Psychosis: Types, Signs & Symptoms, Causes, Treatment and Prevention Guide

What is Psychosis?

Psychosis is an abnormal mental condition of brain; it is associated with a serious mental disorder which involves “a loss of contact with reality”. In this chronic mental disorder, an impaired relationship with reality may develop hallucinations or delusions. People experiencing psychosis may develop thought disorder and difficulty with social interaction, which ultimately damages the general life of affected people and hinder them to carry out day-to-day activities.

The term ‘psychosis’ is generally attributed to abnormal negative signs in people might hallucinate and delusion the none-existing things and is to be noted that they have firm delusional beliefs which cannot be shaken without getting proper medical and psychological treatments. Psychosis, the symptom of mental illness can be considered as biological descriptive term for hallucinations and delusions which further characterized by impaired relationship with reality and real world, which may create noticeable deficits in people experiencing psychosis. [1]

Types of Psychosis

Following are the different types and circumstances of psychosis, which occur usually due to different reasons (known and unknown) but stress and sudden trauma is mostly the cause of development of psychosis, a symptom of psychiatric illnesses.

1- Schizophrenia

Schizophrenia is a serious mental disorder which disrupts the functioning of human brain. It disables the brain to understand what is real and develops abnormal social behavior of adapting false belief, confused thinking, and lack of motivation, social withdrawal and hearing voices that others do not hear. [2]

Read more

Paranoid Schizophrenia - Causes, Signs Symptoms,‎‎ Treatment & Prevention Help Guide

2- Bipolar Disorder

Bipolar Disorder is an abnormal mental condition which involves extreme shifts of moods and the mood elevations involve severe mania (mental illness of madness), hypomania and depression. These unusual mood swings damages the thinking potential and reasoning ability of affected people with Bipolar Disorder. As these dramatic shifts in mood and energy from high of manic episodes (lunacy) to low of depression can disturb the social life and creates unhealthy decisions and actions with less concern of consequences.
Read more About Bipolar Disorder 

3- Drug-Induced Psychosis

Drug-Induced Psychosis is characterized by the presence of hallucinations and delusions, and this condition can last up to few days. Drug-Induced Psychosis develops due to over-consumption of amphetamines and cocaine or it might develop due to continuous intake of substance abuse (drugs and alcohol). In drug-induced psychotic episode the drug abused loses touch with reality and their surroundings and may suffer from delusions and memory loss. According to Psychiatric Times, approximately 74 percent of people in one study experiencing their first episode of psychosis had a substance use disorder at some point in their lives, and 62 percent were currently abusing drugs or alcohol. [3]

4- Severe Depression

Severe depression can be referred as Major Depressive Disorder in psychological terms and it is a serious mental disorder of sadness and depression which last up to 2 weeks at least. Severe depression is accompanied by lack of interest in pleasant activities, low self-esteem, low energy and physical pain with no clear cause. In severe cases of severe depression, people having major depressive disorder might experience false beliefs (hallucinations) and see or hear things that other cannot.
Severe depression affects social life i.e. work, school, job as well as sleep, eating habits and general health. It’s been estimated that about 2-7% of adults die by suicide, facing major depressive disorder (severe depression) [4]

Severe depression includes ‘Postnatal depression’, a mental condition of depression that many women experience after having a baby. In some cases, this clinical depression can affect both sexes (parents) after childbirth.
According to a study, 0.5 to 61 % women will experience depression after delivery. [5]

5- Brief Reactive Psychosis

Brief Reactive Psychosis is a short-term display of psychotic behavior with obvious stressor. This sudden and brief condition usually occurs with a stressful event. The psychotic behavior of delusions, speed disorders and hallucinations typically last for a day or a month only, damaging normal functioning of a person in social and general life, but it is reported that there is often a quick recovery in case of brief reactive psychosis. [6]

6- Organic Psychosis

Organic Psychosis is formerly known as organic brain syndrome, which triggers abnormal brain function that is usually caused by known physical abnormality that might be organic disease (embolism, infection, tumor or trauma) of brain in most cases. Organic Psychosis is usually developed by damage to the brain by structural defects or physiological dysfunction of the brain. However this mental illness affects the brain and precipitates hallucinations and delusions, the damages can be temporary or permanent, depending on the severity of diseases to the brain.

Resulting in the combination of other mental disorders i.e. Schizophrenia and bipolar disease, Organic psychosis lasts for hours, days or weeks and as it is a psychotic condition of mental illness, it results in abnormal psychotic behaviors which involves loss of ability to test the reality and surroundings.

Signs and Symptoms of Psychosis

Psychosis, the mental disorder affects an individual’s thoughts, feelings and social behavior, it is a chronic mental condition which enables the brain to precipitates hallucinate the unrealistic things and delusion the non existing facts which do not really exist in reality.
Narrating the signs and symptoms of psychosis that people may experience, one or more depending on the severity of case;

1- Hallucinations

According to Online Etymology Dictionary, ‘Hallucination’ can be referred as “a seeing or hearing something which is not there”.
A person affected with psychosis may hallucinate (wandering in the mind) and sees, hears, smells, tastes and feels the unrealistic things that does not exist in reality, but inside their mind. No doubt, hallucinations are different from illusions but it involves experiencing complex tactile sensations which none exist and hearing voices (auditory hallucinations) which no other per son can hear. 

2- Delusions 

Delusions are unshakable false beliefs which a person having psychosis firmly believe and their false beliefs cannot be altered without proper medications and consultancy of a professional psychologist. Psychotic delusions include paranoid and grandiose delusions which are untrue and difficult for normal people to understand.

• Paranoid Delusions- It may cause the affected person to believe unduly suspicious individuals or organizations, which might harm or kill them.
• Grandiose/Grandeur Delusions- They are completely false but strong belief of psychotic patients which induces them to believe having super power and special authorities, for instance, they might consider them a goddess of Narnia or president of US. [7]

Other Recognized Signs of Psychosis

• Depression and anxiety issues
• Lack of spontaneity and responsiveness
• Decreased interest to take initials
• Reluctant to pleasurable activities and low level of motivation
• Sleep problems i.e. too much sleeping or inadequate  sleep
• Lack in ability to concentrate, reason , thinking etc
• Social withdrawal: Reduction in communication, lack of expressiveness and decreased self-esteem
• Suicidal thoughts , no interest to involve in other people and no motivation to stood up
• Obsessive thinking  and distorted perceptions

Causes of Psychosis

Following are some identified psychotic conditions (primary causes) which are considered responsible to trigger psychotic disorder or psychosis: [8]

1-  Schizophrenia

Schizophrenia is a serious mental illness which drastically affects a person’s thinking, feelings and behavior. It incites the people to develop hallucinations and delusions along with false beliefs, hearing voices that others do not hear and confused thinking. [9]

2-    Bipolar Disorder

Bipolar disorder is a brain disorder, associated with mental illness of mania and depression. It involves extreme mood swings from high manic episodes of mania to low mood of depression and it drastically affects a person’s social life and may cause abnormal behaviors. In bipolar disorder, manic (madness) phase last up to weeks or months and depression may last for days or weeks respectively. The cycle of mood swings from high of mania (mental illness of lunacy) to low of depression (sadness and hopelessness) may cause risk of suicidal thoughts in affected people. [10]

Other causes:

•    Psychosis may develop in result of brain diseases i.e. Parkinson’s disease, Huntington’s disease, and some chromosomal disorders , brain tumors or cysts,
•    Apart from these diseases which affects the structure of brain, psychosis can also be developed due to some types of dementia such as Alzheimer’s disease
•     Including HIV, syphilis, and other infections that attack the brain
•    some types of epilepsy
•    Adverse life experiences

How psychosis is diagnosed?

 As a matter of fact there is any proper medical or clinical method through which psychosis can be diagnosed. As it’s a mental illness of abnormal behaviors, Diagnosis of Exclusion is carried out in which the psychiatrist questions about complete details from history, examination or testing.

However the psychologists ask about certain symptoms and abnormalities in the initial assessment, which involves the general following questions:

• Details of hallucinations and voices.
• Mood swings
• Medications, if you are taking any.
• Family history, if anyone of your close relative ever suffered from mental health conditions, such as schizophrenia.

Clinicians may perform some blood tests to measure medical illness which are associated with psychosis i.e.
Serology to exclude syphilis or HIV infection, Full blood count including ESR to rule out a systemic infection or chronic disease, Basic electrolytes and serum calcium to rule out a metabolic disturbance and Thyroid stimulating hormone to exclude hypo- or hyperthyroidism.

Early diagnosis of psychosis is very crucial and is important to recognize the symptoms of psychosis. To avoid misdiagnosis , Delirium should be make the real consideration to determine the visual hallucinations and differentiate acute onset and fluctuating level of consciousness, indicating other underlying factors, including medical illnesses. [11]

Epidemiology and Facts About Psychosis

•    In USA, About 100,000 adolescents and young adults experience first episode psychosis each year. [12]

•    In 2007, approximately 3% of Australians are affected by psychotic illness; such as schizophrenia, where there is a loss of contact with reality during episodes of illness .[13]

Global Epidemiology of Mental Disorders/ Schizophrenia, Bipolar Disorders and Depressive Disorders. [14]

Treatment of Psychosis

In ancient times, psychosis was treated through trepanning, as archeologists have found skulls with clearly visible drillings, some datable back to 5000 BC.
For the treatment of psychosis, exorcism is still considered an option to nullify the demonic possession as many religious scholars consider psychotic symptoms as demon spells.[15]

Medication To Treat Psychosis:

Nowadays, psychosis and psychotic symptoms are being treated by antipsychotic medication, specialist psychological therapies and community support program to help with social connection, physical health, accommodation and work or school. Since 1952, antipsychotics (also commonly known as neuroleptics) are used in the treatment of psychosis and various mental illnesses i.e. schizophrenia, bipolar disorder, neurological major depressive disorder, anxiety disorders, dementia, and some autism spectrum disorders. [16]

However, in 1963, clinical trials remarked harsh consequences of antipsychotic which included high rates of often irreversible Parkinsonian symptoms such as tardive dyskinesia. While atypical antipsychotics (also known as second generation antipsychotics) showed comparable response rate but a far different, though still extensive, side-effect profile that included a lower risk of Parkinsonian symptoms but a higher risk of cardiovascular disease. Since then atypical antipsychotics are used to block dopamine that is the primary neurotransmitter implicated in psychotic symptomology.

Atypical antipsychotics block the dopamine receptors (namely, the dopamine D2 receptors) and decrease the dopaminergic activity. According to a recent study "From dopamine to salience to psychosis—linking biology, pharmacology and phenomenology of psychosis”, Schizophrenia Research 2005, decrease in dopaminergic activity does not eradicate psychotic delusions or hallucinations, but rather attenuates the reward mechanisms involved in the development of delusional thinking; that is, connecting or finding meaningful relationships between unrelated stimuli or ideas.

Cognitive behavioral therapy

Cognitive behavioral therapy engages the affected person to talk with mental health counselor with the goal of changing thinking and behaviors. This talk therapy maximizes the patient's ability to get back to normal life and reduce time between appearance of symptoms and initiating therapy. This approach is often helpful for psychotic symptoms that don’t completely
Resolve with medications and enhance the chances to
Accelerate remission and prevent relapse.[17]

Psychosis can be treated with 100% success rate with a combination of antipsychotic medicines, psychological therapies, and social support.

Social support for psychosis:

Social interactions of family and friends can be a key component of the recovery process from psychosis. As it drastically push the person to suffer loneliness and social withdrawal. Social support may include family talk therapy which engages the family members and the affected person to talk about signs and symptoms of psychosis and they try to come over the negative feelings of hallucinations and delusions in a productive way. Patients are often suggested to have pets and make friends which really pull them out of difficult feelings of loneliness and isolation.
Treatment of psychosis may continue for 2 -5 years and it is all about feeling better and connects with the real world. 

Real Life Success Story of Psychosis/ Recovery from psychosis

An anonymous person has shared her successful recovery after a treatment of medications and consulting a psychiatrist. According to him, he was suffering from hallucinations and delusions for 5 years and he got recovered in a year after seeking a psychiatrist. He states that; “Having a mental illness is not the end of the world, by any means, 1 year later and I'm doing well, I'm probably just about back to normality. Just keeping physically healthy helps and I'm working on the rest.” (Walter)
Click the link below to read the full story of a real hero, who stood against the psychotic symptoms and worked out to get through the  non existing realities.

Reference

1. GP Guidance: Emerging Psychosis & Young People - What You Need to Know
2. gov Schizophrenia Information
3. Emma Barkus, PhD, The Link Between Psychotic Disorders and Substance Use January 01, 2007 in Psychiatrictimes Journal
4. Virginia A. Lynch, Janet Barber Duval Forensic Nursing Science - E-Book
5. gov Depression information
6. Linda Edelstein Writer's Guide to Character Traits 09-Aug-2006 F & W Media, Inc. p. 117. ISBN 9781582973906.)
7. Healthline Topic Psychosis
8. The ICD-10 Classification of Mental and Behavioural Disorders Word health Organocation EBOOK
9. The ICD-10 Classification of Mental and Behavioural Disorders Word health Organocation EBOOK
10. Ian M Anderson, professor of psychiatry1, Peter M Haddad, Clinical Review Bipolar disorder, Published 27 December 2012 BMJ 2012;345:e8508
11. Christian Nordqvist, What is Schizoaffective Disorder? In Medicalnewstoday Mon 8 August 2016
12. Fact Sheet: First Episode Psychosis in NIH
13. Facts and stats about mental illness in Australia
14. Amanda J. Baxter Global Epidemiology of Mental Disorders: What Are We Missing? June 24, 2013
15. Vlachos I.O. · Beratis S. · Hartocollis P. Magico-Religious Beliefs and Psychosis Psychopathology 1997;30:93–99
16. Maher AR, Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis. 2011 Sep 28;306(12):1359-69. doi: 10.1001/jama.2011.1360.
17. Psychosis and schizophrenia in adults: prevention and management , The National Institute for Health and Care Excellence February 2014

Sources:

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Statistic, New data is provided by different authentic websites along with reference, you may consult with each respective owner. 

Disclaimer:

The information provided on  Psychosis is provided for information and education purpose only, don't use this guide for diagnosis or medical treatment options, if you feel any discomfort or Psychosis symptoms, consult your psychiatric,