Psychosis
WHAT IS PSYCHOSIS?
Psychosis is a treatable mental illness that can affect anyone. The key characteristic is a loss of contact with reality. When a person experiences psychosis, it means that he/she:
- Does not understand what is real and what is not real
- Has hallucinations and delusions (see definitions in the following section)
- Is confused and unable to think clearly
- Is unable to communicate properly with others
- Behaves in an odd or inappropriate way
Some disorders may include psychotic symptoms. These include the following:
- Depression
- Manic depression (bipolar disorder)
- Schizophrenia
- Alzheimer’s disease
- Multi-infarct dementia
- Alcohol-related dementia
- Drug and alcohol abuse
WHAT ARE THE SYMPTOMS OF PSYCHOSIS?
Confused Thoughts
The person’s thoughts are muddled and don’t fit together. He/she may have a hard time following a conversation and may become forgetful. Also, he/she may say things that don’t make sense.
Hallucination:
Sight, sound, smell, or touch that is not really there. For example, a person with auditory hallucinations hears voices when no one is talking. A person with kinesthetic (feeling) hallucinations may feel that insects are crawling on his/her body.
Emotional Changes
A person experiencing psychosis may feel alienated from others or cut off emotionally. He/she may feel like everything is moving slowly. Mood swings, from depressed to anxious to elated, are another characteristic.
Behavior Changes
The person acts differently from their normal way of behaving. He/she may respond to normal experiences in an odd or bizarre way and may become suddenly upset or laugh inappropriately. The person’s behavior may be in response to delusions or hallucinations.
Delusions
A person who is in a psychotic state may believe in things that are not true. He/she is completely certain that these beliefs are true. Examples include believing that he/she is being watched or plotted against or that he/she is terminally ill.
Hallucinations
A psychotic person may see, hear, feel, or taste something that is not really there. For example, he/she may see people or animals that are not present or hear voices that tell him/her to carry out certain instructions.
Delusion
Firmly holding a false belief. Delusional beliefs are usually odd or unusual and not ordinarily held by members of the person’s cultural group.
Delusions may be paranoid (believing that people are out to get you in some way), grandiose (having exaggerated ideas of your importance), or somatic (believing that you have a serious illness even though you are perfectly healthy).
Nihilistic delusions are beliefs that one’s body is decomposing or rotting inside.
Thought Disorders
These can include thought insertion, thought broadcasting, and ideas of reference.
Thought insertion.
Patients feel that their thoughts are not their own. They become convinced that someone else has inserted thoughts into their minds. These thoughts may be very demanding or controlling; in response to them, patients may behave in unusual ways. They become very confused and have a hard time organizing or controlling their thoughts.
Thought broadcasting.
Patients feel that their thoughts are being broadcast to others. It is confusing to hold a conversation with these patients because they believe that they only have to think their part of the conversation. It is also quite upsetting for the patient to think that others can hear all of his/her thoughts.
Ideas of reference.
Patients feel that events and conversations having nothing to do with them have some kind of significance to them.
WHAT ARE THE STAGES OF PSYCHOSIS?
Most episodes of psychosis have the following three phases, the length of each varying with each person:
Prodrome.
In the early stage of psychosis, there are slight changes in the way the person behaves and thinks. The person may become depressed, anxious, irritable, or more suspicious than usual. He/she may notice appetite changes, disturbed sleep, or mood swings. Things may just feel different, as if the world around him/her has changed in some way. As the person’s behavior changes, the people around him/her are often the first to realize that something is wrong. The person may withdraw from others, and his/her work or studies may suffer.
Acute.
The symptoms are pronounced and obvious. The person may experience confused thinking, hallucinations, and delusions.
Recovery.
The person’s symptoms disappear, and the person returns to normal.
WHAT CAUSES PSYCHOSIS?
When a person experiences psychosis, there are many possible causes. The psychotic symptoms may be part of another condition, such as depression, bipolar disorder, schizophrenia, and Alzheimer’s disease. The symptoms may also be caused by drug or alcohol use, major stress, or an organic (physical) cause such as a head injury or tumor.
WHAT IS THE TREATMENT?
Psychosis is a treatable illness, and most people recover from it. The course of recovery varies from person to person and is based on each person’s specific diagnosis. Many people who experience one episode of psychosis recover and never experience another.
It is critical to recognize psychotic symptoms as early as possible and to obtain proper treatment immediately. After being assessed by a qualified medical professional, a person with psychotic symptoms may be treated with a combination of hospitalization, medication, counseling, and group support.
WHERE CAN I GO FOR MORE INFORMATION?
National Institutes of Mental Health (nimh.gov).
National Mental Health Association (nmha.org).
Torrey, E. Fuller. Surviving Schizophrenia: A Manual for Families, Consumers, and Providers. New York: Quill, 2001.
Woolis, Rebecca, and Hatfield, Agnes. When Someone You Love Has a Mental Illness: A Handbook for Family, Friends, and Caregivers. New York: Jeremy Tarcher, 1992.