Psychosis is a psychiatric condition in which a person loses touch with his or her sense of reality. People with psychosis may experience hallucinations, delusions, or disorganized thinking; they may hear voices no one else can hear or perceive threats that do not actually exist. Additionally, their thoughts, feelings, and behaviors may be extremely inappropriate and disconnected from the world around them, without the individual being aware of this disconnection. Psychosis is also often associated with a number of mental health disorders such as schizophrenia, Alzheimer’s disease, or substance abuse. While psychosis may only last a few days or weeks, in some instances it can be a chronic condition. The presence of psychosis is the sign of a serious illness and anyone displaying symptoms of psychosis should be evaluated immediately in order to receive appropriate medical treatment.
What are the Characteristics of Psychosis?
The essential features of a psychotic episode, often called a called a psychotic break, include hallucinations, delusions, thought disorders, and movement disorders. Individuals experiencing psychosis may display one or more of these symptoms, which are described in more detail below:
Hallucinations: Sensory perceptions that occur without an outside stimulus, causing an individual to hear voices or see things that are not really there. However, for the individual who is experiencing them, they are very real.
Delusions: Beliefs that are not true and have no basis in reality. For example, an individual may think that someone is trying to harm them or that the government is reading his or her thoughts. The existence of delusions indicates that there is an abnormality in the affected person’s thought content. One key feature of a delusion is the degree to which an individual is convinced that the belief is true; a person with a delusion will continue to hold onto that idea regardless of evidence to the contrary. Delusions exist in four primary forms:
- Bizarre delusions: are highly irregular and completely implausible. An example of a bizarre delusion is that one’s brain has been removed by aliens.
- Non-bizarre delusions: are delusions that are defiantly incorrect beliefs, but are at least possible. For example, believing that the government is constantly watching over you.
- Mood-congruent delusions: are delusions where the content is consistent with either a person’s depressed or manic state. A depressed individual may believe that the world will end tomorrow, while a person in a manic state believes they are some form of deity.
- Mood-neutral delusions: delusions where the content is not in line with a person’s depressive or manic state, or is completely mood-neutral. These can take the form of a psychotic person believing that something has been implanted in his or her mind.
Disorganized or catatonic behavior: Disorganized behavior is behavior that is unpredictable and completely inappropriate to the situation or surrounding environment. These abnormal, disorganized behaviors can cause major challenges in the completion of normal activities of daily living. These behaviors may also involve cyclical motions, staring, grimacing, refusal to think, or echoing things that other people say. On the other end of the spectrum, those who are catatonic have either a complete lack of, or inappropriate excess of, motor activity. This means that they may be unable to move at all, or are in a constant state of motion.
Disorganized thoughts: Disorganized thinking consists of disturbed and confused thoughts that an individual with psychosis may experience. Thinking may speed up or slow down and the mind may become full of different emotions or random ideas. This jumbled way of thinking can become apparent in the way and individual speaks; they may talk very quickly without stopping, they may not listen, or they could even stop talking in the middle of a sentence. Due to this mixed up way of thinking, it may be very difficult or even impossible to understand what the person is trying to communicate.
Causes and Risk Factors for Psychosis
Psychosis can be caused by a number of different biological and social factors, all of which depend upon the specific disorder and underlying symptom. The most commonly cited causes and risk factors for psychosis are as follows:
Genetic: There appears to be a link between the development of psychosis and a familial history of the disorder. It seems that being susceptible to psychosis may actually be an inheritable trait. Additionally, multiple genes are involved in the development of certain mental health disorders, such as schizophrenia, which have psychotic features. This means individuals who have relatives who have been diagnosed with disorders that have psychotic features are more likely to experience psychosis themselves.
Physical: Another cause for psychosis is the presence of an organic medical condition such as neurological conditions, metabolic imbalances, endocrine disorders, renal disease, electrolyte imbalance, and autoimmune disorders. All of these have the ability to trigger psychotic episodes.
Environmental: Experiencing trauma and stress can cause short-term psychosis, which is known as brief psychotic disorder. This type of psychosis can be brought on by the stress associated with major life-changing events, such as the death of a loved one or experiencing a natural disaster.
- Substance abuse and addiction
- Exposure to toxic substances like carbon monoxide
- Diagnosed with certain mental health disorders
- Women who have recently given birth
- History of mood disorders
- Trouble functioning socially
- More ethnically isolated
- Have poor support groups
- Endured more negative life events
- Non-adequate housing
Disorders Associated with Psychotic Symptoms
Bipolar disorder: This disorder is characterized by mood disturbances with extreme manic behavior being followed by deep depression. Bipolar disorder is often accompanied by auditory and visual hallucinations.
Alcohol and drugs: The abuse of or withdrawal from alcohol or drugs may initiate intense hallucinations and confusion. The symptoms of psychosis often emerge rapidly and tend to dissipate once the intoxicating effects of the drugs or alcohol have worn off.
Some forms of dementia: As certain forms of dementia progress, individuals may experience signs of psychosis, which can greatly affect their behavior. These individuals may have visual hallucinations and may develop a number of different delusions.
Physical illness: There are a number of physical illnesses that can trigger psychosis, notably those that interfere with the normal structure and functioning of the brain. These may include HIV/AIDS, encephalitis, brain tumors, metabolic problems, and nutritional deficiencies.
Schizophrenic disorder: This disorder is a type of psychosis that is characterized by persistent psychotic symptoms that are usually accompanied by a decline in an individual’s ability to function within society.
Post-partum psychosis: It is believed that this type of psychosis is triggered by childbirth and usually sets in within the first month after delivery.
Wernicke-Korsakoff’s Syndrome: A neurological disorder that is often caused by alcohol abuse and is responsible for memory loss, creating false memories, hallucinations, and the inability to form new memories.
Signs and Symptoms of Psychosis
The signs and symptoms of a psychotic disorder will vary depending upon the cause of the psychosis and individual factors. Delusions, hallucinations, paranoia, and a general decline in the ability to make decisions are all indications that someone is going through a psychotic illness. Additional signs and symptoms may include:
- Uncontrollable anger
- Thoughts of suicide
- Self-harming behaviors
- Shakes or tremors
- Confused thoughts
- Disorganized speech and behavior
- Being overly emotional or not showing any emotion whatsoever
- Bizarre behaviors
- Loss of interest in normally-enjoyed activities
- Social withdrawal
- Neglect of personal hygiene
How is Psychosis Treated?
For those who are actively psychotic an inpatient treatment center is usually one of the most effective options because it can provide around-the-clock supervision while also meeting any medication needs. Through an inpatient program, highly qualified physicians and mental health care professionals will be able to assess an individual’s specific needs, determine the cause of the psychosis, and develop a treatment plan that will help with the recovery process.
One of the main forms of treatment for those facing psychotic disorders is antipsychotic medications that will not only reduce symptoms, but will also help reduce the risk of future psychotic episodes. These medications will not cure the illness, but they will allow individuals to be able to function on a daily basis and have a better overall quality of life. In addition to medication, psychotherapy can be helpful at reducing stress and helping individuals work through any emotions surrounding their mental health disorder. A proper therapeutic support network involving a multidisciplinary team of professionals and family members can be essential to the continued health and well-being of people who have suffered a psychotic break. A compassionate care team can help the patient learn the skills he or she needs to recover, while also educating loved ones about the underlying illnesses and helping them to cope with their own feelings and concerns.