What is psychosis?

When people think about or hear the term “mental illness,” many think of what is referred to as psychosis.

That’s not an accurate understanding of mental illness.

Just like physical health is a continuum spanning from good health, to a slight cold, to the flu, to a serious illness, to life-threatening disease, etc., mental health is also a continuum. That continuum stretches from good mental health, to stress, to anxiety, to depression, to serious mental illness such as bipolar disorder or schizophrenia, etc. It’s on the more serious end of the mental health spectrum that we would place what is called “psychosis.”

WHAT IS PSYCHOSIS?
Psychosis is a condition that affects the way your brain processes information. Psychosis is a symptom, not an illness, and is more common than you might think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as 3 in 100 people will have an episode at some point in their lives. It can be triggered by a mental illness, a physical injury or illness, substance abuse, or extreme stress or trauma (genetics is an additional risk factor).

The National Institute of Mental Health offers a concise definition of psychosis:

The word psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. When someone becomes ill in this way it is called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficulty understanding what is real and what is not. Symptoms of psychosis include delusions (false beliefs) and hallucinations (seeing or hearing things that others do not see or hear). Other symptoms include incoherent or nonsense speech, and behavior that is inappropriate for the situation. A person in a psychotic episode may also experience depression, anxiety, sleep problems, social withdrawal, lack of motivation, and difficulty functioning overall.

Early or first-episode psychosis (FEP) refers to when a person first shows signs of beginning to lose contact with reality. The National Alliance on Mental Health (NAMI) emphasizes that acting quickly to connect a person with the right treatment during early psychosis or FEP can be life-changing and radically alter that person’s future.

SYMPTOMS OF PSYCHOSIS
Psychosis doesn’t start suddenly. It usually follows a pattern like this:

Warning signs before psychosis – It starts with gradual changes in the way you think about and understand the world. You or your family members may notice:

• • A drop in grades or job performance.
  • Trouble thinking clearly or concentrating.
  • Suspiciousness or unease around others.
  • Lack of self-care or hygiene.
  • Spending more time alone than usual.
  • Stronger emotions than situations call for.
  • Strong, inappropriate emotions, or no emotions at all.

Signs of early psychosis – You may:

• • Hear, see, or taste things others don’t.
  • Hang on to unusual beliefs or thoughts, no matter what others say.
  • Pull away from family and friends.
  • Stop taking care of yourself.
  • Not be able to think clearly or pay attention.

Symptoms of a psychotic episode – Usually you will notice all of the above, plus:
Hallucinations:

• • Auditory hallucinations – Hearing voices when no one is around.
  • Tactile hallucinations – Strange sensations or feelings you can’t explain.
  • Visual hallucinations – Seeing people or things that aren’t there, or you think the shape of things looks wrong.

Delusions – Beliefs that aren’t in line with your culture and that don’t make sense to others, like:

• • Outside forces are in control of your feelings and actions.
  • Small events or comments have huge meaning.
  • You have special powers, are on a special mission, or actually are a god.

TREATMENT
Early treatment of psychosis, especially during the first episode, leads to the best outcomes. NAMI reports:

• Research has shown significant success using a treatment approach called Coordinated Specialty Care (CSC). CSC uses a team of health professionals and specialists who work with a person to create a personal treatment plan based on life goals while involving family members as much as possible.

CSC has the following key components:
– Case management.
– Family support and education.
– Psychotherapy.
– Medication management.
– Supported education and employment.
– Peer support.

Traditional treatment for psychosis includes medication and psychotherapy. Medication targets symptoms and helps reduce their impact; different types of therapy have been successful in helping individuals learn to manage their condition.

Scotty