Breakthrough Symptoms: What They Are

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By Max Guttman

People can be on the best medication targeting a mental health disorder, and still experience disruptive symptoms. Breakthrough symptoms can be voices, delusions, paranoia or depressive features. They often go unchallenged by medication, and can persist. This can happen chronically, or when triggered by something external.

The phenomenon usually occurs when a condition went untreated for a long time before medication or psychotherapy. It can also occur if a person is extremely traumatized and adjusting to new circumstances around living with their diagnosis, e.g. work, living space, interpersonal conflict.

Your World View

When these symptoms manifest, it can be a devastating blow to morale and hope of recovery. Imagine doing everything at your disposal to heal, but continuing to experience intrusive and paralyzing symptoms.

As a provider, these are the toughest features to deal with. Teaching and selecting coping skills can help offset the wake of the symptoms in a person’s life.

Jarred Into a Crisis

Breakthrough symptoms can start as early as prior to your discharge from hospital, from the first onset of your disorder to months and years down the line. They can also start when a new trauma or negative element comes into your worldview.

Many teach radical acceptance, especially when things don’t look like they will improve over time. Teach the person to deal with what is and what will always be, and they will make it through the darkest hours of their healing unscathed. In my opinion, this is a gamble and not a very good one.

The odds of tolerating breakthrough symptoms at every interval and active occurrence are fair. Even so, when the symptoms manifest as new expressions of the illness, a person can easily reach crisis.

Avoid Being Deregulated

I suggest a different approach to managing breakthrough symptoms. My approach is a combination of trigger identification, knowing your reactivity to events or stimuli, and eliminating potential life stressors whenever possible.

In this way, one avoids entering a vulnerable space where these symptoms will be the most paralyzing. This means sometimes making some radical course corrections in life, but when you are dealing with potential breakthrough symptoms you should do everything in your power to avoid becoming deregulated and at risk of further imbalance.

Breakthrough Symptoms are Treatable

Staying positive is critical when approaching these symptoms. With the right attitude, and by creating the right space, you can reduce their harm in your life. Most importantly, treat the symptoms like any others.

There are no super-symptoms in mental health like there are super-bugs associated with colds and flu. Treat the breakthrough symptoms just like any other acute or chronic problem. Therefore, adjust the treatment fit if you continue not to experience relief.

Research suggests breakthrough symptoms are just as treatable as symptoms that have already been knocked out and eliminated by medication and psychotherapy.

It Won’t Persist Forever

The symptoms will not persist forever. Over time, the frequency and intensity of breakthrough symptoms should be less chronic and severe, especially as you begin to manage your recovery and experience healing from the trauma of breakthrough symptoms.

Remember to be even more vigilant in staying focused in your recovery. Aspects of your symptoms will make you vulnerable, and focusing on recovery will go a lot further than fearing their chronicity and ongoing future occurrences.

Some of us are a little more susceptible to setbacks when dealing with breakthrough symptoms. These setbacks can be waiting just around the corner so don’t tempt fate and continue walking the path of healing and recovery at all times.

Originally published here and reproduced with permission mentalhealthaffairs.org