The word psychosis is used to describe when someone has unusual or strange experiences which may cause distress. Someone with psychosis may have difficulty recognising what is real and what is not. Psychosis is a relatively common mental health difficulty which affects approximately 3 out of every 100 people. It can happen at any stage in a person’s life but most people develop psychosis as a teenager or young adult. Psychosis affects significantly more males than females but women tend to develop psychosis at a later stage than men. There are times in a woman’s life that they are at increased risk of psychosis such as childbirth. It is important to know that there are effective treatments for psychosis and that early intervention improves recovery outcomes for the individual.
The experience of psychosis affects people in different ways and symptoms can occur at varying degrees of severity and intensity. The symptoms of psychosis can interfere with many aspects of a person’s life, especially their work and social life. These experiences have been described as ‘dreaming when you are wide awake’. Other symptoms can cause problems with motivation, concentration and experiencing enjoyment; symptoms can appear suddenly or gradually and can vary in intensity and severity over time. Not everyone who experiences psychosis will experience all the symptoms outlined below. Common symptoms include;
Hallucinations: This means that a person can hear, see, feel or touch something that is not there. Hearing voices is the most common form of hallucination.
Unusual beliefs (delusions): This is when an individual holds a strong belief which there is no evidence to confirm. Some examples of this are people believing others want to hurt them, when they don’t, or believing they have special talents or wealth or powers. Another common delusion is believing that others can control their thoughts or actions, or the belief that others are referring to them through the of TV/ radio or television.
Thought disorder: This symptom makes it difficult to stay on topic or talk in an organised way that others can understand.
Cognitive difficulties: This means that a person may have difficulties with paying attention, remembering or understanding concepts.
Changed behaviour: This means that the person may have difficulties performing usual activities such as school work, paid work or hobbies. They may spend less time socialising with people. Sometimes the person may behave in an unusual manner, for example, if a person is hearing voices they may seem to be talking to people who aren’t there.
Negative symptoms: Negative symptoms include a lack of energy, motivation, loss of pleasure and loss of emotional expressiveness. Negative symptoms lead to people having problems or initiating or following through with plans, being interested or enjoying things like they used to, or expressing their emotions to others with facial expression. These symptoms may be accompanied with a feeling of sadness but often they are not.
Several mental health difficulties can have psychosis as a symptom:
Schizophrenia: A person has some psychotic symptoms for at least six months, with a significant decline in the person’s ability to function.
Schizophreniform disorder: A person has psychotic symptoms for less than six months.
Bi-polar disorder with psychotic symptoms: with this type of mental health difficulty, the symptoms relate more to mood disturbance than to thought disturbance.
Schizo-affective disorder: A person will have symptoms of psychosis and symptoms of mood disturbance, either at the same time or altering over time.
Depression with psychotic features: A person has severe depression with symptoms of psychosis.
Drug induced psychosis: The use of drugs such as cannabis, cocaine, LSD, alcohol can sometimes trigger symptoms of psychosis.
Organic psychosis: symptoms of psychosis can appear as a result of some physical illness such as parkinsons’s disease or head injury.
Brief psychotic disorder: The mental health difficulty usually lasts less than a month and is triggered by a major stress or trauma such as bereavement.
Delusional disorder: This type of psychosis consists of very strong beliefs about things which there is no evidence to support.
Schizophrenia and other psychotic disorders can be successfully managed. Different treatment settings (inpatient at psychiatric hospital, day programme, outpatient, private/public psychological therapies, support groups) and treatment plans may be effective for different people depending on the type of disorder, age, severity of symptoms, underlying causes and support networks available to the individual.
At St Patrick’s Mental Health Services, our Psychosis Recovery Service provides care in an outpatient, day patient or inpatient setting according to the needs of the individual.
See also Early Detection of Psychosis at Dean Clinic Sandyford.
Coping with schizophrenia – Steven Jones/Peter Hayward
Schizophrenia – The Facts – Ming T Tsuang/Stephen V Farone
Overcoming Paranoid and Suspicious Thoughts – D Freeman/J Freeman/P Garety
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