Reviewed by Whitney White, MS CMHC, NCC., LPC
Psychosis is an indication of severe mental disorders, distinguished by an altered perception of reality. It is essentially a broad term for a mental health issue that stems from challenges with information processing. Simply put, the challenges make it hard for the person to distinguish reality from fiction. Psychosis is not a mental disorder on its own but a symptom that comes from other mental health conditions.
Someone experiencing psychosis may experience hallucinations or delusions. Hallucinations are sensory feelings that happen without an actual trigger – seeing, hearing, or feeling things that are not there. This may include hearing voices that are not there – someone experiencing auditory hallucinations may hear their mum yelling at them when she is not there. Someone having a visual hallucination may see someone or something in front of them, which is not physically there.
Someone experiencing psychosis may also have beliefs or thoughts that are different from reality or actual evidence – this is a delusion. Delusion is erroneous beliefs about yourself, others, or reality. For instance, psychosis can lead someone to believe they can read other people's minds or are in a different universe or outer space. They may also experience social withdrawal and lack of motivation.
Mental illnesses are generally debilitating, but psychosis can be disturbing for those affected and the people around them. The experiences can be scary and may cause someone experiencing psychosis to harm themselves or, in rare cases, hurt others. It is crucial to see a doctor or mental health professional if you or someone close is experiencing indications of psychosis. Continue reading to learn more about the symptoms, causes, diagnosis, and treatment options.
The Effects of Psychosis
Psychosis disrupts a person's thoughts and perceptions. Their senses may appear to notice nonexistent things, and they may find it hard to identify what is true or real. Someone with psychosis may see things or people not there, hear voices in their head, and smell odors that other people cannot perceive. They may also think they are in trouble, that someone is following or chasing them, or suffer from grandiosity. The person may not know that they have psychosis because the delusions feel surreal. Psychosis, one of the major symptoms of schizophrenia, can be devastating and confusing.
Understanding Psychotic Episodes
An episode of psychosis is a period when someone deals with one or more symptoms of psychosis. Psychotic episodes can persist for days or weeks, with the intensity changing with time. Someone can be thoughtful and balanced before and after a psychotic episode, but while the episode lasts, they cannot differentiate between reality and fiction.
During a psychotic episode, the person cannot comprehend why others cannot follow their line of reasoning or thought patterns. It is usually hard to persuade them that what they think, believe, or see is incorrect. Psychosis makes it hard for people to comprehend their thoughts or explain them to other people.
Sometimes, the episode will cause grandiosity – feelings of unrealistic superiority or eccentric beliefs about their self-worth. For instance, someone experiencing a psychotic episode may accept that a new, invincible conspiracy targets them or that they are a celebrity and popular with people. They may think they have some made-up power or authority, like thinking they are the president of a country or possess the ability to raise the dead. These delusions could cause them to behave irrationally or dangerously.
The Common Symptoms of Psychosis
Someone experiencing psychosis will have a specific set of symptoms and experiences, depending on their circumstances. However, there are four major symptoms linked to psychotic episodes. They include hallucinations, delusions, lack of insight and self-awareness, and disturbing thoughts. The symptoms can be mental or physical behaviors. Most people only deal with a few of the symptoms – the only common aspect of the symptoms is that they result from a problem with how the brain observes and processes information.
This is when someone detects something unreal. It can show in all the five senses, including:
- Sight –the person, may see people, animals, color, or shapes that are not present
- Sounds – hearing unpleasant, angry, or sarcastic voices
- Touch – thinking someone is touching you when no one is there
- Small – a strange or unpleasant odor that is not perceived by others
- Taste – complaining of a persistent unpleasant taste in the mouth
This is when someone has an unwavering belief in something unbelievable, bizarre, or wrong. Paranoid delusions or delusions of grandeur are two instances of psychotic delusions. When someone with psychosis believes that someone or an organization is planning to harm or kill them, they can start behaving unusually. For instance, someone in psychosis may decline to be around mobile phones because they believe the devices can control minds.
Confused or disturbing thoughts
People with psychosis typically have confused, irregular, and disturbing thought patterns. Indications of this include:
- Quick and constant speech
- Random talks – for instance, they may change topics in the middle of a sentence
- An abrupt loss of a train of thought, causing a sudden pause in activity or conversation
Lack of Insight
People who experience psychotic episodes are usually completely unconscious of the strange behavior or false hallucinations or delusions. They may notice strange or delusional behavior in others but lack the consciousness to identify it in themselves. For instance, someone with psychosis undergoing treatment in a psychiatric ward may whine about other patients' mental conditions while believing they are perfectly okay.
Postnatal psychosis, also known as puerperal psychosis, is a complicated form of postnatal depression, a kind of depression some women notice after childbirth. The estimate is that postnatal psychosis affects one in 1000 women who experience childbirth. It usually occurs within the first few weeks after delivery. This condition is more likely to affect women with a preexisting mental health disorder like schizophrenia or bipolar disorder.
Together with the symptoms of psychosis, postnatal psychosis may also cause mania (high mood) or depressive symptoms (low mood). Postnatal psychosis is considered a medical emergency and should be treated immediately.
Catatonia – unresponsiveness
Strange psychomotor behavior – indeliberate movements such as tapping, fidgeting, and pacing
Depending on the cause of psychosis, psychosis may occur slowly or suddenly. The symptoms may be mild or severe. In some situations, it can start as mild and get more intense gradually. The person may also notice mood swings, problems with concentration, and sleeping difficulties. Some of the mild, early warning signs of psychosis include:
- Social isolation
- Difficulty taking initiative
- Low tolerance to stress
- Mild to moderate disruptions in energy levels, language, and thoughts
- Feeling suspicious
- Neglecting self-care
- Ideas and thoughts that are odd to others
Causes of Psychosis
Psychosis can stem from different origins – categorized under mental (psychological) disorders, substances (such as drugs and alcohol), and general medical conditions. The precise cause of psychosis is still unknown, although research is ongoing as humans continue to gain more information about how the brain works.
Mental health disorders that usually lead to psychosis are classified as psychotic disorders. Psychosis can be short- or long-term, depending on the underlying condition. Most psychotic episodes are the result of disorders like schizophrenia or bipolar disorder. Other psychological causes include major depressive disorder, severe stress or anxiety, lack of sleep.
Psychosis can also be caused by drug abuse, trauma, or physical conditions like brain tumors or head injuries. Medications, hormone imbalances, and genetics all play a crucial role in whether someone develops a psychotic disorder or not. Certain health conditions, like Parkinson's disease, can also cause psychotic episodes.
The regularity and the duration of a psychotic episode may depend on the underlying cause. For instance, schizophrenia can be long-term, but most people recover fully, and a few have only one psychotic episode. Episodes caused by bipolar disorder may eventually stop but may reappear.
Teenagers and young adults are more prone to developing symptoms of psychosis, with most people noticing the symptoms between ages 15 to 30. Early psychosis is when someone first exhibits psychotic symptoms. It can sometimes be confusing, distressing, and scary for the person and the people around them.
If you are experiencing symptoms of psychosis, you should visit a medical professional as soon as possible. Prompt intervention is crucial as it helps to ensure better long-term outcomes. The doctor will review the symptoms and eliminate short-term causes such as substance abuse. You may need to answer questions to identify the cause of psychosis. For instance, the doctor will want to know about:
- Use of medications
- Use of illegal substances
- Your mood – maybe you have been depressed
- Day-to-day functions
- A family history of mental health issues, such as schizophrenia
- Your delusions: maybe you feel under someone's control
- Your hallucinations; maybe you have heard voices
- Presence of other symptoms
You may get a referral to a mental health specialist for additional assessment and treatment
Treatment for Psychosis
Treatment often includes a combination of the following:
- Psychological therapies – individual psychotherapy in cognitive-behavioral therapy (CBT) has been effective for helping people with schizophrenia. Sometimes, family therapy has been proven to lower the need for clinical intervention for people with psychosis.
- Antipsychotic medication – to relieve the symptoms of psychotic episodes
- Social support – provision of adequate support with social needs such as employment, education, or accommodation.
Most people with psychosis who notice improvements with medication need to keep using it for another year. Some people need to use meds over the long-term to stop the recurrence of symptoms. If the symptoms of psychosis are severe, the person may require admission into a psychiatric hospital.
Helping Someone with Psychosis
The only assistance you can give someone with psychosis is to ensure they get medical attention. Psychosis is a sign of a broader health issue and requires proper diagnosis and treatment. In a case where someone you know might be endangering themselves or others due to their psychotic episodes, emergency intervention may be necessary to de-escalate the situation and provide needed help.
Often, people with psychosis may resort to alcohol or drugs, trying to get relief from the signs of an untreated mental illness. When searching for treatment for someone battling both psychotic symptoms and substance abuse, it is imperative to get a rehabilitation program designed to assist people with dual-diagnosis disorders.
People with psychosis often lack insight, unaware of their strange thought or behavior. They usually need help from people close to them to get the required treatment. It is necessary to note the first signs of psychosis and help those dealing with psychotic symptoms to get practical help. The earlier treatment begins, the higher the chances of better life quality in the long-term.
If you are worried about someone close and think they may be dealing with psychosis, you can contact their doctor to know if they have had a previous diagnosis of a mental health condition. If the affected person refuses to get help and appears to present a risk to themselves or others, their nearest relative can ask for a psychological assessment.
Those who have a history of psychosis are more susceptible to drug or alcohol misuse issues, or both. This may be due to the short-term relief that the substances give, although they only worsen the symptoms in the long run. Side effects may also occur if someone is using antipsychotics over the long-term. Weight gain is a common side effect. In rare situations, someone with psychosis may develop type II diabetes.
Getting medical intervention or treatment for yourself or someone dealing with signs of psychosis or other mental health disorders can appear challenging. No medical complications are associated with psychosis, but people experiencing psychotic episodes may find it hard to take proper care of themselves without treatment. With appropriate treatment, most people with psychosis can recover. In severe cases, medication and therapy are effective. Complete an assessment test for psychosis here.