What Is Psychosis?

Psychosis is a symptom of a mental health disorder, or an underlying medical or neurological issue. Psychosis is often used as criteria to rule out and determine a specific mental health disorder. The fundamental component of psychosis is a loss of connection with reality that is often demonstrated through perceptual distortions, such as visual or auditory hallucinations (seeing or hearing things that aren’t there), and delusions (a belief or perception that isn’t grounded in reality).

Onset of psychosis can begin in late teen years through mid-twenties. There are about 100,000 new cases of psychosis a year in the United States. People who are affected by psychosis may also exhibit behaviors that can be harmful to themselves and others. Psychosis can feel frightening, and left untreated, can be debilitating over time. It is important to reach out to a medical or mental health professional if psychosis is experienced.

What Are the Symptoms of Psychosis?

The following signs and symptoms are characteristic of psychosis:

• Hallucinations
• Delusions
• Confused speech or trouble communicating
• Significantly disorganized or catatonic behaviors
• Suspiciousness, paranoid ideas, or uneasiness with others
• Sudden drop in grades or job performance
• New and uncharacteristic difficulties in thinking clearly or concentrating
• Withdrawing from family and friends, spending much more time alone than normal
• Unusual, overly intense new ideas, heightened feelings, or no feelings at all
• Decline in self-care or personal hygiene
• Difficulty distinguishing fantasy from reality
• Depressed mood
• Anxiety or anxious distress
• Sleeping problems
• Suicidal thoughts or actions

Hallucinations are distortions in a perception of reality that create a sensory experience in the absence of any external stimuli. They can be auditory or visual, meaning a person can see or hear something that is not really there.

Delusions are distortions in a perception of reality. They are a firmly held false belief or impression that reality contradicts. Delusions indicate a disconnect from reality. There are several types of delusions, which include: erotomanic, grandiose, jealous, persecutory, and somatic.

• Grandiose type: An inflated sense of self-importance, or the belief of having some great (but unrecognized) talent, insight or discovery
• Persecutory/paranoid: Belief that one is being conspired against, followed, spied on, cheated on, poisoned or drugged, etc.
• Somatic: Involves bodily functions or sensations, and sometimes a belief that one is dying of a terminal illness when good health is evident

What Are the Causes of Psychosis?

Psychosis can be caused by psychological (mental), physiological/biological (medical), or substance related (medications, drugs, alcohol) issues. Psychosis can often be triggered by mental health disorders or underlying medical issues. The following conditions can sometimes trigger the onset of a psychotic episode:

• Schizophrenia: A mental health condition that can exhibit delusions, hallucinations, disorganized speech and difficulties communicating, disorganized or catatonic behavior, and diminished emotional expression
• Bipolar Disorder: A mental disorder characterized by periods of depression and periods of elevated mood (manic or hypomanic) that can last from 4 days to a week or more
• Post Traumatic Stress Disorder, Acute Stress Disorder, or severe anxiety
• Major Depressive Disorder or severe depression (this can include peripartum or postpartum onset, which means during or right after pregnancy)
• Insomnia or a consistent lack of sleep

There are also certain medical and substance misuse issues that can cause psychosis. These issues include, but are not limited to, the following:

• Brain tumor
• Substance misuse (certain drugs or excessive consumption of alcohol)
• Side effects of certain medications (rare)

How Is Psychosis Diagnosed?

Because Psychosis is a diagnosis of exclusion (determined by ruling out other mental disorders and underlying health conditions), several clinical examinations, assessments, labs, and tests will be administered by medical and mental health professionals.

These tests and questions include the following:

• Brain scans (checking for brain injury or neurological conditions)
• Thorough assessment of family history (mental health and medical)
• Ruling out other medical conditions
• Substance use or misuse (medical or recreational)
• Blood test
• Urinalysis
• Electroencephalogram (EEG)

How Is Psychosis Treated?

Psychosis treatment typically consists of medication management and psychotherapy. Medications may consist of antipsychotics and antidepressants. Evidence-based therapies that have proven effective in treating psychosis are as follows:

• Cognitive Behavioral Therapy: Helps a patient start to recognize when they’re having a psychotic episode.
• Supportive Psychotherapy: Helps a patient learn acceptance and utilizes skills and resources to help manage the psychosis.
• Cognitive Enhancement Therapy: Utilizes group interventions and computer skills to help a patient improve their thinking and cognitions.
• Family Psychoeducation and Support: Educates families and loved ones to be able to give support, accountability, solve problems together, and connect with resources.
• Coordinated Specialty Care: A community or team approach that allows coordination of care between families and mental health and medical professionals, across work and academic settings.

Experiencing Psychosis?

Whether you or someone you know is showing signs of psychosis, it can feel like a frightening experience. Make sure to reach out to your medical and mental health professionals for appropriate diagnosis and treatment.