Psychoses involve a loss of contact with reality and may involve hallucinations and delusions. It is a symptom of schizophrenia and bipolar disorder, but there are plenty of other causes.
In this article, you’ll learn more about psychoses, including their causes and available treatment options.
What is psychosis?
Psychosis affects how a person thinks and how they perceive. Your senses seem to recognize things that don’t exist, and they may find it difficult to determine what is real and true.
People with psychosis can:
- Hear voices
- See people or objects that aren’t there
- Smell odors that other people don’t recognize
can. They may also believe that they are in trouble, someone is stalking them, or that they are very important when these situations are not the case.
A person may not be aware that they are suffering from psychosis because the delusions feel real to them. Psychosis can be overwhelming and confusing. Sometimes the symptoms can cause the person to hurt themselves. In rare cases, they can hurt another person.
Psychosis is one of the main symptoms of schizophrenia.
Symptoms of psychosis
The signs and symptoms of psychosis include:
- Hallucinations: The person hears, sees, smells, tastes, or feels things that don’t exist.
- Delusions: The individual believes things that are wrong and they may have unfounded fears or suspicions.
- Disorganized thinking, speech, and behavior: The person can jump between unrelated topics in speech and thought and make connections that seem illogical to other people. Your speech may not make sense to others.
- Catatonia: The person may stop responding.
- Unusual psychomotor behavior: The person makes unintended movements such as pace, tapping, and fidgeting.
The person may also experience:
- mood swings
- difficulty concentrating
- , sleep disorders
Depending on the cause, psychosis can occur quickly or slowly. It can also be mild or severe. In some cases, it may be mild when it first appears but becomes more intense over time.
Mild, early symptoms of psychosis may include:
- general anxiety
- social isolation problems
- , which focuses on
- mild or moderate language disorders, energy levels, and difficulty thinking
- , take initiative
- lower tolerance
- Neglect of self-care
- , mistrust
- Thoughts and ideas that seem strange to others
Hallucinations can affect all senses — sight, hearing, smell, taste, and touch — in a person with psychosis.
Auditory hallucinations appear to be the most common types of hallucinations among people with schizophrenia. The person hears things and believes they are real when they don’t exist.
Often, the person hears voices. There can be one or more voices, and they sound exactly like real voices.
The votes can:
- recognizable, unspecific, or from someone who has died
- Sound clear or like murmurs in the background
- Give instructions or criticize the person
- Be intermittent or constant
Hearing voices can be very confusing and can affect a person’s actions. It can cause the individual to harm themselves or, more rarely, to others.
Treatment may treat or prevent psychosis, but it may return if the person stops taking their medication.
There may also be a risk of suicide.
If you know someone who is at imminent risk of self-harm, suicide, or harm, another person:
- Ask the tough question: “Are you considering suicide?
- Listen to the person without judgement.
- Call 911 or the local emergency number, or send TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove weapons, medicines, or other potentially harmful objects.
If you or someone you know is having suicidal thoughts, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 and then 988.
Click here for more links and local resources.
Delusions in psychoses
During a psychotic episode, a person may experience delusions.
Paranoid delusions can cause a person to be suspicious of individuals or organizations and believe they are planning to harm the person.
Delusions of grandeur include the firm belief that the person has a particular power or authority. For example, they may believe that they are a political leader.
Diagnosis of psychosis
Anyone suffering from psychosis should receive urgent medical attention. Treatment can help both in the short and long term.
Schizophrenia and bipolar disorder usually occur during teens or early adulthood. Early treatment may improve long-term outcomes, but it may take time for healthcare professionals to make an accurate diagnosis.
Psychiatrists recommend considering the possibility of a psychotic disorder in a young person if they have signs of:
- increased social retreat
- mood changes, decreased focus, or performance in
- at school or at work
- show stress or anxiety without being able to explain why
There is no biological test for psychosis, but lab tests can rule out other medical issues that could explain the symptoms.
To diagnose psychosis, a doctor will conduct a clinical examination and ask various questions.
They will ask for:
- the person’s experiences, thoughts, and daily activities
- any family history of psychiatric illnesses
- medical and recreational drug use, and
- other symptoms
You can also run tests to rule out other factors, including:
of drugs or other substances
- a head injury
- , other conditions such as multiple sclerosis (MS) or a brain tumor
Possible tests include:
- blood tests
- an electroencephalogram (EEG) that records brain activity
If the signs indicate a psychiatric cause. The doctor uses criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) to make a diagnosis.
Causes of Psychosis
The exact causes of psychosis are not well understood, but may include:
- Genetic factors: Research shows that schizophrenia and bipolar disorder are a common common genetic cause.
- Hormones: Some people suffer from postpartum psychosis after giving birth. For this reason, and the fact that the early signs of psychosis often occur first in adolescents, some experts have suggested that hormonal factors in patients with a genetic predisposition.
- Brain changes: Tests have found differences in brain chemicals — particularly the activity of the neurotransmitter dopamine — in people with psychosis.
Lack of sleep can also trigger psychosis.
Treatments for psychosis
Psychosis can be disruptive, but there are treatments that help people deal with it.
Antipsychotics are the main form of treatment for people with a psychotic condition.
Antipsychotics may reduce symptoms of psychosis in people with psychiatric disorders, such as schizophrenia. However, they do not treat or cure the underlying disease.
Examples of these drugs include:
- Haloperidol (Haldol)
- chlorpromazine (thorazine)
- Clozapine (Clozaril)
A person can only use these drugs under the supervision of a doctor, as they can have negative effects.
The doctor also treats all underlying conditions responsible for the psychosis. Family support can also help where possible.
Acute and maintenance phases of schizophrenia
In schizophrenia, there are two phases of antipsychotic treatment:
The person may stay in hospital.
Sometimes a doctor prescribes a quick sedative. They give the person a fast-acting medication that relaxes them to make sure they’re not harming themselves or others.
The person does not stay in hospital but uses antipsychotics to prevent further episodes. Stopping the medication may cause relapses.
Psychotherapy may also help treat cognitive problems and other symptoms of schizophrenia and other psychotic disorders.
types of psychosis
Apart from schizophrenia, several other disorders and factors can cause psychosis. The different types include:
- Schizoaffective disorder: This disorder is similar to schizophrenia but includes periods of mood disorders.
- Brief psychotic disorder: The symptoms arise in response to a stressful life event, last less than a month and do not return.
- Delusional disorder: The person has a strong belief in something irrational and often bizarre without any factual basis.
- Bipolar psychosis: Some people with bipolar disorder experience psychosis, either during a very high or very bad mood.
- Severe depression: Also known as major depression with psychotic characteristics.
- Postpartum (postnatal) psychosis: This type of psychosis can occur after birth.
- Substance-induced psychosis: Misuse of alcohol, some recreational drugs, and certain prescription drugs can cause this.
Psychoses can also result from other illnesses, such as:
- a brain tumour or cystic dementia
- , including Alzheimer’s disease
- , neurological disorders such as Parkinson’s and Huntington’s disease
- HIV and other infections that can affect the brain
- some types of epilepsy
to take away
It is one of the main symptoms of schizophrenia, but it also has other causes.
It can make individuals and those around them anxious, but treatment is available to help treat psychosis in people at risk.
It is important to follow the treatment plan for schizophrenia and other mental illnesses to prevent a relapse of symptoms such as psychosis.
If someone is concerned that a person is suffering from psychosis, they should take them to the emergency room or call 911 if possible.