Research shows that around 3% of Americans experience psychotic symptoms at some point during their lives. Psychosis disturbs someone's sense of reality. In a psychotic episode, a person cannot accurately distinguish their own hallucinations or delusions from the truth. Therefore, they might see, hear, feel, or taste things that don't really exist.
Understanding psychosis is important for individuals and their loved ones. This symptom can occur in many mental health conditions, but it's treatable with the right mental health services. Let's get into what you need to know.
Understanding Psychotic Symptoms
When someone is experiencing psychotic symptoms, they have temporarily lost touch with reality. As a result, they experience or believe things that are not factual.
Hallucinations entail seeing, hearing, or feeling stimuli that aren't there. For example, someone might hear voices or see strange figures. These hallucinations can range from being extremely upsetting and scary to being mildly inconvenient.
Hallucinations can also sometimes be enjoyable. For example, someone with psychosis may see a dead loved one, and the image of that person might bring them immense comfort. Or they might taste sweetness in their mouth, which can be pleasurable.
Delusions refer to having intense beliefs that aren't congruent with one's standard culture. As a result, they come across as strange and irrational.
For instance, a person may believe that they are God or have special, secret powers assigned to them. At times, delusions can be dangerous, particularly if they lead people into thinking they need to harm themselves or others.
Incoherent or Incomprehensible Speech
Someone experiencing psychosis may not be able to speak clearly. Sometimes the communication is so disorganized that all conversations are impaired.
Perseveration: Repeating certain words or phrases
Thought blocking: Forgetting the original topic and stopping speaking altogether
Pressured speech: Speaking very quickly (and so fast that others can't understand it)
Neologisms: Coming up with unique words or phrases that don't exist
Social impairment is often one of the first clues that someone is experiencing a psychotic episode. The specific type of inappropriate behavior varies, but it may include hypersexuality, violence, or nudity.
Paranoia often coincides with psychotic disorders. Paranoid usually emerges from a fear that others are out to harm them. This paranoia can make people engage in consuming behaviors like harassment, stalking, avoiding others, or spending time excessively researching specific details.
Someone with a psychotic disorder may also have co-occurring symptoms of depression. The individual may present as highly apathetic or emotionless. They may struggle with suicidal thoughts connected to this depression.
A person experiencing psychosis might find it difficult to rest or sleep. Psychosis can sometimes have features of mania, meaning someone may be showing signs of hyperactivity, restlessness, and excessive energy. That said, sleep problems tend to make mental health problems worse. Likewise, research shows that, in extreme cases, sleep deprivation may trigger psychosis.
In a psychotic episode, someone might spend money recklessly, act promiscuously, or otherwise engage in self-destructive behaviors. At this time, someone is at an increased risk for self-harm and suicidal behavior.
Psychosis often goes hand-in-hand with substance use. This makes understanding the symptoms of psychosis even trickier, particularly if medical professionals are trying to discern whether the situation is acute or chronic. Stimulants, marijuana, and hallucinogens can all trigger psychotic symptoms.
Extreme Social Withdrawal and Isolation
People with psychosis may isolate themselves from others because they fear judgment or want to protect loved ones from seeing their positive symptoms. If they feel overwhelmed by hearing voices or paranoid thoughts, they might prefer to be left alone.
Difficulty Functioning With Basic Tasks
Psychosis makes self-care challenging, as it can erode someone's mental state and affect the ability to engage in personal hygiene.
Problems With Gait And Coordination
Some people experiencing psychosis experience motor deficits. They may have issues with balance, coordination, and posture.
Types of Psychotic Disorders
Psychosis itself isn't a psychiatric diagnosis. However, it is a symptom within clusters of other psychotic disorders.
Schizophrenia is a psychotic disorder associated with unusual beliefs and behaviors. Hallucinations and delusions are the most common symptoms of schizophrenia. However, individuals also have negative symptoms like emotional blunting and cognitive impairment.
Some people with severe depression experience features of psychosis during their depressive episodes. The psychotic symptoms are directly related to depression.
Schizophreniform disorder has the same criteria as schizophrenia, but the symptoms last for a shorter duration. For example, a psychotic episode in this condition lasts between 1-6 months.
Schizotypal Personality Disorder
Schizotypal personality disorder refers to patterns of disorganized thinking and odd, eccentric behavior. People with this condition may believe they are a more powerful person than they really are. This disorder is pervasive across the lifespan.
Brief Psychotic Disorder
This refers to a brief episode of psychotic symptoms. The symptoms last between 1-30 days.
People with schizoaffective disorder experience schizophrenia symptoms with major mood episodes simultaneously. It's common for people to have cycles of severe symptoms followed by periods of remission or significant improvement.
Substance-Induced Psychotic Disorder
This disorder occurs when someone experiences psychosis due to specific drugs. These symptoms can occur after taking too much of a substance or problematic drug interactions occur. Someone with underlying mental health issues may be more susceptible to experience psychosis from substance use.
Puerperal psychosis occurs in approximately 1 in 500 mothers after giving birth. This is a serious mental illness that can emerge anytime within the first year of the baby's life. Suicide and infanticide are the most concerning risks associated with this type of psychosis.
Risk Factors of Psychosis
There isn't a specific, single cause contributing to psychosis. However, mental health professionals point to many risk factors that may increase the chance of psychosis occurring.
Like with most conditions, genetics can play an influential role, especially if an immediate family member exhibits a history of psychotic symptoms.
Trauma also appears to be a significant risk factor. Trauma can fundamentally change how the brain interprets and reacts to stress. Psychosis represents a break from reality- these symptoms can emerge when the body floods with various stress hormones.
Certain Mental Illnesses
Preexisting mental illnesses represent risk factors. Psychotic episodes underlie many conditions, including severe depression, bipolar disorder, schizophrenia, substance use disorders, and some personality disorders. A qualified mental health professional, such as a psychologist or therapist, can assess these conditions accurately.
Psychosis can also emerge from medical issues, including brain tumors, epilepsy, certain prescription medications, and brain infections.
People with past or current histories of substance abuse may be at high risk for psychotic episodes. Psychosis can also happen during the initial stages of withdrawal.
Treatment For Psychosis
Research shows that many people experience psychotic symptoms for at least a year before seeking treatment. Stigma, co-occurring mental health conditions, inaccessibility, and other variables may impact someone's ability to seek care.
That said, psychosis is treatable, and the odds of success increase when someone receives an accurate diagnosis and early intervention. It's quite possible to have a single episode without having another one. Some people will experience recurrent psychosis, but their treatment helps them manage their symptoms and live fulfilling lives.
Effective Community Mental Health Team
Many times, someone with psychosis needs wraparound care. This includes getting all family members on the same page. It also entails multiple treatment mental health professionals, including doctors, psychiatrists, and qualified therapists.
Medication is usually the first line of defense against psychosis. Finding the right medication can make a significant difference in the intensity and frequency of psychotic episodes.
Antipsychotics support psychosis by inhibiting the effects of dopamine. They also decrease feelings of anxiety and depression within a few hours of use. Some common antipsychotics include Abilify, Latuda, Zyprexa, Risperdal, and Seroquel.
All medications come with potential side effects. Sleep issues, low mood, poor libido, appetite changes- these are common reactions to psychiatric medication. Your healthcare professional will monitor these symptoms and review changes as needed.
Psychotherapy can also help treat the underlying issues triggering psychosis. Cognitive-behavioral therapy (CBT) supports clients in understanding the connection between their thoughts, feelings, and behaviors.
By learning how to untangle distorted thoughts, their psychotic symptoms may reduce or disappear altogether. Overall, their mental health condition may improve significantly.
Family therapy teaches loved ones about psychosis and mental illness, and it also provides a safe place for everyone to discuss boundaries and healthy communication. It is important for family members to feel supported during this challenging time.
Life Skills Training
Finally, life skills training can be an essential part of a comprehensive treatment plan. Despite their mental health disorder, people do best when they feel encouraged and empowered.
Learning how to obtain a job, secure housing, and follow dependent living skills can make a tremendous difference in one's own well-being.
Psychosis can be confusing and frightening for individuals and their loved ones. This is especially true if someone becomes incredibly unstable or violent. Make sure that you have a safety plan in place and that everyone understands the protocol.
Family intervention is key when it comes to early treatment. Young people may be especially prone to harming themselves, especially if they don't realize the severity of their symptoms.
What Should Loved Ones Do During a Psychotic Episode?
Amid psychotic episodes, you may feel completely out of your element. How are you supposed to intervene or respond? Will you unintentionally make things worse?
Below are some tips for loved ones to consider:
Practice staying calm: A psychotic episode is a break from reality. Even if your loved one becomes hostile or aggressive with you, try to stay grounded. Things will only become more escalated if you try to match their intensity.
Avoid challenging the psychosis: You don't need to enable delusional thoughts or hallucinations, but you shouldn't try to dismiss or refute them, either. Instead, you can consider saying something like, I'm not really sure how to make sense of what's going on, but I appreciate you telling me. It sounds really scary.
Offer support: Ask how you can provide practical assistance without focusing directly on the mental health symptoms. For example, you might say, I know you've been feeling worried to leave the house. Do you need me to pick up some food for you? Can I help with groceries this week?
Keep providing empathy: People experiencing psychosis often feel afraid, alone, and distant. Even if you don't think your supportive statements make much of a difference, they can go a long way in helping someone feel validated. Empathy sounds like, That does sound hard. I believe you're going to get through this, though. I know you can do it.
Encourage treatment: Keep recommending that your loved one seek support. With that, you should also anticipate resistance. Remember that the person experiencing psychotic symptoms already probably feels suspicious of your motives (and the motives of others).
Look after your own needs: Even though you may feel consumed by what's happening with your friend or family member, try to take care of yourself. Otherwise, you run the risk of burnout or resentment.
How We Support People With a Serious Mental Health Condition
Effective treatment starts with an effective care team. Our dynamic program includes the following services:
trained crisis team to ensure safety and well-being
medication management for all prescribed medication and supplements
self-help groups, psychoeducation, and peer support
coordination with local community and social services
guidance for families if a loved one refuses treatment
At Mental Health Transitions, we understand that loved ones often feel confused, upset, or anxious about psychotic episodes. After all, nobody wants to see someone feeling suicidal or acting irrationally.
We care deeply about the clients we help, and we are here to provide unwavering compassion. Psychosis doesn't mean all hope is lost. Instead, psychosis means there is a mental health condition, and that means your loved one needs additional support.
Contact us today to learn more about our unique treatment approach.