Numbers: ...he seems to think I'm psychotic (actually he seems very sure of it) and he says that I'm probably going to need medication because there's only so much he can do, and it's not even his exact field of psychology.

Hello Numbers,
It's my understanding that psychosis tends to be glaringly obvious but I suppose there are shades and nuances of degree. Meanwhile, if an individual is talking with a therapist they're usually talking about something that has occurred in the past however, there is also a present taking place as they sit on their chair in their therapist's office. A diagnosis of psychosis can only be made as based upon behavioral responses so do you know if it was your past behavior (what you were talking about) or your present behavior (what you were doing in that moment) that has nudged your therapist towards a diagnosis of psychosis?

Is it possible to get better without meds?

Yes. Although not always and in this culture where meds are considered a first line of defense in treatment, it can be downright impossible to find a doc who won't treat with meds if he/she suspects psychosis. There are various reasons for why that's so but for now, suffice to say that your psychologist is likely legally mandated to refer you to a psychiatrist and prescribing medication is, essentially, what psychiatrists do these days. Many people see both a psychiatrist and a psychologist although those decisions might be guided by your health insurance.

Overall, meds are a tool -- they are one of many tools. Some people identify them as exceptionally helpful, some people don't. Depending on what's happening for you, you might be able to talk (and work) the situation through with your psychologist but that's going to depend on the level of distress you might be experiencing and how well you are functioning, i.e. can you still tend to your studies and daily needs? It's also going to depend on your therapist's comfort levels.

Something I recommend you do now while you still have the chance, is to review any information as related to any mental health laws in your location. You can probably find such information through your favorite search engine. Your profile says you're 18 and in some areas, that's considered a legal adult -- in other jurisdictions, it's not. As an adult you're usually allowed to make your own treatment decisions (unless you have presented as a threat to yourself or another) but it's possible you live in an area where adulthood is not legally recognized until you're a year or two older. If that's the case, your parents or guardians would likely make treatment decisions on your behalf. Do they know how you feel about medication and treatment options? If not, now would be the time to let them know.

Anti-psychotic medication is frequently the norm if psychosis is suspected but anti-depressants, anti-anxiety agents, mood stabilizers and other medications may also be prescribed. Ideally, you (and possibly, your parents/guardians) would know the risks and benefits of those drugs beforehand so you can make your best, informed decisions.

To sum up, these are the things you should review...

- The rationale for the diagnosis of psychosis

- Whether or not you're considered a legal adult and therefore, permitted to make your own treatment decisions.

- If your health insurance will allow you to see both a psychologist and a psychiatrist if necessary.

- What forms of treatment your health insurance will pay for, e.g., they might pay for a psychiatrist but refuse to pay for a therapy such as CBT.

- Whether or not you possess the necessary information to help you (or your parents/guardians) make the best treatment decisions.

As a final consideration, if you are taking or experimenting with recreational drugs -- certainly not an unusual pastime among people in your age group -- it would probably be best to let your caregivers know you have done so and to set the practice aside. There does seem to be a strong link between cannabis and psychosis in particular, although I've known of other "street" drugs that can trigger psychotic states of consciousness.

~ Namaste