Psychosis is a very serious mental health problem that causes an individual to see, perceive or interpret things in very different ways to others.
The most well-known signs of psychosis are hallucinations and delusions. Those who suffer from psychosis are said to “lose touch” with reality.
Psychosis is a very serious problem that can have severe repercussions on both the individual suffering, and those around them.
In rare cases, psychosis can be a positive thing – with some suggesting they can hear the voices of dead loved ones. Unfortunately, the majority of people have serious ill health when suffering from symptoms of psychosis.
Psychosis itself isn’t a mental health condition, though is a key part of mental health, and plays a role in several conditions where psychotic episodes are common.
Types of Psychosis
Psychosis is a problem that is linked to several different mental health conditions. Psychotic episodes are often key symptoms of a number of conditions. These conditions include:
Delusional Disorder: This condition involves an individual having one or more delusions that are present for at least a few weeks. The person will have irrational beliefs, and be steadfast in their belief of the delusion. However, they will not exhibit any other form of psychosis, such as hallucinations. It is a rare disorder, but is sometimes seen.
Brief Psychotic Disorder: Brief Psychotic Disorder is a condition characterised by a short-term episode of psychosis, which, following the conclusion of the episode, will see the individual involved return to their normal level of functioning. It is a rare condition, but can cause distress. In many cases, it will be the first sign of a more severe psychotic disorder, but it can also be a one-off experience.
Shared Psychotic Disorder: Shared Psychotic Disorder is a rare, yet serious condition that involves an individual imposing a delusional belief onto someone else. The person who initially has a delusion will typically have a close relationship with the affected individual – who will begin to follow the same delusion. It is often seen in cases where a couple are socially isolated.
There are a range of other conditions that involve psychosis. However, these conditions have been included in a different section – which you can access by clicking on the condition name [construction].
- Schizoaffective Disorder
- Schizophreniform Disorder
- Bipolar Disorder
- Psychotic Depression
- Paranoid Personality Disorder
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Symptoms of Psychosis
While the symptoms of each sub-type of Psychosis vary, in general, symptoms include, but aren’t limited to:
- Hallucinations: Where a person sees or hears something that doesn’t exist outside of their mind. For example, they may hear voices.
- Delusions: A delusion is where an individual has a belief that they wholeheartedly believe in, although it isn’t true. An example is paranoia.
- Thought Disorder: Disturbed thoughts which leads the patient to lose touch with reality.
- Disorganised speech: This is where a person struggles with their speech, whether through making up words or struggling to concentrate on one topic
- Disorganised behaviour: They may be impulsive or unpredictable in their behaviour
- Unusual movements: Unusual movements may include pacing up and down or making the same, repetitive movements.
These symptoms can cause significant distress to an individual. The person will likely be scared, anxious and confused by their symptoms.
They will commonly withdraw from friends and family, with delusions particularly causing someone to be suspicious of those around them.
It ranges from person-to-person in terms of how often a psychotic episode will take place. Some people have sporadic psychotic episodes, while others may have to live with psychosis for the majority of their life.
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Causes of Psychosis
Psychosis is normally caused by an underlying mental health condition. Sometimes however an individual may not have been diagnosed with any condition prior to having a psychotic episode. In some cases, it isn’t always possible what causes psychosis. Possible causes include:
- Mental Health Condition: Psychosis is linked to a range of mental health conditions, such as Delusional Disorder, Schizophrenia, Bipolar Disorder, Schizoaffective Disorder, Psychotic Depression and some Personality Disorders.
- Brain Differences: People with abnormally high levels of the neurotransmitter Dopamine in the brain may be more vulnerable to developing psychosis. Dopamine is normally linked to psychotic episodes, with brain scans backing this notion up.
- Medical Condition: Many medical conditions have the potential to trigger psychotic episodes. HIV and AIDS, Malaria and a brain tumour are just some of these conditions.
- Traumatic Experience: Any traumatic experience can cause a mental health condition to develop – with psychosis a possible symptom.
- Substance Abuse: Substance abuse has long been linked to psychotic episodes. Psychosis can often be a symptom of withdrawal from either drugs or alcohol – especially if they have been taken over a long-term period. People who are ‘high’ on drugs or have consumed excessive alcohol could be vulnerable too.
- Genetics: As with all other mental health conditions, psychosis has the ability to run in families. People whose parents experienced psychosis are considerably likelier to have a psychotic episode, than others.
- Birth Complications: People who had a complicated birth appear to have an increased risk of developing psychosis. Complications include premature birth or a lack of oxygen. This may be a significant risk factor.
More often than not, the combination of a range of factors is likely to cause psychosis.
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Diagnosis of Psychosis
Psychosis itself isn’t a mental health condition. Instead, it is a symptom of several other mental health conditions. As a result, an individual who has experienced a psychotic episode will often have already been diagnosed with a condition.
However, if it is the first psychotic episode, an individual will need to be assessed. The starting point is to visit a Doctor.
There is no way of a doctor knowing through a medical examination or laboratory test if an individual had a psychotic episode. Instead, a doctor will ask the individual a series of questions regarding their symptoms.
Questions will normally be based around details of their episode, how the person’s mood has been, the effect of the symptoms, history with illicit substances, family history of mental illness, and anything else that is relevant.
By getting the full picture of the psychotic episode and its effects, a Doctor should be able to make a determination on the next steps. Generally, one of the following three events will happen:
- Referral: Normally, an individual will be referred to a specialist team for treatment. Normally, an Early Intervention Team will provide care. They are a team made up of mental health professionals that assist people who have had their first psychotic episode. Sometimes, a Community Mental Health Team or Crisis Resolution Team can provide treatment.
- Support: If the psychotic episode was seemingly caused by substance abuse, the doctor may suggest the individual engages in self-help materials. Or, they may take part in a form of low-intensity talking therapy.
- Sectioning: Under the Mental Health Act 1983, an individual with very severe psychosis may need to be compulsorily detained at a secure hospital for assessment and treatment. This is a rare move, but one that is done if there is evidence that an individual needs detaining for their own safety, or someone else’s.
Treatment can then proceed once one of these three steps is taken.
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Treatment of Psychosis
Treatment for psychosis consists normally of a combination of medication, support and talking therapy. The symptoms of psychosis should be able to be controlled more, and in some cases, full recovery is possible.
Because psychosis isn’t an actual condition it is difficult to state exactly how it is treated, This is because the conditions where psychosis is involved in, such as Bipolar Disorder and Schizophrenia, all have different treatment plans. In any case, typical components include:
- Medication: Medication is normally recommended to be the first line of treatment for psychosis. Antipsychotics (also known as neuroleptics) are normally prescribed.
Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.
Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Valproate is a well-known anticonvulsant which is often used as a stabiliser for people who cannot take Lithium Carbonate.
- Talking Therapy: Some form of talking therapy can sometimes complement medication. Several types of therapy are available, with a selection made based on individual circumstances.
Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.
Psychodynamic Psychotherapy: Psychodynamic Psychotherapy is a talking therapy that is closely related to Psychoanalytical psychotherapy, though combines more areas into the therapy process. This talking therapy aims to bring to light thoughts and memories in the unconscious mind. It works on the idea that past trauma is pushed to the back of the mind, with the conscious mind neglecting to process them. This may cause long-term problems though, when a person develops defence mechanisms to cope with the issues. This tends to be a shorter-term therapy than others.
Other: In very severe cases of psychosis, an individual may need to be compulsorily detained at a secure hospital for assessment and treatment under the Mental Health Act 1983. This will only happen in circumstances that warrant such a drastic move, such as the need to detain someone for their own safety.
Psychosis is very scary, and can be very debilitating. Treatment is available, and in many cases will lead to an individual being able to control their symptoms more, leading to a better quality of life in the long term.
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Living with Psychosis
Psychosis is a very serious issue, and for those suffering from psychotic episodes, it can be a very distressing time.
Those suffering from psychosis need support from their friends and family. It is especially important that family members remember that for people suffering from psychosis will feel their beliefs are very true.
It can therefore be distressing when these ideas, which are clearly wrong, are dismissed. Listening to their problems, and supporting them in any way, is important.
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Psychosis is a very serious problem that is associated with a wide array of mental health conditions. However, it can be controlled.
Early intervention is crucial with psychosis, and can lead to symptoms being controlled more, and a possible recovery taking place. Left untreated, psychosis will commonly exacerbate into a long-term mental disorder, which can lead to several problems.
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