The word psychosis is loaded with decades of baggage that has a negative impact on how people understand mental health disorders with symptoms related to psychosis: if we want to move past this current state of affairs, it’s important for people to understand the basic facts about psychosis and mental health disorders that have psychotic features.
To that end, we’ll share five important facts about psychosis we adapted from this article published by the University of Michigan (U of M). The U of M is an important institution in mental health treatment in the U.S. Not only does U of M publish the National Survey on Drug Use and Health (NSDUH), but they also provide a wide variety of resources for patients and families with mental health and/or behavioral disorders.
We’ll frame the information by offering a definition of psychosis published by the American Psychological Association (APA):
“Psychosis is a generic term that refers to distortions and impairments of thought, feeling, and behavior leading to a loss of contact with consensual reality. It is signified by delusions, hallucinations, thought disorder, and disorganized/atypical motor behavior.”
To learn more about psychosis, and the signs that may precede mental health disorders with psychosis, please read the following article on our blog:
What are Some Early Signs of Psychosis?
That article offers a solid overview of psychosis. Have a look at that to get a good understanding of the topic, then come back and read this next section.
Five Facts About Psychosis: How We Can Expand Our Understanding
Fact #1: Symptoms Vary By Individual
Symptoms of psychosis may appear as:
- Hearing voices
- Feeling like someone wants to harm you
- Seeing things that aren’t there
- Thinking other people or entities can access your thoughts
- Thinking other people can insert, remove, or control your thoughts
In addition, people who experience these symptoms can become detached from reality over time. In some cases, this causes confusion and disorientation. When a person with these symptoms goes untreated for an extended period, they can lose their ability to determine what’s real and what isn’t.
Fact #2: Early Onset Psychosis is Real
Patients under age 17 cannot be diagnosed with psychosis, but they can receive a diagnosis for early onset/prodromal psychosis. Therefore, the overall age of onset is relatively broad: initial symptoms can appear anytime between age 14 and age 30.
Fact #3: Symptoms of Psychosis Can Overlap With Other Mental Health Disorders
Delusions and hallucinations happen in other mental health disorders, too. Delusions are beliefs/ideas/thoughts that are objectively false, while hallucinations are objects/individuals/things people see that aren’t there.
Disorders that may involve delusions and/or hallucinations:
- Major depressive disorder (MDD)
- Bipolar disorder I & II
- Schizophrenia
- Schizoaffective disorder
- Borderline personality disorder
- Post-traumatic stress disorder
Disorders or medical conditions that may involve delusions and/or hallucinations:
- Alzheimer’s disease
- Parkinson’s disease
- Age-related dementia
- Autism spectrum disorder (uncommon)
Fact #4: The Connection to Violence is Overstated
The idea that people with psychosis are violent by default is false. Studies show people with mental health disorders are more likely to be victims of violence than perpetrators of violence. It’s important to reiterate this fact, and share it with friends: this stereotype accounts for a large proportion of the stigma associated with psychosis.
With that said, people with psychotic disorders can experience extreme mood swings, display intense emotions, and engage in unpredictable behavior. In some cases, this emotional volatility leads to violent behavior. These impulsive acts occur most often at home, rather than in public spaces.
Fact #5: Treatment Improves Symptoms
The consensus among mental health experts (APA) is that an approach called Coordinated Specialty Care (CSC) is effective for patients with psychosis. CSC is a multifaceted treatment modality with following components:
- Case management. Case managers are caretakers of the overall treatment journey, and ensure continuity of care and equitable access to all forms of support.
- Family participation. Families that participate in treatment learn about psychosis understand how to support loved ones in treatment, which improves outcomes.
- Peer engagement. Peers can make a big difference: when a person understands they’re not alone, they can develop belief in the treatment process and find hope for the future.
- Lifestyle changes/education: Changing daily habits can create a healthy foundation for healing and growth. Learning about nutrition, stress management, appropriate levels of exercise/activity, and good sleep habits helps people with psychosis create a daily schedule that promotes long-term, positive outcomes.
- Evidence shows that cognitive behavioral therapy for psychosis (CBTp) is the most effective talk-therapy for psychosis.
- The most common medication for psychosis include typical and atypical antipsychotics
Applying New Knowledge About Psychosis
What we want people reading this article to learn and apply to daily life is this: psychosis is a treatable mental health disorder that can improve significantly over time. When patients receive an accurate diagnosis and engage in treatment, they can learn to manage their symptoms and live a full, productive life.
There’s one last thing we need to share about psychosis. People with psychosis and psychotic disorders have an elevated risk of self-harm and suicide. According to Dr. Ivor Tso of the University of Michigan:
“We know that there are very high rates of suicide in people with psychosis, compared with the general population. Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things.”
We saved this item for last, since it also involves an essential piece of advice. We recommend families collaborate with treatment providers and their loved one to create a good safety plan in case of emergency. A good safety plan includes:
- Cards with contact info for therapists/providers
- Location of emergency psychiatric services
- List of names and contact info for safe, supportive friends who know how to help
- Removal of lethal means of self-harm or suicide in the home
Finally, any safety plan should feature the National Suicide Prevention Line at 988. Families and patients can call 988 any day of the year, at any time of day or night, and connect to a real human, trained in crisis management, who knows how to help.
Gianna Melendez
Jodie Dahl, CpHT