What is psychosis?
Psychosis is a generic psychiatric term used to describe a mental state where there has been some loss of contact with reality.
Psychosis is most likely to occur in young adults and is quite a common problem, affecting around 3% of the younger adult population. Most people who have a ‘psychotic episode’ go on to make a full recovery and lead a normal life.
It is important to know that psychosis can happen to anyone and with treatment a full recovery can be achieved.
Psychosis is often characterised by some or all of the following:
- confused thinking – sentences are not understandable, abnormal ideas, difficulty concentrating
- false beliefs – delusional ideas, difficult to persuade that these are not real, content is changeable
- hallucinations – see, hear, smell, taste or feel something that is not actually there. Content may change
- changed feelings and/or behaviour – mood may be different for no apparent reason, behaviours may change, becoming overactive or lethargic for example, or suffer from an inability to sleep
Symptoms vary in individuals and can change over time.
Psychotic episodes usually occur in three stages:
Prodrome
The prodrome is the initial stage of psychosis. Early symptoms may be vague and not distinguishable from your normal behaviour. Changes may be slow and you, and people who know you, may not notice these changes straight away.
Over time these changes will become more pronounced. You may describe your thoughts and feelings becoming different or you may feel that these feelings or thoughts become more problematic for you.
Some common problems encountered during the prodrome are:
- mood swings
- confusion, irritability, anxiety or feeling depressed
- loss of concentration
- struggling to cope with work or study
- reckless or disinhibited behaviour
- preferring to spend time alone or becoming withdrawn
- loss of interest in activities
- perceiving or interpreting things oddly
Many of these issues, if taken in isolation, are normal human behaviours. However, when a person’s behaviour begins to change, and more of these problems are noticeable, or become problematic you should seek help from your GP. Talking therapy and learning to manage stress levels may prevent the development of a psychosis episode.
Acute Phase
The acute phase is marked by the onset of clear psychotic symptoms. Psychosis is a condition that affects the mind, resulting in a loss of contact with reality. This can lead to changes in mood, behaviour, and beliefs you may hold. If you are experiencing psychosis, your perceptions, thoughts, feelings, and behaviour may be dramatically different from your usual experience or from those around you, sometimes for no apparent reason.
If you become unwell in this way it is called a psychotic episode. This can be frightening and upsetting for both you and those close to you.
Nobody’s experience of psychosis is the same and psychotic features will vary from person to person and will often change over time.
Some common symptoms of psychosis
Hallucinations
You may hear, see, smell, feel or taste things that may not actually be there. Examples include hearing voices or seeing shapes or object that others cannot. You may believe your senses are playing tricks on you.
Sensory sensitivity
You may find that you become more sensitive to light and colours or find that sounds are louder or quieter than normal.
Confused thinking
Your everyday thoughts may not join up correctly or may be confused or jumbled. Concentration and memory can also be affected.
False or delusional beliefs
You may have strange ideas or beliefs that you didn’t have before. Sometimes you may become preoccupied or convinced of these beliefs, no matter how good or logical the counterargument is. Examples of delusions include the belief that people are watching you or are going to harm you, feeling that people can read your mind, or believing you have special powers.
Ideas of reference
You may begin to read more into normal occurrences or attach special meaning to seemingly innocuous or random things.
Abnormal speech
You may find it difficult to communicate or others find you hard to understand. Your speech may not flow smoothly and may seem disjointed. Sometimes, you may invent new words.
Changes in behaviour
If you have psychosis, you may begin to act or behave differently to the way you normally would do. You may become extremely active or lethargic, or withdrawn or less inhibited. Often these changes correspond to specific symptoms; for instance, responding to hallucinations or beliefs by talking back to voices or avoiding food if you believe you are being poisoned.
All of these changes make it difficult for you to distinguish between what is real and is not real. This can be very distressing for all concerned.
Recovery
Psychosis can be treated, and most people recover. With the right help it’s likely you will never experience more than one psychotic episode. Therefore, it is vitally important to seek help at the earliest stage possible, often with the support of family or friends.
If the correct interventions are provided early enough, it is possible to prevent someone experiencing prodromal symptoms from going on to develop a full psychotic experience. Even if a psychotic episode does occur there are many proven ways of aiding and helping recovery and preventing further episodes.
The path to recovery
The course of recovery is different in every person; some may recover quickly with little intervention while others may require more long-term support. It is important for both the person experiencing a psychotic episode and those supporting them that they are actively involved in the treatment process and receive as much information as possible both about psychosis and the recovery process.
Recovery from a first episode can take a number of months or years, if symptoms return this may mean a longer recovery path next time.
The causes of psychosis
The current thinking is that we all develop a level of vulnerability throughout early life. A combination of biological, environmental and social factors shape this vulnerability, and each factor will have a different amount of influence in each individual. The vulnerability determines how much stress you can cope with. Once the stress levels in your life breach that safe level, the symptoms described above may be triggered, and you may have a psychotic episode.
Research into the cause of psychosis is ongoing and as a result understanding of these problems changes continually.