What Is Psychosis?

What is Psychosis? What are the symptoms? And who gets it?

This is a big topic, with lots to discuss but, for now, here is a brief overview. Psychosis is often characterized as “a break with reality” or “ a mismatch in realities”, meaning there's a difference in the reality of the individual experiencing psychosis and the general public's understanding of what's going on around them. Symptoms of psychosis can be divided into two categories, positive and negative.

Positive Symptoms

I'm going to explain positive symptoms first because this is often what people notice first. Positive symptoms don't mean good but rather in addition to a "normal" state of functioning and they are actually a category of symptoms. Things that fall under this category include hallucinations, delusions, and disorganization of both speech and behavior. And, like I mentioned before, these are the symptoms that lead families or individuals to present to professionals first because they are the most obvious.

Negative Symptoms

Negative symptoms can be pretty tricky to spot because they often present similarly to, or can be confused with, depression, laziness, and / or apathy. They can also create a significant amount of frustration with families of individuals who experience psychosis because they don't understand what's actually going on or how to best help the individual.

Negative symptoms are most often seen in schizophrenia and, like positive symptoms, they are a group of various presentations and they can include things like diminished emotional expression, avolition (a lack of motivation), anhedonia (the inability to feel pleasure), asociality (a decline or incapability of engaging in social interaction), and alogia (poverty of speech).

Does Psychosis Mean Schizophrenia??

Psychosis can be present in numerous diagnoses, both medical and psychiatric, which is why seeking professional help during the initial stages of an illness, is so important. That being said, the range diagnoses that can have symptoms of psychosis is vast and includes things like depression, bipolar disorder, schizoaffective disorder, brief psychotic disorder, schizophrenia, PTSD, autism spectrum disorder, types of seizure disorders, personality disorders, neurodegenerative disorders and acute substance intoxication, just to name a few.

I think it is important to mention, because I don't often see it in informational posts, that each variation of psychosis found above, have a different "flavor". This means that a depression with psychotic features, presents somewhat differently than psychosis in schizophrenia or substance intoxication. These differences can be subtle but also can be pretty obvious, think depression VS mania, and help us reach a better understanding of what a diagnosis might be.

Another thing that I often hear individuals and their families express frustration about is their confusion on the diagnosis or the time it took to receive a diagnosis. Sometimes I think this is absolutely warranted, not all professionals are comfortable or understand psychosis and this can lead to a delay in diagnosis or a misdiagnosis. That being said, psychiatry is not like medical diagnoses, we don't have labs or tests we can run to get a clear answer, presentations can change over time and it is often hard to say for certain at the beginning of someone's illness, what exactly is going on. This is in part because some diagnoses require time to formally be given - for example, a schizophrenia diagnosis requires 6 or months of symptoms to given, so it is likely a diagnosis of brief psychotic disorder or schizophreniform would be given prior to that. Symptoms can also change and grow in intensity/severity over time, which can lead to them being missed or misdiagnosed initially. The process of finding the correct diagnosis is like putting a puzzle together.

Treatment for Psychosis

As you might have guessed, the treatment for psychosis can vary depending on the diagnosis; however, treatment for positive symptoms, is essentially the same for all psychiatric diagnoses, which is an antipsychotic. This is good because, even if the exact diagnosis is still unclear, individuals and their families can be confident that the treatment will still be helpful. Psychosis, both negative and positive symptoms, can also be treated with with various psychotherapy interventions. People often do best with both support from medication and therapy.

Do People with Psychosis Get Better?

Yes! People with psychosis can get better and, in some cases, can live their life without another episode. But I think this topic deserves it's own post which you can read here.

Questions? Thoughts? Leave them below!

Nothing on this blog should be taken as a replacement for medical, clinical, or professional advice or intervention. All content is for educational purposes only.