Psychosis, a debilitating mental and emotional state, is a key feature of a group of mental health conditions known collectively as psychotic disorders.

Understanding Psychosis

Learn about psychosis

Symptoms of these conditions are severe and alter a person’s ability to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately.

Individuals experiencing psychosis have challenges staying in touch with reality and are usually unable to meet the demands of activities of daily living. A psychotic state, or psychosis, is a set of experiences that can be described as the loss of contact with reality, but not in a way that is a part of a person’s religious or cultural beliefs and traditions.

Psychosis, while not a specific illness, is a very important indicator of the presence of a psychotic disorder that will require professional intervention and residential treatment. This experience can take many forms, and the severity of the symptoms will vary for each affected individual.

Statistics

Psychosis statistics

The percentage of people who experience psychosis at any one time varies tremendously across countries and cultures, ranging from 0.66% in Vietnam to 45.84% in Nepal. But in sum, about 1% of the world’s population suffers from psychotic disorders, reportedly affecting men and women equally. Generally, people who have psychotic disorders experience their first episode between the ages of 18 and 24. While it is quite rare, some adolescents can display early symptoms of psychosis, which usually indicates that a psychotic disorder will develop later in life.

Causes and Risk Factors

Causes and risk factors for psychosis

With the exception of medical or substance-induced psychosis, the specific cause for a psychotic disorder remains unknown. Most researchers agree that a combination of genetics, physiological characteristics, and environmental causes likely work together to cause the onset of a psychotic disorder. Some of the most common causes for psychotic disorders and accompanying psychosis may include:

Genetic: While a specific gene has yet to be isolated, it is well-accepted that most psychotic disorders have a hereditary component. People who have a parent or sibling with a psychotic disorder or related mental illness are at increased risk for developing psychotic disorders. Additionally, imaging studies performed on the brains of those who have psychotic disorders indicate that there are subtle differences in the structure and function of the brain of those who are suffering from this type of mental illness.

Environmental: Psychotic episodes are often brought about by a life stressor so great that it causes a person to enter psychosis. This response may be as the result of triggering a chronic but dormant problem like physical or sexual abuse.

Risk Factors:

Tobacco, marijuana, alcohol and other substance abuse
Prenatal exposure to infectious agents
Exposure to environmental toxins
Having certain mental health conditions such as bipolar disorder, schizophrenia, or depression
Social isolation
Poverty
Lack of support system

Signs and Symptoms

Signs and symptoms of psychosis

When a person is struggling with psychosis, his or her emotions, behavior, and inner thoughts will change tremendously. The precise symptoms of psychotic disorders will vary from person to person, but based upon genetic makeup, life experiences, and the underlying cause for the disorder. The experience of psychosis may include:

Behavioral Symptoms:

Decreased ability to maintain a normal routine
Worrisome drop in job performance or academic grades
Frequent absences from work or school
Increasing amount of time spent alone
Catatonia – rigid, unresponsive behavior while awake
Decline in ability to care for self
Blunt affect
Self-harm
Suicidal thoughts and behaviors
Violent behaviors
No longer participating in activities that were once enjoyed

Physical Symptoms:

Loss of appetite
Notably disheveled appearance
Increased sensitivity to sounds or sights
Changes in sleep schedule – sleeping more or less than normal

Cognitive Symptoms:

Feeling of being controlled by outside forces
Paranoid thinking
Preoccupation
Delusions
Hallucinations
Unusual or very intense new ideas
Trouble remembering simple tasks
Depersonalization – intense feelings of being outside of oneself
Disorganized thinking
Neologisms – making up new words without a meaning
Sudden inability to concentrate

Psychosocial Symptoms:

Anxiety
Depression
Agitation
Anhedonia – inability to feel pleasure
Mistaking noises for voices
Loss of interest in peers
Social withdrawal
Not trusting others / suspiciousness
Trouble relating to the environment

Effects

Effects of psychosis

The long-term effects of psychosis will vary tremendously based upon an individual’s makeup, the underlying cause of the psychotic episode, and the severity of the symptoms experienced. However, because they can endanger the affected individual and others, all bouts of psychosis should be treated as medical emergencies. When left untreated, psychotic episodes may result in the following:

Declined ability to care for oneself
Developing an addiction to drugs and/or alcohol
Homelessness
Joblessness
Interaction with the legal system
Loss of important relationships
Physically harming someone else
Engaging in self-harming behaviors and suffering the consequences of those behaviors
Chronic suicidal ideation
Making repeated attempts at committing suicide

Co-Occurring Disorders