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Psychosis

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 discuss them with a therapist.

Symptoms of Psychosis

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
  • Hallucinations

What Causes Psychosis?

Psychosis is most commonly associated with schizophrenia, a severe mental illness that may cause an ongoing loss of contact with reality. Other psychiatric 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 can some medical conditions such as Parkinson’s disease and Alzheimer’s. Severe infection that has spread to the brain, the late stages of AIDS, stroke, and epilepsy also have the potential to cause psychotic episodes, but psychosis is not characteristic of these illnesses.

Treatment for Psychosis

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. 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.

 

The false beliefs of people experiencing psychotic episodes are frequently 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.

Therapy for 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 are seen as well as the person experiencing psychosis, both with him or her and separately, have been found to reduce the relapse of psychotic episodes. This type of therapy aims to improve family relations, as the family is encouraged to become a type of therapeutic agent to the person in treatment.

Inpatient Treatment for Psychosis

Because psychosis causes disrupted thought patterns, at times people experiencing this symptom can 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.

 

References:

  1. Burns, T. (2010). Early intervention in psychosis. The British Journal of Psychiatry, 197(5), 415-415. doi: 10.1192/bjp.197.5.415.
  2. 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.
  3. Garety, P. (2003). The future of psychological therapies for psychosis. World Psychiatry, 2(3), 147-152.
  4. McCarthy, J. (n.d.). Talk therapy for psychosis recommended - irishhealth.com. Iris Health. Retrieved from http://www.irishhealth.com/article.html?id=13951.
  5. Psychosis. (n.d.). The New York Times Health Guide. Retrieved from http://health.nytimes.com/health/guides/disease/psychosis/overview.html.
  6. Velligan, D. I. (n.d.). Cognitive behavior therapy for psychosis: Where have we been and where are we going? Medscape. Retrieved from http://www.medscape.com/viewarticle/708327.

 

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Last updated: 03-23-2015

     

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