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I. Introduction Psychosis is a serious but treatable medical condition that reflects a disturbance in brain functioning.

A person with psychosis experiences some loss of contact with reality, characterized by changes in their way of thinking, believing, perceiving and/or behaving. For the person experiencing psychosis, the condition can be very disorienting and distressing. Without effective treatment, psychosis can overwhelm the lives of individuals and families. Psychosis is a medical condition that affects the brain. It can be treated. A person with psychosis may:

experience confused thoughts feel their thoughts have sped up or slowed down feel preoccupied with unusual ideas believe that others can manipulate their thoughts; or that they can manipulate the thoughts of others perceive voices or visions that no one else can hear or see feel 'changed' in some way act differently than they usually would

Sometimes psychosis emerges gradually over time, so that in the early stages symptoms might be dismissed or ignored. Other times, symptoms appear suddenly and are very obvious to the individual and those around them. Symptoms vary from person to person and can change over time. The initial experience of psychotic symptoms is known as the 'first episode' of psychosis. It is important to pay attention to possible symptoms and seek help early. Psychosis can happen to anyone. Symptoms of psychosis most often begin between 16 and 30 years of age. Both males and females can be affected. Males tend to experience symptoms a few years earlier than females. Persons with a family history of serious mental illness are at increased risk of developing psychosis. When psychosis occurs for the first time it is difficult to know the cause. Psychosis is associated with a number of medical conditions including schizophrenia, depression, bipolar (manic-depressive) disorder and substance abuse, among others. Because the first episode of psychosis can signal a variety of conditions, it is important to seek a thorough medical assessment.

Low doses of anti-psychotic medications are a key component of treatment, along with education and support for the individual and their family. Treatment strategies are aimed at allowing the individual to maintain their daily routines as much as possible. There have been tremendous advances in the treatment of psychosis during recent years, reducing the need for hospital stays and promoting faster, fuller recovery. Typically, psychosis does not disappear on its own. Instead, if left untreated, the condition can worsen and severely disrupt the lives of individuals and families. If you, or someone close to you, is experiencing symptoms of psychosis: Don't wait. Look for help. Many persons with psychosis wait a long time before seeking treatment. But recovery is more difficult when effective treatment is delayed. Talk to your family doctor. They can refer you to a specialist for a full assessment. At present, early psychosis intervention is the focus of much interest in the mental health community. Many medical and mental health professionals are themselves learning about the best approaches to treatment. Some cities in Canada already have centres designed specifically for the treatment of early psychosis. Ask questions. Be persistent. It is important to consult with a medical professional who is familiar with early psychosis. Educate yourself. Get the facts. There is a great deal of information available about early psychosis and recent developments in treatment. Psychosis is a common medical condition affecting 3% of the population results from a disruption in brain functioning can radically alter a person's thoughts, beliefs, perceptions and behaviour affects males and females equally tends to emerge during adolescence and young adulthood is more likely to occur in families with a history of serious mental illness can be effectively treated If you suspect psychosis, don't ignore it. Treatment is most effective when it is started early. With proper treatment, most people recover fully from the first episode of psychosis. For many, the first episode is also the last.

Psychosis can happen to anyone. Early detection and effective treatment can promote full recovery.

II. Personal Data Name : N.C Birth date : April 17, 1984 Age : 27 y.o Gender : male Type of birth : Normal Spontaneous Vaginal Delivery Order of Birth: fourth eldest child of six children Address : Paliwas Obando, Bulacan Nationality : Filipino Religion : Roman Catholic Civil status : Single Occupation : Caretaker III. Developmental / Family History N.C is the fourth eldest child of six children. During his early life at the age of 3 yrs. old his parents were a busy one to earn money in able to race their family. The work of his mother was an OFW in Hong Kong while his father was a security guard in an establishment. The children were supervised by the grandmother whenever the parents are not available. At the age of 15 her mother went back to Philippines and decided not to work abroad again and his mother was built a Sari-Sari store to have an extra income. At the age of 20, his father became jobless. As he grows older, he described his childhood as difficult because his life was controlled by his mother's demands. His mother also relied on him for emotional support, effectively replacing him for his alcoholic father. While he was living at home, his mother was repeatedly treated for depression and anxiety. During these early years, he also suffered from extreme anxiety, which required medication to help him to function. His anxiety and the lack of encouragement by his parents to relate to individuals his own age, including his siblings, complicated his ability to make friends with peers and resulted to a deep sense of loneliness during his childhood and adolescence. It was at this time that N.C also found himself too much worrying about some

common tasks, like, he would return home to make sure that he had locked the front door. IV. Educational History N.C finished his primary education, secondary education and graduated the course of computer science in college. In high school and college, his intellectual gifts provided him with some foundation for a social network, especially through academic clubs. N.C continued to experience anxiety and depression in college, in part related to the confusion he felt about his future. During college, he also began thinking about his career. Although he acknowledged feeling of doubtful about his career, he decided to work directly after college even it was hard to look for a job.

V. Socio-psychological History During the time he feel the anxiety, his anxiety and the lack of encouragement by his parents to relate to individuals his own age, including his siblings, complicated his ability to make friends with peers and resulted to a deep sense of loneliness during his childhood and adolescence. It was at this time that N.C also found himself too much worrying about some common tasks. As a result of these early experiences, he avoided contact with his peers, did not date, and coped by developing his intellectual gifts and by engaging in fantasy. N.C found a job after he graduated. While in the work, he was moderately successful and at times even enjoyed his work experience. During his first assignment, he experienced significant conflict with others, some of which was related to his too much worrying and he always emphasizing the things (doors/windows) to be checked and rechecked. Excessive hand washing, another sign of his continuous anxiety, also began at this time. VI. Problem Presented Because of his recurring depression, and his increasing inability to function in his work, N.C sought help and came for an evaluation. His supervisor in the work was concerned not only about his depression but also about recent reports of increasing anxiety and some unusual behaviors. In the past few months, N.C often isolates himself in his room in the boarding house he rented near in his work, rarely come out except for the few important meetings that were scheduled for him. Co-workers reported that he was not showering regularly and that his clothes were often untidy and dirty.

*******Although he was often silent during the clinical interviews, Fr. Smith gradually revealed that he believed he was being followed by parishioners who were angry with him and that he frequently heard threatening messages about himself coming from the radio during the assessment and later in treatment, these paranoid symptoms persisted. Not only was Fr. Smith suspicious of others within the treatment community, he was also suspicious of the clinical staff. Treatment of Psychosis As a result of the assessment, it became clear that Fr. Smith was dealing with much more than depression; namely, he was experiencing psychosis. Efforts to assist Fr. Smith were two-fold: first, stabilize him on an appropriate antipsychotic medication, and then attempt to talk with him about his perceptions in the context of his emotional world. Working collaboratively with the consulting psychiatrist, Fr. Smith was prescribed an antipsychotic that helped him to distance from his suspicious and paranoid thoughts, while also easing some of his emotional distress. The medication allowed him to be more receptive and more comfortable in some individual and group psychotherapy settings. With some "wiggle room" between Fr. Smith's thoughts and his conviction about the reality of those thoughts, he was able to begin to question his distorted thinking and understand some of the emotional underpinnings of his perceptions. Through therapy, he also realized that there was a history of psychiatric disorders in his family. This realization helped him to understand the genetic and biological nature of his illness, which lessened the shame he felt about his diagnosis. In the course of working with Father Smith in therapy, clinicians learned that it was counter productive to confront his paranoid thoughts directly, since this approach usually led to non-

cooperation. Rather, the clinical team attempted to connect with him and understand what he might be feeling within his view of the world. This approach allowed him to talk more directly about his anxiety, fear, sadness, and alienation from others, a common experience of the severely mentally ill. As Fr. Smith began to feel safer within the therapeutic context, he also became more receptive to benign explanations of others' behaviors toward him. By the end of treatment, he was able to acknowledge the possibility that at least some of his perceptions might be erroneous. In addition, he was able to distance himself enough from his paranoid thinking, that he experienced a greater degree of choice about whether to focus on the suspicious behavior of others. With the help of a continuing care therapist, Fr. Smith arranged a network of support, including ongoing psychotherapy, in order to assist him in his long-term recovery after leaving residential treatment. His support network was helped to understand his illness, particularly his need to prevent the most common cause of relapse, a failure to take his medication.