Psychosis

Psychosis is a complex topic, and understanding its definition, characteristics, causes, and treatment is the first step toward informed discussion and support. Psychosis itself isn't a disorder; instead, it's a term used for the cluster of symptoms a person experiences.

What is Psychosis?

Psychosis is diagnosed in individuals who have difficulty differentiating reality. The core characteristics involve having hallucinations and delusions, which can range in severity from non-extreme to extreme.

Causes and Risk Factors

Psychosis can be caused by a variety of factors, including mental health conditions, substance use, medical issues, and environmental/psychological factors.

Mental Health & Genetic Factors

Certain mental health conditions can lead to psychosis, such as:

• Schizophrenia

• Bipolar disorders

• Severe stress or anxiety

• Severe depression

• Severe lack of sleep

A genetic predisposition is also a significant factor; having a family member with conditions like schizophrenia, bipolar disorder, schizoaffective disorder, or schizotypal personality disorder increases the chance of developing psychosis.

Substance-Induced Psychosis

Taking certain drugs in large quantities or over a long period can cause psychosis. These substances include:

• Amphetamines and methamphetamine

• Cocaine and alcohol

• Benzodiazepines and marijuana

• LSD, peyote, mushrooms, ketamine, PCP, and ecstasy

Medical Conditions

Several medical issues can also be causes of psychosis:

• Traumatic brain injuries, brain tumors, and strokes

• Parkinson's disease, Alzheimer's disease, and dementia

• HIV, AIDS, lupus, and multiple sclerosis

• Low blood sugar (hypoglycemia)

• Syphilis and malaria

Environmental & Psychological Factors

Psychosis can be linked to factors that occur throughout a person's life:

• Early life events such as obstetric complications, season of birth, prenatal/postnatal infection, maternal malnutrition, and maternal stress.

• Childhood experiences like adverse child rearing, child abuse, and head injury.

• Later life factors include drug abuse, migration/ethnicity, urbanization, social adversity, and life events.

Symptoms of Psychosis

Symptoms of psychosis are broadly categorized as positive, negative, cognitive, and other.

Positive Symptoms

These are symptoms that add experiences to the person's reality:

• Hallucinations: Experiencing sensations—seeing, hearing, feeling, smelling, or tasting—that are not actually present.

• Delusions: Strongly held beliefs that are not true or rational, such as believing one is being watched or that others can hear one's thoughts.

• Disorganized Thinking and Speech: This can involve talking off-topic, having inappropriate emotional responses, exhibiting unusual behavior, lacking response to others, or being unable to perform daily tasks.

Negative Symptoms

These are characterized by a reduction or absence of normal functions:

• Reduced motivation

• Limited emotional expression

• Social withdrawal

• Difficulty in daily functioning

• Reduced interest in sexual activity

Other and Cognitive Symptoms

Other symptoms include depression, anxiety, suicidal thoughts, substance use problems, and sleep

problems.

Cognitive symptoms specifically involve difficulties with attention, concentration, memory, learning, problem-solving, and interpreting social norms.

Diagnosis and Assessment

Diagnosis involves analyzing behaviors over time and considering a patient's family history. For example, a patient with a father who has bipolar disorder may develop a related disorder with psychosis symptoms.

• Role of Professionals: Psychologists and social workers provide assessment, resources, and support, while psychiatrists are responsible for prescribing medication.

• Diagnostic Tools: Patients are typically asked questions about their experiences, such as any hallucinations or delusions they may have.

• Differential Diagnosis: This is the process of determining whether symptoms are caused by medical conditions (like neurological issues) or psychiatric causes (such as bipolar disorder or depression).

This is crucial for identifying the specific type of psychosis.

Treatment and Management

Effective treatment for psychosis is multifaceted, involving medication, psychotherapy, and various forms of support.

Antipsychotic Medications

These medications alter neurotransmitter signals to help reduce psychosis symptoms and are also used for related symptoms in non-psychotic disorders.

• First-generation medications block dopamine and other receptors.

• Second-generation medications block dopamine and serotonin receptors while activating others.

• Next-generation medications aim to improve memory and cognition with fewer side effects.

Keep in mind that antipsychotics can have side effects like weight gain, dizziness, dry mouth, constipation, abnormal movements, high cholesterol, and diabetes.

Psychotherapy

Psychotherapy offers crucial tools for managing psychosis:

• Cognitive Behavioral Therapy (CBT): Helps patients identify and change harmful thoughts and behaviors.

• Psychoeducation: Educates patients about psychosis, its symptoms, and available treatments.

Support and Lifestyle Changes

Support services and lifestyle adjustments are essential parts of management:

• Community Support Programs provide help at home from non-profit or private groups.

• Peer Support Groups offer emotional support from others with shared experiences.

• Holistic Approaches address mental, social, spiritual, and physical challenges.

• Lifestyle Changes focus on improving sleep, diet, physical activity, and reducing addictions.

Prognosis and Recovery

Early intervention is vital as it helps reduce the progression of symptoms and social decline. Effective recovery is a long-term management strategy that includes medication, therapy, and social support to prevent relapse.

• Recovery means that with treatment, many individuals can regain independence and function in daily life. It involves both symptom reduction and rebuilding goals and relationships.

• Relapse Prevention involves strategies to maintain positive behaviors and manage triggers.

• Stigma and Social Challenges like poverty, unemployment, and poor housing can worsen mental health outcomes and are important factors to address.

Written by and researched by Yaren

2025 The HEAL Project