What is psychosis?

Psychosis is a mental health condition that occurs when someone loses touch with reality. This can happen when a person becomes delusional or has false beliefs about what’s happening, or the person may suffer hallucinations and see or hear things that aren’t there.

What are the different kinds of psychotic disorders?

According to Mental Health America, the most common types of psychotic disorders include:

  • Schizophrenia is a serious mental health disorder that affects how a person thinks, feels and acts. People with schizophrenia may have trouble distinguishing what is real and what is imaginary.
  • Schizophreniform Disorder consists of the same symptoms of schizophrenia but occurs for a time period of at least one month but no more than six months. If symptoms last longer than this period, a person is given a diagnosis of schizophrenia. 
  • Schizoaffective Disorder is characterized by persistent symptoms of psychosis resembling schizophrenia with additional periodic symptoms of mood (or affective) disorders.  
  • Delusional Disorder is characterized by irrational or intense belief(s) or suspicion(s) which a person believes to be true. These beliefs may seem outlandish and impossible (bizarre) or fit within the realm of what is possible (non-bizarre). Symptoms must last for 1 month or longer in order for someone to be diagnosed with delusional disorder.
  • Brief Psychotic Disorder includes symptoms of psychosis that last at least 1 day but no longer than 1 month. Symptoms are typically sudden and are sometimes responses to a stressful life event. While an individual may experience severe distress during the episode, people quickly return to their daily lives and their symptoms do not return.
  • Schizotypal Disorder is a personality disorder that can easily be confused with schizophrenia due to the nature of people with schizotypal personality disorder to have “magical” or eccentric beliefs, unusual thoughts and paranoia. People with schizotypal personality disorder may experience brief psychotic episodes with delusions or hallucinations, but the episodes are not as frequent, prolonged or intense as in schizophrenia. 

What are the symptoms of psychosis?

Someone with psychosis may exhibit any of the following signs:

  • Difficulty concentrating
  • Disorganized thought and speech
  • Delusions, especially unfounded fear or suspicion
  • Hearing, seeing or feeling things that aren’t there
  • Thinking in a disordered way with thoughts that jump between unrelated topics
  • Withdrawal from family and friends
  • Depression, anxiety, suicidal thoughts or actions     

What are the risk factors for psychosis? 

According to National Alliance on Mental Illness, there are several factors that can contribute to psychosis: 

  • Genetics. Many genes can contribute to the development of psychosis, but just because a person has a gene doesn’t mean they will experience psychosis. Ongoing studies will help us better understand which genes play a role in psychosis.
  • Trauma. A traumatic event such as a death, war or sexual assault can trigger a psychotic episode. The type of trauma—and a person’s age—affects whether a traumatic event will result in psychosis.
  • Substance use. The use of marijuana, LSD, amphetamines and other substances can increase the risk of psychosis in people who are already vulnerable.
  • Physical illness or injury. Traumatic brain injuries, brain tumors, strokes, HIV and some brain diseases such as Parkinson’s, Alzheimer’s and dementia can sometimes cause psychosis.
  • Mental health conditions. Sometimes psychosis is a symptom of a condition like schizophrenia, schizoaffective disorder, bipolar disorder or depression.

How is psychosis diagnosed?

Doctors diagnose psychosis with a psychiatric evaluation that entails checking someone’s behavior and asking questions about what they’re experiencing. In addition, doctors may use blood tests, X-rays and drug screening or have an individual undergo an MRI to help pinpoint a diagnosis and determine whether there is an underlying illness causing symptoms of psychosis.

How is psychosis treated?

In general, doctors treat psychosis with a combination of medications and therapy. Antipsychotic drugs can reduce the incidences of delusions and hallucinations suffered by people with psychosis. These meds help individuals to think more clearly, but the type of drugs used depend on the symptoms someone is experiencing.

In addition, when people go through a psychotic episode that causes them to become agitated, doctors use a fast-acting shot or liquid medicine to quickly relax them. This method of treatment is called rapid tranquilization.

Besides drug therapy, physicians use cognitive behavioral therapy (CBT) to treat people with psychosis. This method of treatment has patients meeting regularly with a mental health counselor to talk. The goal of cognitive behavioral therapy is to change patients’ thinking and behavior so they can more effectively manage their illness.

Last Reviewed: February 28, 2019