Psychosis Articles

Medically reviewed by Paige Henry, LMSW, J.D.

Psychosis can be described as an episode that causes a person to lose touch with reality. Rather than being a condition itself, it is usually a symptom of several different mental health disorders. However, you do not have to have a mental illness to experience psychosis. Sleep deprivation, high levels of stress, and other factors can also lead someone to have difficulties in determining what’s real and what’s not. There can also be a difference between one episode of psychosis and chronic psychotic episodes. Here, we’ll explore some of the common symptoms of psychosis, discuss what may cause it, and review its potential treatment options. It can be important to note that while online therapy may be helpful in managing mental health, psychotic episodes should generally be addressed with immediate in-person treatment.

Common causes of psychosis include a number of mental health conditions that were previously classed as mental illnesses. In the DSM 5, the following are classed under “Schizophrenia Spectrum and Other Psychotic Disorders”:

• Schizophrenia
• Delusional disorder
• Drug induced psychosis
• Alcohol induced psychosis
• Schizoaffective disorder
• Schizophreniform disorder
• Schizotypal personality disorder

Psychotic episodes are not only connected with a psychotic disorder or primary psychotic illness. People with other mental health conditions can experience psychotic episodes, including those with mood disorders like bipolar disorder, major depression, and anxiety disorders. 

There are a number of medical conditions that can cause psychotic episodes. When a known illness or use of controlled substances is the cause, it is called secondary psychosis. Experiencing psychosis of this kind may be due to one of the following:

• Brain disorder or brain injury
• Dementia
• Hormone related disorders
• Postpartum psychosis
• Stroke
• Vitamin deficiency
• Infections of the brain or spinal cord

Symptoms of psychosis

Psychosis symptoms can vary depending on a variety of factors, including the condition or illness that’s causing them. The two main symptoms include:

• Delusions, which are false beliefs that an individual will hold fast to, despite plenty of evidence to the contrary. For example, an individual may believe that their brain is being controlled remotely by the government. Someone with grandiose delusions may believe that they are imbued with power from alien forces. 
• Visual, auditory, or tactile hallucinations. This is when the sensory parts of the brain send signals that you are experiencing something that isn’t happening in reality. For example, hearing voices that aren’t there. 

Other symptoms can include suspicion and paranoia, withdrawing from others, difficulties communicating, difficulty thinking clearly, poor concentration, and a lack of personal grooming. 

When a person slips into psychosis, it may be subtle at first. However, with time, it often progresses and involves increasingly uncomfortable symptoms. Some of these symptoms might include the following:

• Visual or auditory hallucinations
• Disordered speech
• Paranoia 
• Derealization
• Agitation
• Disassociation
• Involuntary movements
• Delusions
• Lack of sleep - for example, not sleeping for days at a time

What causes psychosis?

Psychosis can be caused by some mental illnesses, like schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features. However, people can also experience psychosis due to lack of sleep, alcohol or substance misuse, postpartum complications, or extreme stress levels.

Further, psychosis can develop as a side effect of a medication change or withdrawal. For instance, people who take psychiatric medication to prevent psychosis may slip into psychosis by abruptly (or even gradually) stopping their medications. 

If you have psychosis, it can be crucial to reach out to your doctor immediately. Your provider can help ensure that you are safe, and they may need to adjust your treatment plan. Managing psychosis can be a life-long process, but with the right treatment and support system, it can be possible to live a full, healthy life.

What does "psychotic" mean?

In general, psychotic is an adjective that describes actively experiencing psychosis. Some people may use the word "psychotic" in a derogatory way, which can further stigmatize people living with conditions like schizophrenia. There tend to be many misconceptions about psychosis. For example, despite what people may believe, individuals with psychotic disorders may not be inherently dangerous. In fact, people who live with a mental illness are usually more likely to be a target of a crime rather than a perpetrator.

Before using the word "psychotic," it can be important to assess the environment that you’re in and determine whether you’re using it in a factually correct way. Understanding this term and using it in the right manner can help someone with psychosis get proper support and treatment for their condition. 

Stress and psychosis

Although excessive stress generally isn’t healthy for anyone, it can be especially harmful for those experiencing psychosis. If you’re prone to psychotic episodes, minimizing your stress levels can be crucial. You may be able to work on ways to manage these concerns in therapy. Talking to a therapist about your stressors can be freeing and productive, and you and your provider can work together to develop an effective stress-management plan.

Psychosis treatment 

Medication is usually the first line of treatment for psychosis, with the most common option being antipsychotics. Even in low doses, antipsychotics can prevent or manage the symptoms of psychosis and keep them from worsening.

Your diagnosis can greatly affect which medication you can take. For example, if your psychosis is caused by a lack of sleep, one of the first things your doctor is likely to do is improve your sleep hygiene. This could include a structured schedule with a regular bedtime and self-care routine.

Regardless of the type of medication you’re prescribed, it can be vital to keep taking it and avoid stopping it without your doctor’s approval. If you experience any side effects, be sure to report them to your doctor, as some of them can be dangerous. Remember, you may always have the option of changing medications under the guidance of a doctor, but you should never start, stop, or change the way you take medication without first consulting a licensed medical professional.

Treating psychosis typically means treating the underlying cause. A physician or mental health professional will diagnose the underlying disorder, and then proceed with one (or a combination of) several treatment approaches.

These include:

Antipsychotic medications. For certain mental health disorders, a professional will prescribe antipsychotic drugs. These prescription medications are the most common type used to treat psychosis, although sometimes antidepressant medications or lithium can be effective as well. 

Talk therapy. Cognitive behavioral therapy is often used alongside antipsychotic medications for certain mental health conditions. 

Support programs. Many individuals experience psychosis because of substance use disorders, personality disorders, and other conditions. Both early treatment and ongoing treatment often require a team approach, with programs addressing work, social, and family factors. 

Inpatient care. For those with severe cases of psychosis, inpatient care may be necessary for a time to protect themselves and others. 

Psychosis is treatable 

If you're living with psychosis, you may be scared to reach out for help. You might feel like no one will understand what you're experiencing. That's generally not the case, and many medical professionals are skilled at diagnosing and treating psychosis symptoms. You're not alone, and it's okay to reach out for help. Please note that psychosis can be highly treatable, and it's important not to ignore your symptoms. Make sure you see a doctor if you're experiencing psychotic episodes. They may seem scary or overwhelming, but the right treatment can help you manage psychosis.

If you or a loved one has experienced psychosis, it could be beneficial to connect with a mental health professional who understands the impact of losing touch with reality. With online therapy platforms like BetterHelp, you can choose the environment for your sessions. Whether this means participating in therapy from your home, office, or elsewhere, you can have the ultimate say over your therapeutic experience. Being in a safe setting while speaking with your provider may give you the sense of security you need to be vulnerable. Please note that if you’re currently experiencing a psychotic episode, it can be best to seek in-person treatment. However, online therapy can be effective in managing your mental health when you’re not actively experiencing psychotic symptoms.

Research shows that mental health concerns like schizophrenia, which can involve psychotic symptoms, can be addressed effectively using online therapy interventions. In one study, researchers found that online mindfulness-based therapy interventions could reduce symptoms of depression, anxiety, and distressing voices in those living with a schizophrenia spectrum diagnosis. These outcomes generally mirrored the results found with face-to-face mindfulness programs. Mindfulness-based therapy usually works by helping people learn concepts like observation, self-compassion, non-judgment, and acceptance.

Takeaway

In this section, you can read articles about the nature of psychosis and how to manage it in yourself or a loved one. Understanding this condition, which generally involves a disconnection from reality, can be crucial since the symptoms of psychosis may be unfamiliar to some people. There can be many ways to treat and manage psychosis, and a therapist can offer guidance in getting the appropriate support and care. While active psychosis should normally be treated in person, online therapy can be helpful for managing mental health when you’re not actively experiencing psychotic symptoms.