The word psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. When someone becomes ill in this way it is called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficulty understanding what is real and what is not.
Psychosis affects how a person thinks and their perceptions. Their senses may seem to detect things that do not exist, and they may find it difficult to determine what is real and true.
People with psychosis may:
- hear voices
- see people or items that are not there
- smell odors that other people cannot detect
They may also believe that they are in trouble, someone is chasing them, or they are very important when these situations are not the case. A person may not be aware that they have psychosis because the delusions feel real to them. Psychosis can be overwhelming and confusing. Sometimes, the symptoms can cause the person to harm themselves. In rare cases, they may hurt another person. Psychosis is one of the key symptoms of schizophrenia.
Symptoms of psychosis
The signs and symptoms of psychosis include:
- Hallucinations: The person hears, sees, smells, tastes, or feels things that do not exist.
- Delusions: The individual believes things that are false, and they may have unfounded fears or suspicions.
- Disorganized thinking, speech, and behavior: The person may jump between unrelated topics in speech and thought, making connections that appear illogical to other people. Their speech may make no sense to others.
- Catatonia: The person may become unresponsive.
- Unusual psychomotor behavior: The person makes unintentional movements, such as pacing, tapping, and fidgeting.
The person may also experience:
- mood changes
- difficulty focusing
- sleep problems
Depending on the cause, psychosis can appear quickly or slowly. It can also be mild or severe. In some cases, it may be mild when it first appears but become more intense over time.
Causes of psychosis
The exact causes of psychosis are not well-understood but might involve:
- Genetic factors: Research shows that schizophrenia and bipolar disorder may share a common genetic cause.
- Hormones: Some people experience postpartum psychosis after giving birth. Due to this, and the fact that the early signs of psychosis often occur first in adolescents, some experts have suggested that hormonal factors may play a role in those with a genetic susceptibility.
- Brain changes: Tests have found differences in brain chemicals — specifically, the activity of the neurotransmitter dopamine — in people who experience psychosis.
A lack of sleep may also trigger psychosis.
Early signs
The mild, early symptoms of psychosis might include:
- general anxiety
- depression
- social isolation
- problems focusing
- mild or moderate disturbances in language, energy levels, and thinking
- difficulty taking initiative
- lower tolerance to stress
- sleep problems
- neglecting self-care
- feelings of suspicion
- thoughts and ideas that seem strange to others
Hallucinations can affect any of the senses — sight, sound, smell, taste, and touch — in the person with psychosis.
Diagnosis of psychosis
Anyone who is experiencing psychosis should receive urgent medical attention. Treatment can provide both short- and long-term help.
Early diagnosis
Schizophrenia and bipolar disorder usually appear in a person’s teenage years or during early adulthood. Early treatment can improve long-term outcomes, but it can take time for healthcare professionals to provide an accurate diagnosis.
Psychiatrists recommend considering the possibility of a psychotic disorder in a young person if they show signs of:
- increased social withdrawal
- changes in mood
- reduced focus or performance at school or work
- distress or agitation without being able to explain why
There is no biological test for psychosis, but laboratory tests can rule out other medical problems that might explain the symptoms.
Treatments for psychosis
Psychosis can be disruptive, but treatment is available to help people manage it.
Antipsychotic drugs
Antipsychotic drugs are the main form of treatment for people with a psychotic illness.
Antipsychotics can reduce psychosis symptoms in people with psychiatric disorders, such as schizophrenia. However, they do not treat or cure the underlying condition.
Examples of these medications include:
- haloperidol (Haldol)
- chlorpromazine (Thorazine)
- clozapine (Clozaril)
A person can only use these drugs under supervision from a doctor, as they can have adverse effects.