What Is Psychosis?

What Is Psychosis?

Psychosis is a loss of contact with reality, typically including delusions (false ideas about what is taking place or who you are) and hallucinations (seeing or hearing things that aren't there). It impacts the way that the brain processes information. When experiencing psychosis, people may hear, see, feel, or believe things that are not real.

Psychosis is a symptom associated with a number of health conditions including the manic phase of bipolar I disorder, as well as schizophrenia, post-traumatic stress disorder (PTSD), and schizoaffective disorder. Other conditions where psychosis may be present include postpartum psychosis and depressive episodes. About 7 in every 1000 people experience psychosis at some time in their lives.

Types

Some forms of psychosis are brought on by a specific condition, such as:

• Bipolar disorder, which may involve manic episodes that can lead to psychosis
• Brief psychotic disorder, which is a short and sudden onset of psychosis, often in response to a stressful situation, that usually lasts less than a month
• Delusional disorder, which is marked by an inability to distinguish between what is real and imagined
• Drug-induced psychosis, which may occur when a person is withdrawing from a drug such as alcohol or methamphetamine
• Postpartum psychosis, a severe form of postpartum depression that, while relatively rare, requires emergency medical intervention
• Schizoaffective disorder, which involves symptoms of a mood disorder and schizophrenia
• Schizophrenia, which is characterized by a range of psychotic symptoms
• Schizophreniform disorder, a short-term type of schizophrenia
• Severe depression can also cause people to experience symptoms of psychosis

Psychosis can also be induced by illness or medication or caused by a medical condition, such as a brain tumor, brain disease, or brain infection.

Symptoms

Psychosis in itself is a symptom of another problem, not its own illness. Symptoms of psychosis include:

• Delusions
• Disorganized, scattered thinking and speech
• Hallucinations
• Thoughts that jump around from subject to subject

If you think you or someone you love is experiencing psychosis, it's important to seek medical treatment immediately. The earlier you get treatment and intervention, the better. Experiencing psychotic symptoms can be scary to both you and the people around you and may even cause you to hurt yourself or others.  

Potential Precursors to a Psychotic Episode

Not everyone has warning signs that a psychotic episode is coming, but some people do. These signs and symptoms can occur over several months and may fluctuate in both severity and type. This period of changing thoughts, feelings, and behaviors before a psychotic episode is called the prodromal phase. Symptoms of prodrome can include:

• Mood changes: You may feel more irritable, angry, depressed, suspicious, anxious, or experience mood swings.
• Changes in your thinking: You may have more trouble concentrating than normal, feel like your thoughts are either faster or slower, have memory difficulties, or come up with strange ideas.
• Changes in your perception and physical needs: You may find yourself sleeping more erratically than normal or not sleeping as much, eating more or less than usual, having less energy, perceiving things in a different way than you normally do, or having physical ailments like headaches or stomachaches.
• Changes in how you view yourself and the world around you: You may feel off or different or as if the environment around you has changed.

Causes

The exact causes of psychosis are not entirely clear and each person's experience may be different. Physical problems that can cause psychosis include:

• Alcohol and certain illicit drugs, including methamphetamine
• Brain cysts or tumors
• Certain prescription drugs, particularly steroids and stimulants
• Certain types of epilepsy
• Dementia
• HIV
• Parkinson's disease
• Stroke

Psychosis can also be caused by a mental health condition such as schizophrenia, schizoaffective disorder, bipolar disorder, or depression. People are more likely to develop psychosis if they also have a close family member who has a psychotic disorder.

Diagnosis

Psychosis is a symptom of another health condition, not a diagnosis in and of itself. In order to determine what might be causing psychosis, a doctor will perform a physical and collect a medical history. They will also ask questions about the symptoms including its severity and duration. They will also want to know about any other symptoms that you might be experiencing.

In some cases, your doctor may perform special tests in order to rule out medical conditions that may be causing your psychosis. Once your doctor has diagnosed what is causing your symptoms, they can recommend treatments that are best suited to your particular situation.

Treatments

Treating psychosis depends on the cause. Hospitalization may be necessary. If you have a disorder that involves psychosis, starting, or changing antipsychotics may also be helpful in keeping psychotic symptoms and episodes at bay. 

Typical Antipsychotics

The older, first generation of antipsychotics are known as typical antipsychotics. They can be a very effective treatment but may have harsher side effects, such as tardive dyskinesia and extrapyramidal side effects. Common typical antipsychotics include:

• Haldol (haloperidol)
• Loxitane (loxapine)
• Navane (thiothixene)
• Prolixin (fluphenazine)
• Stelazine (trifluoperazine)
• Thorazine (chlorpromazine)
• Trilafon (perphenazine)

Atypical Antipsychotics

The newer, second-generation antipsychotics are called atypical antipsychotics and tend to have a lower risk for tardive dyskinesia and other movement disorders. Examples of common atypical antipsychotics include:

• Abilify (aripiprazole)
• Clozaril (clozapine)
• Fanapt (iloperidone)
• Geodon (ziprasidone)
• Invega (paliperidone)
• Latuda (lurasidone)
• Rexulti (brexipiprazole)
• Risperdal (risperidone)
• Saphris (asenapine maleate)
• Seroquel (quetiapine)
• Vraylar (cariprazine)
• Zyprexa (olanzapine)

Psychotherapy

Psychotherapy may be useful for dealing with cognitive symptoms of conditions such as schizophrenia and psychotic disorders. Psychotherapy can also be useful when people also have comorbid conditions such as anxiety or mood disorders.

Coping

If you are experiencing symptoms of psychosis, it is important to seek help immediately. There are also things that you can do along with treatment that may help you better cope:

• Find social support. Friends and family can help, but it can also be useful to others who have had the same experiences. Try looking for local support groups in your area or find an online group.
• Understand your triggers. Episodes of psychosis are often influenced by or worsened by specific triggers which can include low mood, lack of sleep, or stressful situations.
• Have a plan. You may not be able to communicate your needs when you are having a crisis, so enlist a loved one who can watch for signs and take the appropriate steps if you are experiencing psychosis.