What You See and What You Don't - Psychosis

Psychosis is a mental health condition where a person perceives or interprets reality in a different way to other people.

The word psychosis is used to refer to an experience where a person 'loses touch' with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions).

There is often a misunderstanding about what it means to experience psychosis. Lots of people wrongly think that the word 'psychotic' means 'dangerous'.

Some people have positive experiences of psychosis. This can include seeing the faces, or hearing the voices, of loved ones. This can be comforting, helping the person understand the world better or make them more creative.

However, for others, psychosis can be a difficult and frightening experience. It can adversely affect a person’s behaviour, which can be hugely disrupting to general life. It can make a person feel tired, overwhelmed, anxious, scared, threatened and confused.

It can also be distressing if other people dismiss experiences as untrue when they seem very real to someone suffering from psychosis. This can lead to frustration if other people don't understand.

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What are the causes of psychosis?

Doctors generally describe someone as ‘experiencing’ psychosis rather than giving them a specific diagnosis of the condition itself.

There are several mental health conditions through which psychosis may be experienced. These include severe depression, schizophrenia, bipolar disorder (BPD), schizoaffective disorder and paranoid personality disorder.

The onset of psychosis may also be triggered by a number of factors such as a traumatic experience, stress, drug misuse, alcohol misuse and the side effects of prescribed medicine.

In certain circumstances a person may experience psychosis on its own. This is  usually determined by experiencing it for less than a month and there being no other diagnosis that describes the symptoms better. In this instance, a doctor may diagnose a person with 'brief psychotic disorder'.

What are the symptoms types of psychosis?

The two main symptoms of psychosis are:

  • Hallucinations: where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices.
  • Delusions: where a person has strong beliefs that are not shared by others; a common delusion is someone believing there's a conspiracy to harm them.

The combination of hallucinations and delusional thinking can cause severe distress and a change in behaviour. Experiencing the symptoms of psychosis is often referred to as having a psychotic episode.

Whilst hallucinations and delusions can make your thoughts and emotions feel confused and disorganised, another specific symptom of psychosis is called disorganised thinking (sometimes 'formal thought disorder').

This is characterised by racing thoughts and flight of ideas (when thoughts move very quickly from idea to idea). Many people experience both at the same time, which can lead to speaking very quickly, stumbling over words and changing the conversation topic quickly.

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How do you treat psychosis?

Treatment for psychosis involves using a combination of anti-psychotic medicine, psychological therapies and social support.

Anti-psychotic medicines are usually recommended as the first treatment for psychosis. They work by blocking the effect of dopamine, a chemical that transmits messages in the brain.

The psychological therapies include cognitive behavioural therapy (CBT), which attempts to educate a person, making sense of their experiences and why they become distressed by them.

CBT seeks to reduce distress and allow the person to regain a sense of control, thereby helping them in general life, socially with friends and family, and more formally, in the environments of work, education or training.

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At Man Behind The Mirror, we review and discuss a wide range of topic including mental health. If you recognise these symptoms either in yourself, or a family member or friend, we encourage you to have an open conversation. You should also reach out to your GP, who is knowledgeable in these areas, and can listen, advise and support you.

 If you have any follow-up questions don't hesitate to contact us at help@manbehindthemirror.co.uk

Written by Mike Firth, GP and Medical Director

This article is for informational purposes only and is not a substitute for professional medical advice or diagnosis. Always talk to your doctor about the risks and benefits of any treatment.