Understanding Psychosis

 

The word psychosis is used to describe a mental health problem that can affect the brain, so that there is a loss of contact with reality. When someone develops a mental health problem in this way it is called a psychotic episode. According to Rethink Mental Illness charity, about 3 out of every 100 people will experience a psychotic episode, making psychosis more common than diabetes. Most people make a full recovery from the experience.

The word ‘psychotic’ relates to ‘psychosis’, which is a psychiatric term, and describes experiences, such as hearing or seeing things or holding unusual beliefs, which other people don’t experience or share. Psychotic experiences are surprisingly common, but can also lead to diagnosis such as schizophrenia, bipolar disorder, schizo-affective disorder, paranoia, several depression or puerperal psychosis (a very severe form of postnatal depression).

One sign of psychosis is that a person lacks insight into their own state of mind. Psychosis distorts the senses, making it very difficult for the ill person to tell what is real from what is not real. Someone experiencing a first-episode psychosis may not understand what is happening. Symptoms are unfamiliar and frightening, leaving the person confused and distressed. If they do not know the facts and have no real understanding about mental illness, their distress may be increased by negative myths and stereotypes.

A psychotic episode occurs in 3 phases: (1) Prodrome, (2) Acute, (3) Recovery.

1. PRODROME - refers to the early symptoms and signs of an illness that precede the characteristic manifestations of the acute, fully developed illness. It is defined as the period of time from the first change in a person until development of the first frank psychotic symptoms.

2. ACUTE - clear psychotic symptoms are experienced, such as disorganised thinking, hallucinations or delusions.

3. RECOVERY - psychosis is treatable and most people recover, however, the pattern of recovery varies from person to person.

CAUSES OF PSYCHOTIC EXPERIENCES

Almost anyone can have a brief psychotic episode. In general, psychotic experiences may be caused by:

• Physical causes, such as illness: For example through a lack of sleep or high fevers (including malaria, pneumonia, other viral infections). They can also be a result of damage to the brain or dementia, lead and mercury poisoning, or changes in blood sugar levels.
• Drug use: Alcohol, street drugs, prescription medication (including steroids) can result in a psychotic experience that may continue even if the drug has worn off.
• Changes in brain chemistry: It’s not clear though whether these changes are the cause or the effect of the psychotic experience.
• Inherited vulnerability: However, no single gene has been found to be responsible, though, and the majority of people who have these experiences have no known family history.
• Traumatic events such as abuse: Many people who have psychotic experiences have been physically, emotionally, or sexually abused, and feel a need to push their feelings and memories away, because they are so painful. Psychotic experiences may be an expression of these overwhelming feelings and forbidden thoughts, and a way of coping with trauma.

TREATMENT OF PSYCHOSIS

Treating psychosis involves education, medication, close monitoring of symptoms, stress management and creating a strong, supportive environment. These treatments all help to speed up the recovery process and promote good quality of life for both the person and the family. 

RECOVERY

Some of the most recent and hopeful news in psychosis research is emerging from studies in the field of Early Intervention. New studies challenge several long held myths in psychiatry about the inability of people with psychosis to recover. It now appears that such myths, by maintaining an overall pessimism about outcomes, may significantly reduce a persons opportunities for improvement and/or recovery. After three decades of empirical study, it is now clear that early intervention is an important part of the treatment strategy. Furthermore, the importance of family input for treatment and the benefits of supportive partnerships between clinicians and families are well established (Rethink Mental Illness Charity).