity complications with the metabolic rates of people.

Compliance issues

Treatment of psychosis and handling of psychotic patients has been a significant challenge faced by various health providers. Compliance with the treatment of psychosis affects the level of psychotic disorders among people. Compliance refers to the extent to which a person’s behaviors coincide with health advice from the health providers (Gómez-Revuelta 2020, pp. 217-229). Research has shown that female patients and middle-aged patients are highly compliant with the treatment of psychosis. Non-compliance happens when patients don’t want to buy drugs or access any form of treatment regardless of their worse conditions. Non-compliance can be classified into secondary and primary levels. In secondary levels of non-compliance, patients don’t follow instructions as prescribed by the doctor, which usually leads to overdose or under-dose. As mentioned by health experts, there are various reasons for non-compliance: low-income family support, ignorance, poor insight, defective remission of symptoms, and side effects of medicines.

In most cases, people develop stigmatization due to their conditions and resort not to complying with the treatment procedures. Besides, when the conditions of patients improve, they see no need to continue with their medication. In some places such as India, non-compliance has been due to lack of knowledge, financial difficulties, and distance to hospitals. Some patients have a low priority regarding their health status; hence, they choose to be non-compliant. In the event of addressing the compliance issues, there needs to be a seminar in every locality to inform people about the various advantages of seeking medical attention. Besides, more qualified health personnel need to be deployed to ensure patients are guided into accepting their medical conditions. The motivation for accessing medical health should come from a person rather than other people. Also, people should change their attitudes concerning their situations and seek treatment as it goes a long way in affecting their well-being.


Containment of psychotic disorders is essential to address the global health insecurity experienced globally. Mental health is vital to ensuring a productive country as it affects how people behave and work in their different stations. People should not judge patients experiencing psychotic but instead encourage them that they would be okay. Family support and friends support is essential in ensuring patients with psychosis comply with their treatment. Health providers should prioritize improving good doctor-patient relationships. A good relationship between the doctor and the patient encourages the patients and helps them cope with their conditions. Management of associated physical symptoms of psychotic disorders involves a person’s priority to his/her health status.

Reference List

Gómez-Revuelta, M. et al. 2020. Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone. International Journal of Neuropsychopharmacology 23(4), pp. 217-229.

Lieberman, J.A. and First, M.B. 2018. Psychotic disorders. New England Journal of Medicine 379(3), pp. 270-280.

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