What is Psychosis?
Psychosis is an umbrella term used to describe symptoms of mental conditions that affect the mind and cause derealization (a loss of contact with reality). Individuals who experience psychosis usually do so in periodic episodes. These episodes cause disturbance of thought and/or behavior, and auditory and/or visual hallucinations (seeing or hearing things that are not actually there). A person in psychosis may also experience anxiety, depression, suicidal thoughts, sleep issues, and isolation from friends and loved ones. Although the severity of symptoms can vary from person to person, overall, psychosis makes day-to-day functioning very difficult.
Types of Psychosis
There are numerous mental health disorders that can display psychotic symptoms, including:
- Schizophrenia – Schizophrenia is a serious mental health disorder affecting the way someone feels, thinks, and acts. Individuals with schizophrenia experience periods where it becomes difficult to distinguish between what is real and what is imaginary.
- Schizoaffective disorder – schizoaffective disorder is a mental health condition similar to schizophrenia that can cause periods of mood disturbance and, at times, hallucinations (auditory and/or visual).
- Brief psychotic disorder – when a person experiences psychotic symptoms lasting longer than one day (but no longer than a month), they may be suffering from a brief psychotic disorder. Brief psychotic disorder often develops as a result of going through a stressful life event or trauma. Once psychotic symptoms have dissipated, they will likely not return as brief psychotic disorder tends to only occur once in a lifetime
- Delusional disorder – individuals who are diagnosed with (or are experiencing symptoms of) delusional disorder develop strong, irrational, and often bizarre beliefs. These beliefs are not based in fact and usually, last for at least one month.
- Bipolar psychosis – bipolar psychosis occurs for individuals who have bipolar disorder (intense highs and lows in mood) and also experience periods of psychosis. Those who experience psychosis as a result of their bipolar disorder will usually notice it during periods of mania (high mood).
- Psychotic depression – many people suffer from major depressive disorder (MDD), but some with MDD also will go through periods of psychosis as well.
- Postpartum (also called postnatal) psychosis – a severe form of postnatal depression.
- Substance-induced psychosis – heavy use of alcohol, drugs, and/or misuse of some prescription drugs (including steroids and stimulants) can induce psychosis in many people.
What Causes Psychosis?
Although the cause of psychosis is not well understood, research has identified a few possible contributing factors including genetics, changes in the brain, hormones, and sleep problems.
- Genetics – research shows similarities in the genetics of individuals who suffer from mental illnesses (such as bipolar and schizophrenia) where psychosis is a common symptom.
- Brain changes – chemical and structural changes in the brain connected to decreased amounts of gray matter have been strongly linked to psychosis
- Hormones and changes in sleep – postpartum psychosis can occur very soon after giving birth (as soon as two weeks), while the exact cause is unknown, researchers point to the changes in sleep patterns and hormones of new mothers.
There are other things that may contribute to the development of psychosis including alcohol and drug use, brain tumors and diseases, strokes, and epilepsy.
The link between viral infections and the central nervous system has been studied for many different viruses including influenza, H1N1, and previous coronaviruses, including SARS and MERS. Post-pandemic research has revealed individuals who contracted COVID-19 may have also experienced symptoms of psychosis, even if there are no prior psychiatric conditions. The most commonly noted manifestations of psychosis include delusions of grandeur and delusions of paranoia. And while these delusions were far more common in older adults, most responded positively to a low dose of anti-psychotics, and thus, had a quick recovery.
What is the Treatment for Psychosis
Depending on one’s level of self-awareness and ability to communicate, spotting the signs of psychosis can be difficult. Because of this, many who experience psychosis do not get the treatment they need. But for those who are identified as potentially suffering from psychosis, there are treatment options available; and the earlier psychosis is detected, the better the prognosis.
Methods Typically Used in Treating Psychosis
There are various ways to treat and manage the symptoms of psychosis, yet the use of antipsychotic medication is almost always a part of the treatment plan. While antipsychotic drugs are the most common treatment option for reducing psychosis symptoms, they do not actually treat the underlying cause of the condition. Because of this, many people who experience psychosis require hospitalization for a period of time. Hospitalization is not only helpful for medication management but also for safety, as many with psychosis have self-injurious and suicidal tendencies.
Reasons for Hiring a Therapist
Once an individual with psychosis has stabilized in terms of symptomatology (typically achieved through hospitalization and antipsychotic medication), there is the question of long-term symptom management. For many who experience (and stabilize from) psychosis, retaining a psychotherapist can mean the difference between relapse and wellbeing.
In the maintenance phase, psychotherapy is often encouraged. Cognitive-behavioral therapy (CBT) and dialectical-behavioral therapy (DBT) can help treat the residual symptoms of psychosis, following the administration of antipsychotic medication. Psychotherapy can help individuals return to day-to-day activities, achieve a more stable sense of well-being, and continue to maintain mental health.
What to Look for in a Therapist
Psychosis occurs in cases of a serious mental illness, and thus, should never go untreated. When an individual suffers from psychosis, it is essential they seek treatment not only from a medical doctor but also a mental health professional. With a comprehensive treatment team, an effective approach to treatment can be identified and enacted, thus, allowing for the best possible prognosis and outcome to be achieved.
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Kendler, K., Gallagher, T., Abelson, J., & Kessler, R. (1942). Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample: The National Comorbidity Survey. Archives of General Psychiatry.
Rabin, A. I. (1942). Differentiating psychometric patterns in schizophrenia and manic-depressive psychosis. The Journal of Abnormal and Social Psychology, 37(2), 270-272.
Chaudhary AMD, Musavi NB, Saboor S, Javed S, Khan S, Naveed S. Psychosis during the COVID-19 pandemic: A systematic review of case reports and case series. J Psychiatr Res. 2022 Sep;153:37-55. doi: 10.1016/j.jpsychires.2022.06.041. Epub 2022 Jul 1. PMID: 35797814; PMCID: PMC9248300.