Psychosis occurs when a person’s ability to comprehend reality changes. It is a primary symptom of many other mental health disorders, including some substance abuse problems. A person struggling with psychosis does not experience a complete break from reality, but changes in their perceptions mean that it is difficult for them to recognize what is real and what is not. As many as three in every 100 people will experience psychosis at some point in their lives, and about 100,000 young people in the United States experience psychosis every year.
What Are The Signs of Psychosis
- False beliefs
- Confused thinking
- Changes in feelings
- Changes in behavior
What Are The Phases of Psychosis?
- Early Warning Signs
- Acute Phase
- Recovery Phase
What Are The Causes of Psychosis?
- Schizophreniform Disorder
- Schizoaffective Disorder
- Bipolar Disorder
- Delusional Disorder
- Organic Psychosis
- Psychotic Depression
- Postpartum Psychosis
- Brief Psychotic Disorder
- Substance Abuse Related
Common Signs of Psychosis
There are five general categories of symptoms that indicate psychosis. A person may not experience all of these, but may display a few symptoms.
Phases of Psychosis
There are generally three stages to psychosis. It is important to help a person who is experiencing early warning signs as soon as possible, but due to the person’s wish to withdraw from the world in most cases, this can be difficult. Young men, ages 15-30, and less often women ages 18-35, are more at risk of developing psychosis than other age groups. Here are signs and symptoms associated with each phase.
Early Warning Signs, or ProdomePsychosis can be a persistent symptom of a larger problem, or it can occur one time (first-episode psychosis) and be successfully treated after the underlying cause is discovered. However, psychosis does not typically come out of the blue; most often, there are early warning signs that psychosis will occur. Early warning signs of psychosis include:
- Decline in job or school performance
- Difficulty concentrating
- Cognitive difficulties or an inability to think clearly
- Uneasiness around other people
- Suspicion of people, places, or things
- Decline in personal hygiene and self-care
- Spending more time alone
- Loss of emotional reaction, or strong reactions that are inappropriate to the situation
- Changes in perception (sight, taste, or touch) that are radically different from others’ perspectives
- Confused speech or difficulty communicating
- Unusual or intense new ideas, especially if the individual did not think this way before
There are also symptoms associated with the first episode of psychosis. While many people may believe that psychotic symptoms are easy to identify, a person who experiences this first episode may try to hide the symptoms or mistakenly believe they will go away without help. It can help if loved ones understand that first-episode psychosis is not grandiose or easy to pinpoint.
This phase of psychosis is the most recognized and will continue until the person receives appropriate treatment. Symptoms of acute psychosis include:
Many people recover from psychotic episodes with appropriate treatment. Even if they have a condition that puts them at risk of experiencing another episode, the severity of these can be controlled with medication and therapy. Treatment includes helping the person understand the difference between the symptoms of psychosis and the reality around them.
Causes of Psychosis and Associated Symptoms
There are several different conditions that can lead to psychotic symptoms. Dramatic changes in brain chemistry, brain structure, or hormones can lead to psychotic symptoms, both temporary symptoms and more permanent symptoms. Here are a few conditions that cause psychosis and the symptoms associated with them.
Schizophrenia: Most people associate the symptoms of schizophrenia with psychosis, and this is one of the major signs of this disorder. Schizophrenia is typically diagnosed by monitoring the experience of psychotic symptoms; if the person experiences psychosis for at least six months, they are likely experiencing schizophrenia.
Schizophreniform disorder: This is the experience of psychosis for less than six months. This condition may resolve itself, or it may develop later into other psychological disorders.
Schizoaffective disorder: This involves the occurrence of symptoms of both schizophrenia and a mood disturbance, either alternating or co-occurring.
Bipolar disorder: Mood disturbances and thought disturbance are the primary characteristics of psychosis in bipolar disorder. Hallucinations and delusions are rare, although they may occur during manic periods. During depressed periods, the person may hear voices that talk negatively to them.
Delusional disorder: This involves the experience of strong, persistent false beliefs. This condition typically does not have hallucinations associated with it, but changes in speech, action, beliefs, and emotions are present.
Organic psychosis: Damage to the brain due to head injury or a physical illness that changes brain structure can lead to long-term psychotic symptoms. Brain tumors, HIV/AIDS, some types of epilepsy, strokes, and other organic changes to the brain can affect specific areas, leading to perceptual, emotional, behavioral, and personality changes.
Dementia: Both Alzheimer’s disease and Parkinson’s disease lead to changes in brain chemistry and brain structure that can sometimes trigger psychotic reactions or symptoms.
Psychotic depression:This subtype of major clinical depression is defined by classic symptoms of depression, along with symptoms of psychosis. Symptoms include:
Postnatal or postpartum psychosis:This type of psychosis most often occurs in new mothers, although sometimes new fathers can experience milder symptoms. Postpartum psychosis is an extreme form of postpartum depression, and it affects roughly one out of every 1,000 new mothers after birth. Symptoms become most apparent a few weeks after the baby is born. Symptoms include:
Brief psychotic disorder:A major stress in a person’s life, such as sudden loss of a loved one, an experience of war or terrorism, or something equally devastating, can cause psychotic symptoms that resolve themselves. These symptoms usually last less than a month.
Substance abuse: Drug addiction and abuse can change the brain’s chemistry and sometimes the brain’s structure. This can lead to psychosis and, in some people, may trigger pre-existing conditions like schizophrenia or bipolar disorder, which, if untreated, can lead to psychosis. Substances that can lead to psychotic symptoms include:
Alcohol: Alcohol withdrawal syndrome, or delirium tremens, can include psychotic symptoms, such as hallucinations, paranoia, delusions, and extreme emotional changes.
Caffeine: Although it is unlikely that a person could take a large enough dose of caffeine to truly harm the brain, people who are predisposed to panic attacks or psychosis may have those symptoms triggered if they chronically ingest caffeine. Additionally, drinking a lot of caffeine can be a form of self-medicating depression and insomnia.
Cocaine and amphetamines: These powerful stimulants can, in large doses, induce psychosis while the person is intoxicated. When the person attempts to detox from these substances without medical supervision, they may experience anhedonia or a lack of emotion, that is tied to a longer lasting psychosis. Binges or long-term abuse of these drugs can lead to changes in the brain that can cause permanent psychosis.
Hallucinogens: LSD, mushrooms, and other hallucinogens can trigger psychosis in people predisposed to mental illnesses like schizophrenia or bipolar disorder. Although it is rare, people who abuse hallucinogens for a long time may also change their brain structure enough to develop permanent psychosis.
Opioids: Post-acute withdrawal syndrome from opioid drugs may lead to some symptoms of psychosis, including hallucinations.
Sedatives: Benzodiazepines in particular can lead to a post-acute withdrawal syndrome that features symptoms of psychosis, such as anxiety, paranoia, emotional changes, delusions, and hallucinations.
Nicotine: People who struggle with addiction to cigarettes or nicotine in other forms are more likely to also experience depression, although it is difficult to tell which came first. However, smoking or ingesting nicotine products may be associated with psychotic depression.
Marijuana: Using this drug can trigger psychosis in people who are predisposed to the condition, especially schizophrenia or bipolar disorder. Long-term abuse of marijuana has been linked to brain changes that can induce psychosis, especially paranoia and delusions.