Psychosis is an abnormal psychological state that involves disruptions in fundamental aspects of brain functioning such as cognition, perception, processing, and emotion. Historically, psychosis was used to refer to any mental health condition that interfered with normal functioning. In contemporary psychology, however, it is most commonly used to describe an episode that causes someone to disconnect in some way from reality. Individuals experiencing symptoms of psychosis may find it helpful to seek treatment from a mental health professional.
For a psychotic episode to be diagnosed, the symptoms must include some departure from reality. Someone who is deliberately acting abnormally is not having a psychotic episode. Symptoms can include:
- Extreme emotions, particularly aggression and sadness
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- Disorganized or incoherent speech
- Attempts to harm oneself or others
- False beliefs
Psychosis is most commonly associated with schizophrenia, a severe psychiatric condition that may cause an ongoing loss of contact with reality. Other mental health conditions that may sometimes cause psychosis include major depression and bipolar. Substance abuse and chemical withdrawal have also been known to lead to psychosis, as have some medical conditions such as Parkinson’s disease and Alzheimer’s. Severe infection that has spread to the brain, epilepsy, stroke, and the late stages of AIDS also have the potential to cause psychotic episodes, although psychosis is not characteristic of these illnesses.
In rare cases, psychosis may occur in women after childbirth, generally in the first two weeks after delivery. Postpartum psychosis is linked to postpartum depression, but it is far more rare, occurring after only about .1% of births. Risk factors include a previous psychotic episode, bipolar, or a family history of bipolar. The condition is both temporary and treatable, but it is serious: There is a 5% suicide rate associated with postpartum psychosis, and a 4% infanticide rate. Symptoms of postpartum psychosis include delusions, hallucinations, and irrational judgment, and they may be severe. Although most women who develop postpartum psychosis do not harm themselves or others, in some cases the condition leads to suicidal thoughts or behaviors that harm the self or others. Women demonstrating symptoms of postpartum psychosis should seek out professional medical, mental health, or emergency services immediately.
Treatment for psychosis depends upon its cause. When there is an underlying medical cause, treatment may focus on that illness instead. Infection-related psychosis requires broad-spectrum antibiotic treatment, usually through an IV. In some cases, psychiatric drugs such as antidepressants and anti-anxiety medications may be used to treat conditions that can lead to psychosis. Antipsychotic medications, electroconvulsive therapy, and anti-seizure medication may also effectively treat psychosis. Recent research indicates that early medical intervention can effectively prevent severe psychosis and ongoing episodes of psychosis.
Unfortunately, the false beliefs associated with psychotic episodes can often act as barriers to treatment. People with psychosis may refuse medication or stop taking their medication, and in some cases they must be hospitalized before treatment can continue.
Because psychosis causes disrupted thought patterns, people experiencing psychosis can sometimes be a danger to themselves or others. Inpatient treatment is temporary treatment that ensures the safety of a person who has psychotic symptoms. During hospitalization, a person might obtain a diagnosis, get help managing both medication and its side effects, and develop a course of treatment, which may include therapy, medication, and/or behavior management, to deal with the effects of psychosis. Some residential treatment facilities offer longer-term strategies to those in treatment, teaching things such as life skills, conflict management, stress management skills, and other tactics for coping with psychosis.
Therapy for psychosis often works best when combined with medication, although this is not always the case. A therapist can help a person who is experiencing psychosis recognize their condition, employ coping strategies, and stick to a treatment plan.
Psychosis can often take a heavy toll on a person’s self-image and social life, and a therapist can help him or her navigate the aftermath of a psychotic episode, repair damaged relationships, and develop coping skills for future episodes. Group therapy or support groups may also offer a person who experiences psychosis an opportunity to relate to and support other people who have been through similar experiences.
Family interventions, where families participate in therapy sessions along with the person experiencing psychosis, have been found to reduce the relapse of psychotic episodes. This type of therapy aims to improve family relations, and the family is encouraged to become a type of therapeutic agent to the person in treatment. Family members may have the opportunity to see the therapist in individual sessions as well.
Media portrayals of mental illness are often inaccurate, including distortions and exaggerations of the symptoms of mental health conditions, as well as incorrect and inconsistent descriptions of particular mental illnesses. In film and television, for example, mental health conditions such as bipolar or schizophrenia are often linked to violent tendencies, even when violence is not typical of the condition being depicted. This kind of representation can lead to further stigmatization of mental health issues, and this is especially true of psychosis, which is frequently confused with psychopathy.
Although violence is not always a symptom of psychosis, violent individuals depicted in the media are sometimes termed psychotic. The Joker, for instance, a character in the Batman universe, is often described as psychotic when he actually shows symptoms of psychopathy, according to mental health professionals. These two conditions are often combined or correlated incorrectly, leading to an inaccurate understanding of psychosis, which could potentially delay diagnosis and treatment of the condition, possibly causing symptoms to worsen.
The 2010 film Black Swan depicts a ballerina, Nina, who experiences psychosis, and although some psychiatrists point out that the film does depict psychosis fairly accurately, Nina also suffers from other mental health issues that do not tend to accompany psychosis, such as visual hallucinations, an eating disorder, and obsessive-compulsive behavior. Even though the portrayal of psychosis might be realistic, the depiction of overlapping mental health issues that are not necessarily directly linked may still be misleading to some.
- Burns, T. (2010). Early intervention in psychosis. The British Journal of Psychiatry, 197(5), 415-415. doi: 10.1192/bjp.197.5.415.
- First Episode Psychosis: An Information Guide. (2012). Retrieved from http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/psychosis/first_episode_psychosis_information_guide/Pages/fep_treatment.aspx.
- Garety, P. (2003). The future of psychological therapies for psychosis. World Psychiatry, 2(3), 147-152.
- James, S. (2010, December 20). 'Black Swan': Psychiatrists Diagnose Ballerina's Descent. Retrieved from http://abcnews.go.com/Health/Movies/black-swan-psychiatrists-diagnose-natalie-portmans-portrayal-psychosis/story?id=12436873.
- McCarthy, J. (n.d.). Talk therapy for psychosis recommended. Retrieved from http://www.irishhealth.com/article.html?id=13951.
- Moye, D. (2011, July 21). Batman Villains Psychoanalyzed By Mental Health Experts. Retrieved from http://www.huffingtonpost.com/2011/07/21/batman-villains-psychoanalyzed_n_901913.html.
- Postpartum Psychosis. (n.d.). Retrieved from http://www.postpartum.net/learn-more/postpartum-psychosis.
- Psychosis. (n.d.). The New York Times Health Guide. Retrieved from http://health.nytimes.com/health/guides/disease/psychosis/overview.html.
- Velligan, D. I. (n.d.). Cognitive behavior therapy for psychosis: Where have we been and where are we going? Retrieved from http://www.medscape.com/viewarticle/708327.
Last updated: 07-03-2015
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