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Understanding Psychosis

Understanding Psychosis, What Is Psychosis?

Watching someone you love struggle is never easy, but seeing a friend or family member experience a psychotic episode can be downright terrifying. Taking the time to learn more about what causes psychosis and what treatment options are available can help you best support your loved one as they work toward improving their mental health and overall well-being. 

What Is Psychosis? 

Psychotic episodes can vary in duration and severity. Some may be brief, lasting just hours or days, while others can persist for months or years if left untreated. A person who is in the middle of a psychotic episode may experience hallucinations, delusions, disordered thoughts/speech, and disorganized behavior.

  • Hallucinations involve sensing things that are not actually present. Visual hallucinations cause people to see objects, people, or events that don’t exist. Auditory hallucinations make them hear voices or sounds that aren’t real. Tactile hallucinations create a physical feeling that has no actual source. Olfactory hallucinations involve smelling odors that aren’t there.
  • Delusions are firmly held false beliefs that aren’t based in reality and continue to persist despite contradictory evidence. For example, people with psychosis often believe they have special powers, are being persecuted, or that outside forces are controlling their thoughts.
  • Disorganized thoughts/speech may be described as nonsensical, tangential, or “derailed” from the topic. When your loved one is experiencing a psychotic episode, their words and ideas may be completely incoherent or seem to skip randomly between unrelated points. It can be next to impossible to have a conversation—even if you used to talk for hours about what was going on in your lives.
  • Disorganized behavior may be described as acting in ways that seem bizarre or unpredictable and lack an apparent purpose or motivation. For example, dressing inappropriately, laughing or crying randomly, neglecting personal hygiene, pacing or rocking, hoarding objects, or engaging in unusual repetitive behaviors are some common examples of disorganized behavior patterns seen in people who are in the middle of psychotic episodes. 

People who are experiencing psychosis are not inherently dangerous. In fact, most people with psychosis are not violent and are more likely to hurt themselves than others. However, a co-occurring substance use disorder and delusions that involve feelings of persecution or commands to act aggressively can increase the risk of violent behavior. 

If you believe your loved one poses a danger to themselves or others, do not try to argue or reason with them. Do not make direct eye contact or make sudden movements that could be interpreted as threatening. Call 911, provide them with information on your loved one’s mental health history, and wait for first responders to arrive. 

What Mental Illnesses Are Associated With Psychosis?

Psychosis is not a mental illness. It is a symptom that is associated with serious mental health disorders. This includes:

    • Schizophrenia, the disorder most commonly associated with psychosis. Psychotic symptoms like delusions, hallucinations, and disordered thinking are present for at least six months and must include at least one month of active symptoms in schizophrenia.
    • Schizoaffective disorder, which involves symptoms of schizophrenia along with symptoms of a mood disorder like major depressive disorder or bipolar disorder.
    • Bipolar disorder, characterized by manic episodes, during which some people experience psychotic symptoms like grandiose delusions or auditory hallucinations. Psychosis can also occur during depressive episodes of bipolar disorder, but this is less common.
    • Major depressive disorder with psychotic features, a subtype of major depression in which the person experiences delusions, hallucinations, or psychotic symptoms as well as a severely depressed mood and other depression symptoms.
    • Brief psychotic disorder, a condition that involves at least one psychotic episode lasting between one day and one month, which is often in response to extremely stressful life circumstances.
    • Substance-induced psychotic disorder, which is associated with amphetamines, LSD, PCP, or excessive alcohol use. Symptoms generally resolve when the drug is cleared from the person’s system. 

How Is Psychosis Typically Treated?

Psychosis is typically treated with a combination of medication and psychotherapy. The main treatment approaches include:

  • Antipsychotic medications such as haloperidol, chlorpromazine, or perphenazine, which may be prescribed to block dopamine receptors in the brain to reduce hallucinations, delusions, and disorganized thoughts.
  • Psychotherapy, which helps patients normalize thought patterns, improve functioning, and develop coping strategies. Cognitive behavioral therapy (CBT) teaches how to question delusional thoughts, while family therapy educates loved ones about the person’s specific diagnosis and how to best provide support. 
  • Self-care practices that promote a healthy lifestyle, social interaction, and avoiding drugs/alcohol to help reduce the risk of relapse and improve overall well-being. 

Inpatient hospitalization is needed during acute psychotic episodes, but most people will require long-term antipsychotic medication and ongoing monitoring to prevent a relapse of symptoms. Early diagnosis and adherence to a comprehensive treatment plan leads to the best long-term prognosis. 

If you’d like to learn more about the treatment options offered at Raleigh Oaks Behavioral Health in Garner, North Carolina, contact us today.

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