Learn About The Signs of Psychosis

You may have heard of someone having a "psychotic break" or an "episode of psychosis", and imagined this person ranting, raving, and/or becoming violent. While violence and aggression are possible with psychosis, they are not symptoms of the condition and occur in only a small minority of episodes. Those experiencing psychosis are more likely to harm themselves than someone else. Psychosis can appear on its own, or be accompanied by mood disorders like depression and bipolar disorder. I'll take some time here to outline what psychosis looks like, and what signs and symptoms accompany it.

.Psychosis involves one or both of the following:

• Hallucinations. Hallucinations occur when you hear, see, or otherwise sense something that is not actually present. Auditory hallucinations occur when something is repeatedly heard that others do not hear, most commonly voices. Voices can be loud or quiet, aggressive or gentle, sudden or predictable.  Visual hallucinations involve seeing something that others do not see. These experiences may include seeing shadows, people, animals, or other figures. Less frequently, other types of hallucinations occur. These include tactile (feeling something on the skin or inside the body that isn't there), gustatory (tasting something foreign or inexplicable), or olfactory (smelling something with no known cause). 
• Delusions. Delusions are fixed, false beliefs to which you hold strongly and which interfere with your normal cognitive functioning. Examples could be believing that you are being followed, or that your phone is tapped. These are examples of persecutory delusions. They can be accompanied by hallucations, such as seeing someone following you or hearing someone tampering with your phone. Other types of delusions also exist. Delusions of grandeur involve believing you are special and different from others, have been chosen to perform special tasks, or are being given special sorts of information. Delusions of guilt or sin involve beliefs that you are unforgivable and/or should be punished.  Erotomanic delusions involve beliefs about others being in love with you. Delusions of reference involve placing unusual significance on specific objects, people, or events in your environment. 

Psychosis is not a mental health diagnosis, but rather a set of symptoms that accompany a diagnosis. Schizophrenia, schizophreniform disorder, and brief psychotic disorder are three diagnoses distinguished only by the duration of time symptoms have been present. They each include either hallucinations or delusions, may include disorganized speech and/or behavior, and may include what's called "negative symptoms" which manifest as lack of emotional or behavioral expression. Negative symptoms include decreased interest in activities, decreased speech, decreased social interaction, or decreased ability to experience pleasure.  Schizoaffective disorder involves the symptoms of schizophrenia listed above, with an accompanying mood disruption like depression or mania.  Delusional disorder involves delusional thinking without the symptoms listed above that indicate schizophrenia-related disorder. Depression and bipolar disorder in their most severe forms can include psychosis as well. 

Psychosis can be induced by substance use, and usually pass once intoxication passes. Most notably, methamphetamine, hallucinogens (particularly synthetics like K-2), and stimulants like cocaine can induce symptoms that look like psychosis. Acute alcohol withdrawal can also produce psychotic-like symptoms, and should be treated immediately.  

Some medical conditions may also induce psychosis. The most notable conditions in which this may occur are endocrine and metabolic disorders, autoimmune disorders like lupus, and temporal lobe epilepsy. 

Stay tuned for another post on treatments available for disorders that include psychosis. In the meantime, here is a helpful page from the National Institute of Mental Health on schizophrenia.