Psychosis

Psychosis is a broad term, and its symptoms can be present in many common disorders such as depression, anxiety and bipolar disorder. However, more commonly psychosis is present in:

  • Schizophrenia Disorder

  • Schizoaffective Disorder

  • Delusional Disorder

  • Mood Disorder with Psychotic Features

Regardless of its presentation, it needs rapid treatment to prevent harm to the individual and potential hospitalization. Below are listed some common symptoms of psychosis which may need immediate attention and intervention from a mental health professional.

  • Hallucinations (auditory, visual, tactile, sensory, etc.)

  • Delusions (paranoid, persecutory, grandiose, etc.)

  • Odd behavior including repetitiveness and purposelessness with no clear goal or motivation

  • Difficulty maintaining a clear and coherent thought

  • Speech that is disorganized and difficult to understand with potentially made-up words, repetition of words or complete nonsense “word salad”

Sometimes, before these symptoms even start, prodromal negative symptoms might be present first. These include a blunted affect, ambivalence, alogia (absence or reduced quantity of speech), absence of pleasure or emotion and asociality. Many of these symptoms are often easily recognized, but they are typically noticed by a friend or family member rather than by the individual experiencing them. If you are a family member and notice someone you are close to with any of these symptoms, consider having them speak to a mental health professional for a formal assessment.

Psychosis ≠ Schizophrenia

The sudden development of psychotic features such as hallucinations or delusions doesn’t necessarily mean someone has schizophrenia. These symptoms can commonly present in other disorders such as:

  • Bipolar Disorder

  • Severe Depression

  • Postpartum Depression

  • Substance Use (alcohol, cannabis, methamphetamine and others)

  • Medical: Stroke, tumors, infections

  • Trauma/stress

A comprehensive evaluation is needed to formally assess the presence of primary psychosis or a symptom of an underlying cause. This is vital, since the treatment modalities can come with harsh medication side effects.

Treatment

Treatment is based on the severity of symptoms and the underlying cause of the psychosis. This is determined through a comprehensive history, detailed assessment, and careful review of the timeline of symptoms and any potential triggers.

First-line treatment for psychotic disorders typically involves antipsychotic medications, also known as dopamine blockers. These medications work by reducing dopamine activity in the brain and are considered highly effective in managing psychotic symptoms.

While the exact cause of psychotic disorders remains unclear, current research suggests a combination of genetic vulnerability, brain chemistry differences, and environmental stressors. Despite the unknown cause, substantial evidence supports the effectiveness of antipsychotic medications in reducing and stabilizing psychotic symptoms.

With the guidance of a professional, treatment options will be carefully discussed to find the best fit for each individual—aiming to minimize side effects, reduce the risk of relapse, and support long-term stability and an improved quality of life.