Psychosis is an abnormal condition which affects the way the brain processes information. It is not an illness in itself, but a symptom. 3% of the US experience psychosis at some point in their life and as many as 100,000 each year have their first episode. People with psychosis lose touch with reality and don’t know what is real vs. not real. Psychosis is more likely to affect young people. If caused by a psychotic disorder, it usually presents in the late teens and early adult years.

Psychosis doesn’t usually come on suddenly, but rather it follows a pattern. There are usually warning signs before the first psychotic episode.

Some warning signs before a psychotic episode include:

– gradual changes in a person’s thinking or understanding of the world
– lower performance on the job or in school
– trouble thinking clearly and concentrating
– suspiciousness
– lack of self care (personal hygiene)
– spending more time alone
– showing stronger emotions than usual
– having no signs of emotion

Psychosis will often show early signs like the following:

– hearing, seeing and tasting things that others don’t
– having unusual or false beliefs
– stop caring for yourself
– unable to think clearly or pay attention
– social withdrawl
– lack of motivation
– difficulty functioning
– depression, anxiety
– sleep problems
– inappropriate behavior

Full on psychotic episodes will include the above plus:

Hallucinations
– auditory – hearing things
– tactile – strange sensations or feelings that can’t be explained
– visual – see people/things that aren’t there, or things look wrong

Delusions
– outside forces are in charge of their feelings/actions
– small events/comments have huge meanings
– believe they have special powers, on special missions, think they are god

There are several possible causes of psychosis. Often mental illnesses like schizophrenia or bipolar disease, will cause psychosis, but physical illness (medical conditions) can also cause psychosis. Other causes include sleep deprivation, medications, trauma, extreme stress and substance abuse.

Individuals experiencing psychosis need to be seen by a qualified health care professional (psychiatrist, psychologist or social worker) for a thorough assessment and an accurate diagnosis. Doctors look for physical reasons for the symptoms first, and once those are ruled out, they look to mental illness for causes.

It’s important to get early treatment to increase the odds of a successful recovery. Based on research, treatment provided close to the onset of symptoms had greater improvement in symptoms, functioning and quality of life, than those that got treatment at a later time.

There are several treatments available for psychosis. Depending on the causes, early treatment may mean never having another episode. Those experiencing psychosis should be encouraged to seek immediate treatment. If mental illness is the cause of the psychosis, it may require medicine and therapy with a lot of family support.

Treatment will vary based on the basis for the psychosis. Some treatment will include anti-psychotic drugs as well as psychotherapy:

– counseling with medicine typically uses anti-psychotic medications along with different types of counseling to help control behaviors.
– cognitive behavioral therapy requires anti-psychotic medicines and helps to identify when psychotic episodes occur and how to separate real from imagined.
– supportive psychology teaches patients how to live and manage symptoms, by learning healthy thinking.
– cognitive enhancement therapy uses computer exercises and group sessions to help patients think and understand better.
– family psychology education and support helps families work together toward solutions.
– coordinated specialty care is a team approach with doctors, social services, work, education support and medicines.

With immediate attention, psychosis may not result in further mental illness, but left untreated, it is possible that it turns into a diagnosis of schizophrenia or bipolar disorder. Therefore, it’s very important that family and friends take action when they see a loved one acting out of character or oddly.

Ref: National Institute of Mental Health (www.nimh.nih.gov)

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