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Psychosis

Reviewed by Stephanie Steinman, PhD, CSAC

Outline of a head with lines connecting dots both inside and outside of the head

What Is Psychosis?

Psychosis affects how a person processes and experiences reality. This can result in someone feeling out of touch with reality and believing that they see, hear, and feel things that are not there. Psychosis is also commonly referred to as a psychotic episode, psychotic break, or mental breakdown. 

While psychosis is not a mental health diagnosis, it is a symptom of one, and it’s more common than some may think. According to the National Alliance on Mental Illness, as many as three in 100 people will have an episode of psychosis at some point in their lives.

Psychosis vs. Schizophrenia: What’s the Difference?

Schizophrenia is a serious mental health disorder that causes a person to have false interpretations of reality. While rarer than other mental health disorders, the condition affects nearly 20 million people worldwide. Schizophrenia can involve hallucinations, delusions, disorganized speech, and disordered thinking that can greatly affect daily life. 

As noted above, unlike schizophrenia, psychosis is not a mental health disorder. While those with schizophrenia often experience psychosis as a symptom, a person who has psychosis does not necessarily have schizophrenia. 

Signs of Psychosis

Early Warning Signs

Psychosis rarely comes out of nowhere, and there are many early warning signs that a person may display. 

Common early warning signs of psychosis include:

  • Disorganized thoughts
  • Withdrawal from school or work
  • Extreme emotions or lack of emotions
  • Sudden decline in self-care
  • Suspicion or paranoia
  • Uneasiness around others
  • Spending more time alone than usual

The signs of psychosis can overlap with symptoms of other mental health concerns. While they may not always be a sign of psychosis, experiencing several of the above warning signs may warrant an appointment with a therapist. 

Symptoms

Psychosis can involve many different symptoms. However, the most common indicators of an episode of psychosis are hallucinations and delusions.

Hallucinations involve one or more five senses perceiving something that isn’t there. They can be:

  • Visual (seen)
  • Auditory (heard)
  • Olfactory (smelled)
  • Tactile (felt)
  • Gustatory (tasted)

Delusions are strong beliefs not based in reality. Examples of delusions include believing you are:

  • Being harassed
  • Being stalked, tracked, or surveilled
  • Communicating with powerful forces, such as gods or aliens
  • Not human

Complications

Left untreated, psychosis can greatly affect a person’s relationships, employment, school performance, and overall quality of life. It can also lead to some serious complications.

Psychosis can put an individual at a greater risk for co-occurring mental health concerns, such as substance use disorders. Those who have psychosis are also at a greater risk of self-harm and suicidal ideation. An estimated one in five individuals who suffer from psychosis will attempt suicide, and one in 25 with die from suicide.

Schizophrenia

Psychosis is a common symptom of schizophrenia. However, a combination of symptoms must be present for a diagnosis to be made. Along with delusions, hallucinations, and disorganized speech or thought, someone who has schizophrenia may show symptoms such as lack of eye contact, reduced range of emotions, poor hygiene, and lack of motivation. 

Bipolar Disorder 

Bipolar disorder is a mental health disorder that affects mood. This can result in episodes of extreme highs (mania) and extreme lows (depression). During an episode of mania, someone who has bipolar disorder might experience psychosis as a symptom, but not always. 

Psychotic Depression

Psychotic depression is a severe form of depression that may result in psychosis as a symptom. Common symptoms include fatigue, insomnia or oversleeping (hypersomnia), and not eating enough. 

Posttraumatic Stress Disorder (PTSD)

Posttraumatic stress disorder (PTSD) is a mental health disorder that is caused by trauma and involves symptoms related to the traumatic experience. This can include flashbacks of the event, dissociation, negative changes in mood, avoidance, and isolation. However, mental health experts believe that psychosis should also be considered a symptom, as many people with PTSD also experience hallucinations and delusions. 

Postpartum Psychosis

Postpartum psychosis occurs when someone experiences psychotic symptoms after giving birth. Postpartum psychosis is rare but can develop within two weeks of giving birth. Along with psychosis, a person might feel confused, be superstitious, and show signs of depression. 

What Causes Psychosis?

How psychosis develops is still being studied. While there may not be an exact known cause of psychosis, there are several risk factors that can contribute to its development. 

Risk factors that can increase the chances of developing psychosis include:

  • Genetics: Some genes may contribute to the development of psychosis. However, having these genes does not guarantee that you will have psychosis. 
  • Brain chemistry: Chemical imbalances in the brain may increase a person’s risk for psychosis.
  • Trauma: Traumatic events may trigger psychotic breaks.
  • Drug or alcohol use: Substances that alter one’s experience of reality can cause or exacerbate symptoms of psychosis.
  • Physical illness or injury: Illness or injury to the brain in particular can result in psychosis.
  • Mental illness: Certain mental health disorders, such as schizophrenia and bipolar disorder, can also have symptoms of psychosis.

What Triggers Psychosis?

An episode of psychosis can be a sign of an ongoing mental health condition, or it can be a one-time event triggered by:

Psychosis Treatments

Treatment for psychosis will vary depending on the severity of the symptoms that a person experiences, as well as any other mental health concerns that are present. Several therapy techniques have shown success in treating psychosis, including:

  • Cognitive behavioral therapy (CBT): CBT can help improve a range of mental health concerns, including psychosis. This is done using a variety of strategies, such as improved coping skills, stress management, emotional regulation, and more, to change a person’s thinking and behavior patterns.  
  • Internal family systems (IFS) therapy: IFS therapy is a technique that investigates the “family” of subpersonalities, or parts, of oneself. This involves looking at the parts that make up the self and the roles, intentions, and positive attributes of each.
  • Eye movement desensitization and reprocessing (EMDR): EMDR helps a person access and effectively process traumatic memories that might be causing psychosis and other mental health concerns. 
  • Antipsychotic medications: Antipsychotic medications influence the brain chemicals that help regulate mood, emotions, and thought patterns. This can help reduce the severity of symptoms like psychosis. 

With the right therapy techniques, psychosis is treatable. If you experience symptoms associated with psychosis or another mental health concern, schedule an appointment with a therapist right away. 

Find a certified psychosis therapist near you today

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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