What Is Psychosis?

What Is Psychosis? Symptoms, Causes, and Treatment

Psychosis is a psychological condition that significantly affects how a person perceives and interprets reality. Someone experiencing psychosis may understand events differently from those around them, hear or see things that others do not, or develop strong beliefs that are not consistent with available evidence. These experiences can affect the person’s thoughts, emotions, behaviour, relationships, and ability to manage everyday life.

Psychosis is not a specific diagnosis in itself. Instead, it is a term used to describe a group of symptoms that may occur in different psychiatric or medical conditions. Psychotic symptoms may be associated with schizophrenia, bipolar disorder, or severe depression. They may also develop in connection with certain medical conditions, medications, sleep deprivation, or substance use. Experiencing psychosis, therefore, does not necessarily mean that a person has schizophrenia.

What Are the Symptoms of Psychosis?

Psychosis does not affect everyone in the same way. The type, intensity, and duration of symptoms can vary considerably. The most commonly recognised symptoms of psychosis include hallucinations, delusions, and disorganised thinking or speech.

Hallucinations

A hallucination is a sensory experience that occurs without an external stimulus. A person may hear, see, smell, taste, or feel something that others do not experience. Hearing voices is one of the most common examples. The voices may appear to comment on the person’s actions, speak about them, or instruct them to do something.

These experiences can feel completely real to the person. Dismissing, mocking, or aggressively challenging what they are experiencing may increase their fear, distress, or sense of isolation.

Delusions

Delusions are strongly held beliefs that remain unchanged despite evidence that does not support them. For example, a person may believe that they are being followed, that someone intends to harm them, that others can read their thoughts, or that television programmes contain messages specifically intended for them.

A delusion is more than simply having incorrect information or an unusual opinion. It is connected to a change in the person’s ability to interpret reality and may not respond easily to logical explanations.

Disorganised Thinking and Speech

During psychosis, a person may find it difficult to organise their thoughts or maintain a clear conversation. They may move rapidly between unrelated subjects, provide answers that do not appear connected to the question, or communicate in a way that others find difficult to understand.

Concentration, decision-making, and the ability to complete everyday responsibilities may also be affected. Other possible signs include social withdrawal, reduced emotional expression, disrupted sleep, increased suspiciousness, neglect of personal care, and a noticeable decline in work or academic performance. However, these changes alone are not sufficient to determine that someone is experiencing psychosis.

What Causes Psychosis?

Psychosis does not usually have one single cause. Genetic vulnerability, brain development, psychological factors, stressful experiences, physical health, and environmental conditions may all contribute to its development.

Conditions and circumstances associated with psychosis may include:

•⁠  ⁠Schizophrenia and schizoaffective disorder

•⁠  ⁠Manic or depressive episodes in bipolar disorder

•⁠  ⁠Severe depression with psychotic features

•⁠  ⁠Traumatic experiences or intense stress

•⁠  ⁠Severe and prolonged sleep deprivation

•⁠  ⁠Alcohol or psychoactive substance use

•⁠  ⁠Side effects of certain prescription medications

•⁠  ⁠Neurological, hormonal, or other medical conditions

For this reason, a professional assessment should consider not only psychological symptoms but also the person’s physical health, medication use, sleep patterns, and history of alcohol or substance use.

Are Psychosis and Schizophrenia the Same?

Psychosis and schizophrenia are not the same. Psychosis is a general term describing symptoms that involve some degree of altered contact with reality. Schizophrenia is a particular psychiatric disorder in which psychotic symptoms may occur.

A person may also experience psychosis as part of bipolar disorder, severe depression, substance use, or a medical condition. Some people experience only one psychotic episode, while others may have recurring symptoms. A comprehensive assessment by a qualified mental health professional is necessary to understand the nature and possible cause of the symptoms.

How Is Psychosis Treated?

The treatment of psychosis depends on its underlying cause, the severity of the symptoms, and the individual’s particular needs. Treatment commonly involves a combination of psychiatric assessment, medication when clinically appropriate, psychological therapy, family support, and assistance with social or practical needs.

Psychotherapy may help the person understand their experiences, identify possible triggers, manage stress, develop coping strategies, and gradually rebuild their everyday functioning. Family interventions can also help relatives understand the condition, improve communication, and respond to symptoms in a more supportive manner.

However, particularly during an active psychotic episode, psychotherapy does not replace psychiatric assessment or necessary medical treatment. Collaboration between psychiatrists, psychologists, the individual, and their support network may provide a more comprehensive approach.

Early intervention is particularly important. Research indicates that receiving appropriate treatment soon after psychotic symptoms begin may improve the likelihood of clinical recovery and better functioning in everyday life. 

How Should You Respond to Someone Experiencing Psychosis?

When speaking with someone who may be experiencing psychosis, it is important to remain calm and avoid judgement. You do not need to confirm the person’s interpretation of events in order to acknowledge their emotions. A response such as, “I understand that this feels very real and frightening for you,” may be more supportive than arguing about whether the experience is real.

Blaming the person, making fun of their experiences, or attempting to force them to change their beliefs can make communication more difficult. Instead, focus on creating a safe environment, listening respectfully, and encouraging them to seek professional help.

When Is Urgent Help Necessary?

Urgent support should be sought if the person is considering harming themselves or someone else, hears voices instructing them to cause harm, is unable to meet their basic needs, appears extremely frightened, or seems to have lost control of their behaviour.

The course of psychosis differs from person to person. With a comprehensive assessment, early intervention, and an individualised treatment plan, symptoms can be managed and daily functioning can improve. When psychosis is suspected, the first step should be to obtain a psychiatric evaluation as soon as possible.

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