Psychosis and depression – I’ve got both – What treatments help?

ACT Helps Depression following increased psychosis

A 2015 study “Acceptance and Commitment Therapy for depression following psychosis” explored the effectiveness of ACT as a intervention for people experiencing clinically significant depression following a psychotic episode. In the study, participants were randomly assigned to either an 10-session ACT intervention tailored for psychosis or given Treatment-As-Usual.  In the study participants who received ACT for psychosis intervention, compared to those who received Treatment-As-Usual, were 15 times more likely to achieve clinically significant decreases in depression scores.

To be included, patients required a diagnosis of a:

  • psychotic disorder (i.e.,schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, brief psychotic disorder,
    psychotic disorder NOS), or
  • bipolar disorder with psychotic features, or
  • depressive disorder with psychotic symptoms.

The participants in the study were:

  • no longer acutely unwell – few had clinically significant levels of:-
    • “Positive Symptoms” – problematic thoughts (delusions) or hallucinations or
    • “Negative Symptoms” –  severe reduction in emotional expressiveness (blunted affect) or emotional withdrawal and
  • clinically significant levels of depression.

What was the ACT for Psychosis Intervention?

The ACT for psychosis intervention incorporated the following themes:

  1. distinguishing between different types of experience: internal experience vs. 5-sense experience;
  2. recognising how we get caught up struggling to move away from suffering;
  3. moving towards our values;
  4. getting distance between us and our ‘life stories’;
  5. exploring how trying to control difficult mental experiences can be part of the problem rather than the solution;
  6. noticing that we can notice: focusing on the context in which mental experiences occur rather on the content of these experiences; and
  7. exploring worry thoughts associated with psychosis

This study builds on other studies that explores:

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